Medicare Buz

Access and Quality of Cancer Care AHA AHIP America’s Affordable Health Choices Act America’s Health Care Plans American Hospital Association cancer cancer care Catholic Health Association Employee Retirement Income and Security Act FAH Federation of American Hospitals H. R. 676 H. R. 3200 HCAN Health Care Reform Health Insurance and Mortality in U.S. House bill for health care reform HR 3962 John Geyman John P. Geyman M.D. M.D. Medicaid medical-loss ratio medical-loss ratios National Center for Policy Analysis ncpa ObamaCare Obama health care patient’s health insurance coverage Patient Protection and Affordable Care Act of 2010 PhRMA lobby PNHP PPACA SEIU single-payer bill Single Payer single payer system sustainable system of universal access The Cancer Generation: Baby Boomers Facing a Perfect Storm Under-use of necessary care uninsured United States National Health Insurance Act wellness plans White House’s Health Care Summit
Source: pnhp.org

Video: Risk Adjustment / Data Extraction and Coding Services video for Medical Ofiices

Social Security and Medicare changes for 2012

The original Medicare program has two parts: Part A (Hospital Insurance), and Part B (Medical Insurance). Only a few special cases exist where prescription drugs are covered by original Medicare, but as of January 2006, Medicare Part D provides more comprehensive drug coverage. Medicare Advantage plans, also known as Medicare Part C, are another way for beneficiaries to receive their Part A, B and D benefits. All Medicare benefits are subject to medical necessity. Part A: Hospital Insurance Part A covers inpatient hospital stays (at least overnight), including semiprivate room, food, tests, and doctor’s fees. Part A covers brief stays for convalescence in a skilled nursing facility if certain criteria are met: 1. A preceding hospital stay must be at least three days, three midnights, not counting the discharge date. 2. The nursing home stay must be for something diagnosed during the hospital stay or for the main cause of hospital stay. 3. If the patient is not receiving rehabilitation but has some other ailment that requires skilled nursing supervision then the nursing home stay would be covered. 4. The care being rendered by the nursing home must be skilled. Medicare part A does not pay for custodial, non-skilled, or long-term care activities, including activities of daily living (ADL) such as personal hygiene, cooking, cleaning, etc. The maximum length of stay that Medicare Part A will cover in a skilled nursing facility per ailment is 100 days. The first 20 days would be paid for in full by Medicare with the remaining 80 days requiring a co-payment (as of 2009, $133.50 per day). Many insurance companies have a provision for skilled nursing care in the policies they sell. If a beneficiary uses some portion of their Part A benefit and then goes at least 60 days without receiving facility-based skilled services, the 100-day clock is reset and the person qualifies for a new 100-day benefit period. Part B: Medical Insurance Part B medical insurance helps pay for some services and products not covered by Part A, generally on an outpatient basis. Part B is optional and may be deferred if the beneficiary or their spouse is still actively working. There is a lifetime penalty (10% per year) imposed for not enrolling in Part B unless actively working. Part B coverage includes physician and nursing services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation, immunosuppressive drugs for organ transplant recipients, chemotherapy, hormonal treatments such as Lupron, and other outpatient medical treatments administered in a doctor’s office. Medication administration is covered under Part B only if it is administered by the physician during an office visit. Part B also helps with durable medical equipment (DME), including canes, walkers, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use is also covered. Complex rules are used to manage the benefit, and advisories are periodically issued which describe coverage criteria. On the national level these advisories are issued by CMS, and are known as National Coverage Determinations (NCD). Local Coverage Determinations (LCD) only apply within the multi-state area managed by a specific regional Medicare Part B contractor, and Local Medical Review Policies (LMRP) were superseded by LCDs in 2003. Coverage information is also located in the CMS Internet-Only Manuals (IOM), the Code of Federal Regulations (CFR), the Social Security Act, and the Federal Register. Part C: Medicare Advantage plans With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These programs were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, “Medicare+Choice” plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as “Medicare Advantage” (MA) plans. Traditional or “fee-for-service” Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country. For people who choose to enroll in a Medicare Advantage health plan, Medicare pays the private health plan a capitated rate, or a set amount, every month for each member. Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care and gym or health club memberships. In exchange for these extra benefits, enrollees may be limited in the providers they can receive services from without paying extra. Typically, the plans have a “network” of providers that patients can use. Going outside that network may require permission or extra fees. Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower copayments for doctor visits. Medicare Advantage plans use a portion of the payments they receive from the government for each enrollee to offer supplemental benefits. Some plans limit their members’ annual out-of-pocket spending on medical care, providing insurance against catastrophic costs over $5,000, for example. Many plans offer dental coverage, vision coverage and other services not covered by Medicare Parts A or B, which makes them a good value for the health care dollar, if you want to use the provider included in the plan’s network or “panel” of providers. Because the 2003 payment formulas overpay plans by 12 percent or more compared to traditional Medicare,[11] in 2006 enrollees in Medicare Advantage Private Fee-for-Service plans were offered a net extra benefit value (the value of the additional benefits minus any additional premium) of $55.92 a month more than the traditional Medicare benefit package; enrollees in other Medicare Advantage plans were offered a net extra benefit value of $71.22 a month more.[12] However, Medicare Advantage members receive additional coverage and medical benefits not enjoyed by traditional Medicare members, and savings generated by Medicare Advantage plans may be passed on to beneficiaries to lower their overall health care costs.[10] Other important distinctions between Medicare Advantage and traditional Medicare are that Medicare Advantage health plans encourage preventive care and wellness and closely coordinate patient care.[13] Medicare Advantage Plans that also include Part D prescription drug benefits are known as a Medicare Advantage Prescription Drug plan or a MA-PD. Enrollment in Medicare Advantage plans grew from 5.4 million in 2005 to 8.2 million in 2007. Enrollment grew by an additional 800,000 during the first four months of 2008. This represents 19% of Medicare beneficiaries. A third of beneficiaries with Part D coverage are enrolled in a Medicare Advantage plan. Medicare Advantage enrollment is higher in urban areas; the enrollment rate in urban counties is twice that in rural counties (22% vs. 10%). Almost all Medicare beneficiaries have access to at least two Medicare Advantage plans; most have access to three or more. Because of the 2003 law’s overpayments, the number of organizations offering Fee-for-Service plans has increased dramatically, from 11 in 2006 to almost 50 in 2008. Eight out of ten beneficiaries (82%) now have access to six or more Private Fee-for-Service plans.[14] Each year many individuals disenroll from MA plans. A recent study noted that about 20 percent of enrollees report that “their most important reason for leaving was due to problems getting care.”[15] There is some evidence that disabled beneficiaries “are more likely to experience multiple problems in managed care.”[16] Some studies have reported that the older, poorer, and sicker persons have been less satisfied with the care they have received in MA plans.[17] On the other hand, an analysis of the Agency for Healthcare Research and Quality data published by America’s Health Insurance Plans found that Medicare Advantage enrollees spent fewer days in the hospital than Fee-for-Service enrollees, were less likely to have “potentially avoidable” admissions, and had fewer re-admissions. These comparisons adjusted for age, sex and health status using the risk score used in the Medicare Advantage risk adjustment mechanism.[18][19] In December 2009 the Kaiser Family Foundation published a report that rated Medicare Advantage organizations on a five star scale. The ratings were based on data from CMS, the Consumer Assessment of Healthcare Providers and Systems (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS) data, and the Health Outcomes Survey (HOS). New plans did not receive ratings, because data were not available. Almost six out of ten (59%) of MA plans did receive ratings, and these plans represented 85% of the enrollment for 2009. The average rating was 3.29 stars. Twenty-three percent of enrollees were in a plan with four or more stars; 20% were in a plan with fewer than three stars.[20] Twenty percent of African-American and 32 percent of Hispanic Medicare Beneficiaries were enrolled in Medicare Advantage plans in 2006. Almost half (48%) of Medicare Advantage enrollees had incomes below $20,000, including 71% of minority enrollees.[21] Others have reported that minority enrollment is not particularly above average.[22] Another study has raised questions about the quality of care received by minorities in MA plans.[23] The Government Accountability Office reported that in 2006, the plans earned profits of 6.6 percent, had overhead (sales, etc.) of 10.1 percent, and provided 83.3 percent of the revenue dollar in medical benefits. These administrative costs are far higher than traditional fee-for-service Medicare.[24] [edit] Part D: Prescription Drug plans Main articles: Medicare Part D and Medicare Part D coverage gap Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all. The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates. Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases. It should be noted again for beneficiaries who are dual-eligible (Medicare and Medicaid eligible) Medicaid may pay for drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances.
Source: medicare-health.com

Researchers: Medicare Can Improve Chronic Condition Risk Adjustments

More accurate pricing could encourage plans to offer patients with chronic health problems better care and keep them from developing expensive new health problems, rather than simply trying to attract healthier enrollees, according to Robb Cohen, chief government affairs officer at XLHealth Corp., Baltimore, a company that runs plans that serve enrollees with serious health problems.
Source: lifehealthpro.com

Risk Adjustment Doesn’t Work in Medicare Advantage

Given that the pricing formula makes the most expensive 20 percent of the Medicare population a sure source of financial loss for capitated Medicare plans, the plans have a strong incentive to find ways to keep expensive people from enrolling and to encourage them to disenroll if they are already enrolled. They also have an incentive to exploit the gray areas in coding by diagnosing patients “more aggressively.” The authors mention a variety of ways that plans can attract the healthy rather than the money-losing sick. In Germany, the heavily regulated health plans respond more quickly to inquiries from people in low-cost areas of the country. Plans can also offer benefits likely to be valued by healthy members — 57 percent of Medicare Advantage plans offered free or discounted gym memberships in 2010, while discouraging high-cost members with much higher cost sharing for serious medical conditions.
Source: ncpa.org

The Secret Sauce of Risk Adjustment: Implementation, Implementation, Implementation

1. How long does it take you to compile and refresh data?  Best in class answer: 10 days to compile a health plan or medical group’s data and 1-2 days to refresh it monthly. 2. How long should it take to generate a member suspect list?  Best in class answer: 5-10 business days 3. How long does it take you to recruit or train or allocate member evaluation providers?  Best in class answer: Within 20 days of contract execution, your assessment vendor needs to have their evaluators recruited, trained, and in the field with your members.
Source: gormanhealthgroup.com

Medicare Risk Adjustment – A Brief Input

Medicare Risk Adjustment is a term used to describe about the payment method authorized by Balanced Budget Act of 1997 & utilized by the Centers for Medicare & Medicaid Services (CMS) to make improvements in payment accuracy to Medicare Advantage Organizations.  However, to make such methodology be effectively possible, the ICD-9 coding plays the big part of the process.  ICD-9 coding determines the degree of severity of patient’s health condition through its numerical indexing of illness diagnosis, hospital procedures and other pertinent clinical data.  From such system, Medicare risk adjustment can analyze and provide the appropriate allowable funds that is to be reimbursed to physicians and amount that can be covered during hospitalization.
Source: ezinemark.com

Coders in Cincinnati, OH area

Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.
Source: aapc.com

What You Need to Know About Audit Letters from Anthem Blue Cross

The Blue Cross Prudent Buyer agreement requires physicians to comply with the request (see exhibit F to the Medicare Advantage PPO Participating Physician Agreement, Article VII, Reporting and Disclosure Requirements). The Blue Cross notice asks for certain patient records within a specified date range. Practices can, however, contact Blue Cross and request that they provide the specific dates of service in question. Additionally, the risk adjustment audits usually involve only a handful of patients per practice, but if the request is voluminous, practices may wish to contact Blue Cross and request that it send a copy service out to the practice.
Source: wordpress.com

Medicare Risk Adjustment – A Brief Input

Medicare Risk Adjustment is a term used to describe about the payment method authorized by Balanced Budget Act of 1997 & utilized by the Centers for Medicare & Medicaid Services (CMS) to make improvements in payment accuracy to Medicare Advantage Organizations.  However, to make such methodology be effectively possible, the ICD-9 coding plays the big part of the process.  ICD-9 coding determines the degree of severity of patient’s health condition through its numerical indexing of illness diagnosis, hospital procedures and other pertinent clinical data.  From such system, Medicare risk adjustment can analyze and provide the appropriate allowable funds that is to be reimbursed to physicians and amount that can be covered during hospitalization.
Source: snipsly.com

Find Job Openings, Career Employment Opportunities, Post Jobs

With sophisticated technology we are able to present in real-time almost every newly listed job that has just been posted with thousands of sites. We simply aggregate (that is where we derive our name) each new job as it is posted with all the major sites. Now you don

Choosing from the Medicare PPO list offers you lower copay for your health insurance unlike when you choose the doctors and hospitals outside the Medicare PPO network. Low Income Subsidy or LIS is available for Florida Medicare as well as providing you assistance for your prescriptions. Fl Medicare members also qualify for the Extra Help with their prescription drug plans that are worth $4,000 annually. Extra Help qualifications require you to be a member of Florida Medicare, have limited income, and you reside in the District of Columbia. Enrollment for Medicare is done annually for a period of almost three months. Enrolling and changing of plans should be done within the enrollment period provided for by Florida Medicare. Medicare health insurance covers health care expenses and services and not coinsurance, copayments, and deductibles. These are gaps within everyone’s Medicare insurance. To help you with these gaps or other costs, there is the Florida Medicare Supplements or Medigap. The policies of Florida Medicare Supplements help you cover those gaps in your Medicare health insurance by helping you to pay for some of the other health care costs that you haven’t thought of. These policies have additional benefits and services not provided for in your Medicare insurance. Private insurance companies provide for the plans that range from A to L. The policies offered are standardized which means that the benefits and services of one plan are the same in other insurance companies within the state of Florida. The only difference that you will see is in the cost because of factors like underwriting and rating methodology. Though Florida gives importance to its health care insurance, Fl Medicare rates are high. The Florida Medicare supplement plan is priced at about 60% more than the standard plan. Medicare in Florida in a more expensive because of the kind of easy lifestyle, great climate, low priced housing, and low taxes. The senior citizens are active in this state and Florida might as well be called the Senior Citizen State. So if you are currently living in Florida right now and you haven’t availed of Florida Medicare, you are missing one of the great benefits offered in Florida. Avail Florida Medicare now to enjoy the advantages of having a great health care insurance while living in a great state.
Source: ezinemark.com

Video: Miami: Medicare Fraud Summit Law Enforcement Panel

Why You May Be Waiting For Your Florida Medical License

NOT BEING COMPLETELY CANDID ABOUT YOUR HISTORY AND EDUCATION is the #1 reason for denial of an application for a full unrestricted license. Failure to disclose a problem will get you in trouble with the Board far more often than the problem itself.  Here are some other causes for delay in your application:
Source: wordpress.com

Medicare Advantage Enrollment For People New To Medicare

Becoming eligible for Medicare due to a disability does not require that you wait until you turn 65. You can join a plan during the 7 month period which begins 3 months prior to your 25th month of disability, the 25th month and 3 months after your 25th month of disability.
Source: affordablemedicareplan.com

Health Law Alphabet Soup: ACOs, MLR And Other Implementation News

Politico: Gallup: Uninsured Adults Rising None of the components of President Obama’s health care law that have taken effect appear to be affecting insurance coverage of adults over 26, according to a new poll Friday. The percentage of adults with no health insurance is the highest on record, with 17.3 percent of adults being uninsured in the third quarter of 2011, statistically tying the high set in the second quarter, Gallup found. Three years ago, in the third quarter of 2008, only 14.4 percent of adults lacked health insurance. Gallup cautions, however, that the record high coincides with a methodological change that samples cell-phone only respondents, which tend to be younger and thus more likely to be uninsured. Thus, some of the increase in the figure could be linked to this change (Mak, 11/11).
Source: kaiserhealthnews.org

Hunting For A Prescription Drug Plan Is No Game

You can complete an easy-to-use online application for Extra Help at www.socialsecurity.gov. Go to the Medicare tab on the top of the page. Then go to “Apply For Extra Help With Medicare Prescription Plan Costs.” To apply for the Extra Help by phone or have an application mailed to you, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and ask for the Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020). And if you would like more information about the Medicare Part D Prescription Drug Program itself, visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048). So this open season (October 15 to December 7), after you track down the perfect prescription drug plan for you, hunt for something that could put about $4,000 in your pocket — bag the best Medicare prescription drug plan for you and see if you qualify for the Extra Help through Social Security. 
Source: hispanicallyspeakingnews.com

Florida Auto Dealer Licensing Guidelines and Considerations

You may get a better rate working with a surety agent versus an insurance agent because they specialize in underwriting surety bonds. If you have bad credit, finding a surety agency that works with a large group of sureties may help you get approved. If you need a bond quickly, find a surety agency that has in-house authority. This means that they can approve your bond without sending it to a surety to review and approve. The Surety Group has in-house underwriting authority and works with dozens of sureties.
Source: suretygroup.com

HIT Consultant: CMS releases Medicare Shared Savings application

Medicare Shared Savings Program Application 2012 Appendix A-Electronic Funds Transfer (EFT) Authorization Agreement (CMS Form 588) Appendix B-Participant List Appendix C-Data Use Agreement (DUA) Appendix D-Application Reference Guide Refer to the Appendix D-Application Reference Guide document in the Downloads section of this page for further details on how to complete the application.
Source: blogspot.com

Financial incentive programs for electronic health records › Health Care It Scope

ARRA CCHIT CMS e-prescribing E-Prescription EHR EHR Adoption EHR Certification EHRs EHR software EHR system EHR Systems electronic health information electronic health record Electronic Health Records Electronic Health Record Software electronic medical record Electronic Medical Records electronic prescribing Electronic Prescription electronic prescriptions EMR EMRs EMR Software EMR Stimulus EMR Stimulus Package EMR system Health Health Care Healthcare healthcare IT health IT Health IT Policy HHS HITECH Hospitals meaningful use Medical Billing Medical Billing Outsource Medical Billing Services Medical Transcription Physicians Specialty EMR Stimulus SureScripts
Source: healthcareitscope.com

Hyperthyroidism And How It Affects Florida Medicare Medicaid Within The Villages

Three Approaches to Apply: • Use Cost-free, real time LIVE online Medicare Medicaid health insurance quotes and applications from several insurance carriers, like United Healthcare, Humana, Universal, Gerber (the baby food people), Preferred Care Partners, Mutual of Omaha, Coventry and more. Compare quotes in real time and then apply online from the convenience of your own residence or office. • Desktop share with phone assistance from a broker (Jeff Winters, your broker for life) to apply online. • Request a individual appointment to complete the application method, if this is more comfortable for you and your situation. We hope this post has been helpful and informative inside your search for Medicare Medicaid Florida Health Insurance plans. Personal wellness is among the very best solutions to aid you inside your total health program, together with a FL Medicare plan that fits your existing situation. Please, assessment the following steps and get started toward your Villages Medicare plan.
Source: cash-online.info

Does Hyperthyroidism Have Adverse Affects On Florida Medicare Medicaid Within The Villages

Three Methods to Apply: • Use Free of charge, real time LIVE on the net Medicare Medicaid health insurance quotes and applications from several insurance carriers, including United Healthcare, Humana, Universal, Gerber (the baby food folks), Preferred Care Partners, Mutual of Omaha, Coventry and far more. Compare quotes in real time and then apply on the net from the convenience of your own residence or office. • Desktop share with phone help from a broker (Jeff Winters, your broker for life) to apply on the net. • Request a personal appointment to complete the application procedure, if this is far more comfortable for you and your scenario. We hope this post has been helpful and informative within your search for Medicare Medicaid Florida Wellness Insurance plans. Individual wellness is one of the very best methods to aid you within your total health program, along with a FL Medicare program that fits your present scenario. Please, evaluation the following actions and get started toward your Villages Medicare plan.
Source: best-homeowners-insurance.info

Every one of the plans (A through L) offers a different set of benefits and the price varies with the amount of coverage. Basically, Plan B will cost less then Plan F since it provides much less coverage. Medigap plans that offer more benefits, such as Plan J, usually have a higher premium. Statistically, the most common medicare part F plans for people to buy are Plans C (aka medicare advantage plans) and plan F, mostly since they provide the most coverage and don’t cost much more.
Source: unicarehealthinsurancereview.com

Video: Unicare Medicare Advantage Plans – Compare to 180+ Companie

Is Coventry or UniCare Dropping Your Coverage: Know Your Rights

If you voluntarily disenroll because you decide a Medicare Advantage plan is not right for you, you may have a right to Medicare supplement coverage as long as you have not been covered by a Medicare Advantage plan before and you disenroll from the Medicare Advantage plan within 12 months of your enrollment. This right is limited to the same Medicare supplement in which you were most recently previously enrolled, excluding any outpatient prescription drug coverage. If you do not have a right to get your same Medicare supplement coverage back, you will have to complete the medical questions on an application for Medicare supplement and the insurance company can deny your application.
Source: bloghealth.net

Medicare Advantage Health Plans

There are some options available for you to opt for when you plan to enroll in Medicare health plans. Medicare health plan is the government-sponsored health insurance program that is specially offered for people of 65 years old and over. There are four options available for you to choose from. If you plan for hospitalization you should choose Part A. If you plan for doctor visits you should choose Part B. If you plan for prescription drugs you should choose Part D. If you don’t find one that suits your health care needs, you can choose alternative choice, a Medicare Advantage health plansthat is also known as Medicare Part C.
Source: healthplanscomparison.net

Unicare Health Insurance Review

The original Medicare program has two parts: Part A (Hospital Insurance), and Part B (Medical Insurance). Only a few special cases exist where prescription drugs are covered by original Medicare, but as of January 2006, Medicare Part D provides more comprehensive drug coverage. Medicare Advantage plans, also known as Medicare Part C, are another way for beneficiaries to receive their Part A, B and D benefits. All Medicare benefits are subject to medical necessity. Part A: Hospital Insurance Part A covers inpatient hospital stays (at least overnight), including semiprivate room, food, tests, and doctor’s fees. Part A covers brief stays for convalescence in a skilled nursing facility if certain criteria are met: 1. A preceding hospital stay must be at least three days, three midnights, not counting the discharge date. 2. The nursing home stay must be for something diagnosed during the hospital stay or for the main cause of hospital stay. 3. If the patient is not receiving rehabilitation but has some other ailment that requires skilled nursing supervision then the nursing home stay would be covered. 4. The care being rendered by the nursing home must be skilled. Medicare part A does not pay for custodial, non-skilled, or long-term care activities, including activities of daily living (ADL) such as personal hygiene, cooking, cleaning, etc. The maximum length of stay that Medicare Part A will cover in a skilled nursing facility per ailment is 100 days. The first 20 days would be paid for in full by Medicare with the remaining 80 days requiring a co-payment (as of 2009, $133.50 per day). Many insurance companies have a provision for skilled nursing care in the policies they sell. If a beneficiary uses some portion of their Part A benefit and then goes at least 60 days without receiving facility-based skilled services, the 100-day clock is reset and the person qualifies for a new 100-day benefit period. Part B: Medical Insurance Part B medical insurance helps pay for some services and products not covered by Part A, generally on an outpatient basis. Part B is optional and may be deferred if the beneficiary or their spouse is still actively working. There is a lifetime penalty (10% per year) imposed for not enrolling in Part B unless actively working. Part B coverage includes physician and nursing services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation, immunosuppressive drugs for organ transplant recipients, chemotherapy, hormonal treatments such as Lupron, and other outpatient medical treatments administered in a doctor’s office. Medication administration is covered under Part B only if it is administered by the physician during an office visit. Part B also helps with durable medical equipment (DME), including canes, walkers, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use is also covered. Complex rules are used to manage the benefit, and advisories are periodically issued which describe coverage criteria. On the national level these advisories are issued by CMS, and are known as National Coverage Determinations (NCD). Local Coverage Determinations (LCD) only apply within the multi-state area managed by a specific regional Medicare Part B contractor, and Local Medical Review Policies (LMRP) were superseded by LCDs in 2003. Coverage information is also located in the CMS Internet-Only Manuals (IOM), the Code of Federal Regulations (CFR), the Social Security Act, and the Federal Register. Part C: Medicare Advantage plans With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These programs were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, “Medicare+Choice” plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as “Medicare Advantage” (MA) plans. Traditional or “fee-for-service” Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country. For people who choose to enroll in a Medicare Advantage health plan, Medicare pays the private health plan a capitated rate, or a set amount, every month for each member. Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care and gym or health club memberships. In exchange for these extra benefits, enrollees may be limited in the providers they can receive services from without paying extra. Typically, the plans have a “network” of providers that patients can use. Going outside that network may require permission or extra fees. Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower copayments for doctor visits. Medicare Advantage plans use a portion of the payments they receive from the government for each enrollee to offer supplemental benefits. Some plans limit their members’ annual out-of-pocket spending on medical care, providing insurance against catastrophic costs over $5,000, for example. Many plans offer dental coverage, vision coverage and other services not covered by Medicare Parts A or B, which makes them a good value for the health care dollar, if you want to use the provider included in the plan’s network or “panel” of providers. Because the 2003 payment formulas overpay plans by 12 percent or more compared to traditional Medicare,[11] in 2006 enrollees in Medicare Advantage Private Fee-for-Service plans were offered a net extra benefit value (the value of the additional benefits minus any additional premium) of $55.92 a month more than the traditional Medicare benefit package; enrollees in other Medicare Advantage plans were offered a net extra benefit value of $71.22 a month more.[12] However, Medicare Advantage members receive additional coverage and medical benefits not enjoyed by traditional Medicare members, and savings generated by Medicare Advantage plans may be passed on to beneficiaries to lower their overall health care costs.[10] Other important distinctions between Medicare Advantage and traditional Medicare are that Medicare Advantage health plans encourage preventive care and wellness and closely coordinate patient care.[13] Medicare Advantage Plans that also include Part D prescription drug benefits are known as a Medicare Advantage Prescription Drug plan or a MA-PD. Enrollment in Medicare Advantage plans grew from 5.4 million in 2005 to 8.2 million in 2007. Enrollment grew by an additional 800,000 during the first four months of 2008. This represents 19% of Medicare beneficiaries. A third of beneficiaries with Part D coverage are enrolled in a Medicare Advantage plan. Medicare Advantage enrollment is higher in urban areas; the enrollment rate in urban counties is twice that in rural counties (22% vs. 10%). Almost all Medicare beneficiaries have access to at least two Medicare Advantage plans; most have access to three or more. Because of the 2003 law’s overpayments, the number of organizations offering Fee-for-Service plans has increased dramatically, from 11 in 2006 to almost 50 in 2008. Eight out of ten beneficiaries (82%) now have access to six or more Private Fee-for-Service plans.[14] Each year many individuals disenroll from MA plans. A recent study noted that about 20 percent of enrollees report that “their most important reason for leaving was due to problems getting care.”[15] There is some evidence that disabled beneficiaries “are more likely to experience multiple problems in managed care.”[16] Some studies have reported that the older, poorer, and sicker persons have been less satisfied with the care they have received in MA plans.[17] On the other hand, an analysis of the Agency for Healthcare Research and Quality data published by America’s Health Insurance Plans found that Medicare Advantage enrollees spent fewer days in the hospital than Fee-for-Service enrollees, were less likely to have “potentially avoidable” admissions, and had fewer re-admissions. These comparisons adjusted for age, sex and health status using the risk score used in the Medicare Advantage risk adjustment mechanism.[18][19] In December 2009 the Kaiser Family Foundation published a report that rated Medicare Advantage organizations on a five star scale. The ratings were based on data from CMS, the Consumer Assessment of Healthcare Providers and Systems (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS) data, and the Health Outcomes Survey (HOS). New plans did not receive ratings, because data were not available. Almost six out of ten (59%) of MA plans did receive ratings, and these plans represented 85% of the enrollment for 2009. The average rating was 3.29 stars. Twenty-three percent of enrollees were in a plan with four or more stars; 20% were in a plan with fewer than three stars.[20] Twenty percent of African-American and 32 percent of Hispanic Medicare Beneficiaries were enrolled in Medicare Advantage plans in 2006. Almost half (48%) of Medicare Advantage enrollees had incomes below $20,000, including 71% of minority enrollees.[21] Others have reported that minority enrollment is not particularly above average.[22] Another study has raised questions about the quality of care received by minorities in MA plans.[23] The Government Accountability Office reported that in 2006, the plans earned profits of 6.6 percent, had overhead (sales, etc.) of 10.1 percent, and provided 83.3 percent of the revenue dollar in medical benefits. These administrative costs are far higher than traditional fee-for-service Medicare.[24] [edit] Part D: Prescription Drug plans Main articles: Medicare Part D and Medicare Part D coverage gap Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all. The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates. Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases. It should be noted again for beneficiaries who are dual-eligible (Medicare and Medicaid eligible) Medicaid may pay for drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances.
Source: medicare-health.com

Employees Mutual Health Insurance Company Review

WellPoint wants to help employers and employees to maximize their health insurance dollars by purchasing services within WellPoint’s established relationship network (including doctors, hospitals, and healthcare clinics). Because of the sheer breadth of WellPoint’s relationships, individual employees can take greater control in identifying healthcare solutions. Employers receive greater cost controls while offering employees healthcare products and services.
Source: healthinsuranceproviders.com

Affinity Health Plan Creates Free Health Directory for Young Adults

accessible resource, adolescent health issues, Adults, advantage, advice, Affinity, affinity health plan, Agent, April, area, assistance, Attachments, Bronx, Care, Change, child, city 13, collaboration, Columbia, columbia university, Communications, company, confidentiality, contact, Copyright, Corporation, Coverage, Creates, Department, development, dietary advice, director, Directory, Division, doctors and nurses, enrollment, extent, family, Free, funding, grant, Guide, Health, health questions, health resource directory, helpful guide, Holdings, Inc, Information, January, Lifestyle, List, LLC, Mailman, mailman school of public health, management, max meng, Medicaid, Medicare, metro, mission, model, new york state department of health, number, October, Officer, Parenthood, pilot, Plan, Planned, planned parenthood, PLUS, premium, president, Press, Preteens, privacy, privacy and confidentiality, Program, provider, PRW, PRWEB, Public, Publicity, Releases, representative, Resource, school, school of public health, Senior, State, state department of health, Support, susan beane, Ultimate, Unicare, University, Vice, Vocus, Web, Wire, Young, young adults
Source: bsplitter.info

In accordance with the Patient Protection and Affordable Care Act, Section 6401 (a), all new and existing providers must be reevaluated under the new screening guidelines in Section 6028. Medicare requires all enrolled providers & suppliers to revalidate enrollment information every five years (reference 42 CFR 424.57(e)). To ensure compliance with these requirements, existing regulations at 42 CFR 424.515(d) provide that CMS is permitted to conduct off-cycle revalidations for certain program integrity purposes. Upon the CMS request to revalidate its enrollment, the provider/supplier has 60 days from the date of this letter to submit complete enrollment information using one of the following methods: Providers and suppliers can enroll in the Medicare program using either the:
Source: managemypractice.com

Video: SHIIP Medicare Enrollment Basics.flv

CMS Announces $523 Medicare, Medicaid, & CHIP Enrollment Application Fee for 2012 : Health Industry Washington Watch

2012 application fee for institutional providers (excluding physicians and nonphysician practitioners) enrolling in Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) will be $523 – up from $505 in 2011. CMS uses a broad definition of institutional entities subject to the application fee; it applies to “any provider or supplier that submits a paper Medicare enrollment application using the CMS-855A, CMS-855B (not including physician and non-physician practitioner organizations), CMS-855S or associated Internet-based PECOS enrollment application.” As authorized under CMS’s February 2011 final Medicare/Medicaid/CHIP provider screening rule, institutional providers must pay the application fee when initially enrolling in the Medicare or Medicaid programs or CHIP; revalidating their Medicare, Medicaid or CHIP enrollment; or adding a new Medicare practice location (unless a hardship exemption applies).
Source: healthindustrywashingtonwatch.com

Medicare Enrollment Revalidation and the Revised CMS 855 Forms : Healthcare Integration Advisors : New York Attorneys & Lawyers for Health Care Providers, Hospitals, Insurers : Iseman, Cunningham, Riester & Hyde LLP

In July of this year, CMS published revised Medicare enrollment forms for all provider and supplier types.  CMS revised the enrollment forms in an effort to implement a more rigorous program of integrity standards.  CMS’s theory is that by keeping bad people out of the Medicare system, most of the fraudulent activity that has plagued federal health care programs can be halted before it even begins.  The most substantial revisions were made to the Form 855A for institutional providers and the new Form 855O, which is for physicians and non-physician practitioners who enroll in Medicare for the sole purpose of ordering or referring items for Medicare beneficiaries.
Source: healthcareintegrationadvisors.com

Senior Markets Online Enrollment

We thought we knew the 508 guidelines from the outset of the discovery process, but soon realized we only had seen the tip of the iceberg. At that time, we had only looked to the guidelines for HTML documents as our baseline. We discovered later in the development cycle that there were a host of guidelines related to Flash/Flex-based media; the situation became, well, a bit complicated. There remained quite a bit of work ahead for the Development and QA teams.
Source: celerityinnovation.com

Obtain Medicare Supplement Plans Through Annual Enrollment Time period Golden Opportunity

Medicare Dietary supplement Strategies are the greatest kind of wellbeing insurance plan offered to seniors about the age of 65. Individuals who obtain these plans can check out practically any doctor, hospital, or professional and frequently spend really little or practically nothing at all for these services. The only issue with Medicare Supplement Plans is the businesses who supply this kind of insurance have underwriting guidelines, which can make it difficult to qualify if you have pre-present conditions. Using assured issue guidelines to obtain one of these plans can make a huge distinction in the top quality of treatment you obtain and your out-of-pocket costs for hospital and medical professional providers.
Source: watchmygear.com

Medicare Enrollment Periods for Part C and D

-If you’re already eligible for Medicare due to a disability and then turn 65 you can sign up for a Medicare Advantage and/or Medicare Prescription Drug plan, switch from your current plan to another plan, or drop a plan completely during your Initial Enrollment Period. If during this time you sign up for a Medicare Advantage Plan you are able to drop that plan at any time within the next 12 months.
Source: srbenco.com

Revalidate Your Medicare Enrollment

If you have had to submit a form to CMS in order to accomplish either of the above three items you would find that it could take no less than 30 days and up to six months for this to happen. If for some reason you accidentally miss an item on the form, after the form has been reviewed, it is then sent back to you with the items that are missing and you need to resubmit the form once again corrected. Now somewhere between 30 and 40 days has passed and you are now resubmitting the form only to start the process once again.
Source: medbillingncoding.com

Recent Changes to Medicare Part A Enrollment Forms

Consistent with the Paperwork Reduction Act of 1995, CMS published an Agency Information Collection Activities Notice, on May 20, 2011, consisting of a summary of the proposed revisions to the enrollment forms, with public comments due by June 20, 2011.[4] The final, revised forms became effective July 1, 2011.[5] The revised CMS 855A now explicitly requires disclosure of any entity whose mortgage, deed of trust, or other security interest in the Part A provider is equal to five percent (5%) or more of the total property and assets of the Part A provider.[6] This includes investment funds, holding companies, banks and financial institutions, and charitable and religious organizations.[7] The Part A provider must report the entity’s name, address, tax identification number, type of organization, percentage of interest in the provider, and an organizational chart identifying all of the owning or controlling entities and their relationship to each other and the provider. Dates of birth and social security numbers are additionally required for individuals who hold security interests.
Source: ebglaw.com

What is the claimant number to enroll in Medicare part b?

About affordable article Benefits best Business Care Companies compare comparison Cost costs Coverage dental drug Family financial find from Good great Guide Health home Insurance launches Life Medicaid Medicare much News online Part Plan Plans Private Quotes Report Secrets Security Self Social Supplemental Trends Wisconsin.
Source: healthinsuranceandmedicareupdate.com

Baby Boomers U. S. (The Blog)

Do a quick check-up online, or get someone to help you: People tend to want to avoid a review of their Medicare coverage because it’s a hassle. But, there are a number of Internet sites that can reduce the hassle of reviewing your coverage. Sites like PlanPrescriber.com (owned by Plan Prescriber, Inc.), eHealthMedicare.com (owned by eHealthInsurance Services, Inc.) and Medicare.gov (the government website) make it easy for you to review plans and benefits side-by-side, and get a sense of what plan might work best for you. Or, if you don’t want to use the Internet, you can contact Medicare, your state department of insurance, the insurance company, or work with a licensed agent who represents several insurance companies, like eHealthInsurance.
Source: babyboomersus.net

Medicare Delays Provider Enrollment Revalidation Until 2015

The Centers for Medicaid & Medicare Services (CMS) has delayed the requirement that physicians revalidate their Medicare enrollment under the program integrity screening provisions of the Affordable Care Act. According to CMS, the revalidation effort, originally scheduled for March 23, 2013, will be pushed back through 2015. Physicians will be among the last to revalidate.
Source: wordpress.com

Acquire Medicare Supplement Plans During Annual Enrollment Period Golden Chance

Medicare Dietary supplement Plans are the very best kind of wellness insurance policy offered to seniors about the age of 65. People who obtain these options can pay a visit to nearly any medical professional, hospital, or expert and often pay out extremely small or practically nothing at all for these providers. The only issue with Medicare Supplement Plans is the organizations who offer you this form of insurance plan have underwriting recommendations, which can make it challenging to qualify if you have pre-existing problems. Utilizing assured problem suggestions to purchase one particular of these strategies can make a large variation in the quality of treatment you obtain and your out-of-pocket costs for hospital and physician services.
Source: estateof.com

Medicare Provider Enrollment Revalidation

Providers and suppliers should submit revalidation only after receiving the request from their MAC to do so. Providers and suppliers will have 60 days from the date of the letter to submit the required completed enrollment forms. Failure to submit enrollment forms as requested may result in the deactivation of Medicare billing privileges. Revalidation can be completed through the Internet-based Provider Enrollment Chain and Ownership System (PECOS) or a paper application; currently, federally qualified health centers only may submit paper enrollment applications. Please note: CMS forms 855A, 855B, 855I, 855O, 855R and 855S all have been revised as of July 1, 2011, and should be used for the provider enrollment revalidation. The new forms can be found by searching “855” on the CMS website.
Source: healthcarereforminsights.com

Medicare Enrollment Tips to Consider

No matter what the case is, we do need medical coverage. We never know when something can go bad. If you are currently eligible and have no other health insurance, Medicare enrollment is something that becomes necessary. For most people that have no experience with insurances, this will be a dawning task. In this case it is much easier to handle everything by working with a Medicare patient advocate system. This is due to the fact that the professionals you will work with know everything about all that is linked with Medicare. They can advice you and even take care of documentation for you.
Source: medicareenrollmentsite.com

Learning about 2012 Medicare advantage plans, is essential for all purposes. Part A: This deals with your hospitalisation expenses. You can also make use of this for house nursing or even hospice, if directly related to your condition. Part B: This particular relates to the Outpatient expenses. You are to pay for premiums right here. Part D: Deals with health insurance programs. They are being offered through private insurance agencies in 2012, as approved by the Government to provide such services. Part Deb: Covers prescription medications. If the medications are covered here, you can use this program to repair it.
Source: 10kadayonline.com

Video: Choosing A Medicare Supplement in Fl in 2011

Medicare discontinuation sends seniors scrambling

Wellmark will provide guaranteed acceptance into any Medicare supplement plan for affected members. That means companies cannot turn down an applicant; cannot charge higher premiums and cannot enforce a waiting period.
Source: thegazette.com

Medicare supplement plans for yourself or loved one #78508

You probably already know that Me.dicare does not cover 100% of your me.dical costs. Fortunately there are affordable Me.dicare Supplement insurance plans (also called ‘Me.digap’plans) that can cover what Me.dicare won’t. These plans are regulated by law to provide certain benefits. However, insurance premium costs for these plans can vary from company to company. Try our free service today to see Me.dicare Supplement_pricing in your area. All at no cost and no obligation. Click to get started: http://computerflightsimulation.com/1980879r101h3290430 To unsubscribe, please visit: http://computerflightsimulation.com/1980880r101h3290430 or write: Me.dicareOpenEnrollment PO Box 7022 New York NY 10116 to remove yourself http://computerflightsimulation.com/unsub.php or write Manage your subscription options here. Cancellations are handled promptly. Postal: PO Box 29502 , Suite 46 Las Vegas, NV, 89126, US
Source: bubble.ro

Understanding about Medicare Supplement Plans

Medicare Supplemental Plans or Medigap are Health Plans administered by the Medicare approved private Insurance companies. Medigap as the term implies, has came into the picture to fill the gap which is left by the original Medicare. You have to enroll the original Medicare at first then only think of enrolling the Medigap plans for further relief from health expenses. The Health Plans are very beneficial for the old age people rather we call them the senior citizens for getting support for the extra expenses for medical treatment of their health. This health plans have certain features like an insurance holder can claim the benefits after sixty-five years of age not before that, those having certain disabilities can avail it before sity0five years of age. These health plans covers the hospital and home health care, nursing facility, doctor’s service etc. With the growing rate of price value day by day it is very difficult for the general people to manage the medical treatment; the cost for any kind of treatment is reaching the height of sky. The cost for doctor’s visit, prescribed drugs, test and if required then the hospital bills are problems which has become issues for the normal people, to avoid from all this sort of tension a great solution is getting support of Medicare insurance policy.
Source: articlejadeo.com

Gerber Medicare Supplement Company Offers Help with Coverage Gaps

Gerber Medicare Supplement Insurance offers the beneficiary maximum amount of coverage through Plan F for good returns on the insurance. As we are all well aware of the point that Medicare supplement insurance also known as Medicare Supplemental is meant to fill in the gap that is left behind by the original Medicare plan. Without the proper Medicare supplement coverage, it is easy to for medical costs to escalate very quickly. Gerber plans help the beneficiary fill these gaps with excellent coverage.
Source: longestwalk2011.com

Medicare Supplement Providers

Medicare Supplement insurance provider Medicare National in the third quarter and is hungry for more growth from its senior business, which also includes Medicare supplement coverage. Department of Health and Human Services was in Pueblo on Wednesday to urge seniors to think now about their Medicare supplement plans and to take advantage of some new preventive services that now are free. For people who are more than the age of 65 and at the moment enrolled in an eligible Medicare plan, Medicare supplement insurance (which could also be referred to as Medigap) could possibly be a beneficial selection.
Source: yinzcam.org

Colorado Medicare Supplement Insurance

For people who are more than the age of 65 and at the moment enrolled in an eligible Medicare plan, Colorado Medicare supplement insurance (which could also be referred to as Medigap) could possibly be a beneficial selection. Medicare supplement insurance, also called Medigap coverage is obtainable in each and every state, although Medicare supplement rates can differ widely. Medicare Supplemental insurance is the policy which is designed to enhance the protection that is afforded by the original Medicare program. Although most of the plans that are there in the original Medicare cover most of the expenses yet there are some gaps that remain in the policy that make the Medicare supplement insurance mandatory for the people to take them. The Best Medicare Supplement Insurance is the one that offers the beneficiary maximum amount of profit or returns on the insurance. Medicare Supplemental Insurance is an option that is available with the people who want to satisfy their insurance related needs in a very detailed manner. It is not that the health related problems will not occur to people in the long run, they obviously will occur but the main thing is that is these problems arise in front of the people then it would be very easy for the people to cope up with the expenditure on their health because of the presence of Medicare supplemental insurance.
Source: hereinspirit.com

Do I Need Medicare Supplement Insurance?

You can find more information about plan benefits, and you can compare actual premium prices for Medigap policies available in your area, at weissratings.com/medigap.  Weiss Ratings does not sell insurance, but it does give consumers access to pricing data for more than 165 Medigap insurers. We’ve looked, and you won’t find this kind of premium-price comparison information anywhere else.
Source: thetradingreport.com

ParasolLeads Reports Record Medicare Supplement Insurance Leads Sales

For insurance agents wanting to take their pursuit of success to the next level, few things are more valuable than Medicare supplement leads. In a difficult economy, every advantage helps, and the right leads give agents a competitive advantage. ParasolLeads understands the importance of staying one step ahead of the competition and takes the danger of scam artists and lead generation services that offer deep discounts but deliver low quality leads out of the picture.
Source: travelnets.info

Long Term Medicare Supplemental Insurance

As unfortunate a situation as it may be, there will always be those who are fully dependent on their Medicare policies by way of the fact that they have ongoing medical conditions, perhaps of a rather severe or at least relentless nature. Needless to say, the worry of the condition in question is more than enough in its own right, therefore those facing such problems would of course prefer not to have to worry about meeting the costs of their treatment and whether their Medicare policy is suitable. Sadly, as each and every policy holder will of course be abundantly aware, the gaps and holes left by Medicare are abundant to say the very least and there is always every possibility that payments required by the policy holder may be too high to realistically contemplate over the long term. Needless to say, it is here that the value and worth of the Medicare Supplement Plans of today really come into their own.
Source: theo4you.org

A Brief But Useful Discussion on Medicare Supplement Insurance Plans

These supplementary insurance policies are sold by the private insurance companies and are under their sole administration. According to the law the private insurance companies can offer only twelve standard Medicare Supplement Insurance Plans, named A through L. each of these plans have their own set of benefits, different from the others. However, almost all of the twelve Medigap policies provide the basic benefits of Medicare part A and B. Therefore it is always recommended to study all the Medigap plans before deciding to choose the one that would fit the best for you. Besides that the fact that should be kept in mind is that, no matter from whatever insurance company you may purchase a particular plan, all of the plans with the same letter cover must provide the same benefits. As for example if you purchase a Medigap plan C policy, it should cover the same benefits without depending on the company that is selling the plan. However, the premium rates may vary for different companies. Therefore you are free to purchase any Medigap policy from the company you like and be sure to get the same benefits provided by the other companies.
Source: ip-hedgefund.com

Beginning Jan. 1, Medicare auditors will review claims before they are paid in Florida, California, Michigan, Texas, New York, Louisiana and Illinois. The idea is to block fraudulent claims rather than follow the usual “pay and chase” method of trying to recover payments already made.
Source: gestetnerupdates.com

Video: Melin Medicare Insurance Services-Senior Health Insurance,Medicare Supplement Plans,Santa Clara,CA

CA's GOP Representatives Vote to End Medicaid/Medicare, Shift Billions of Cost to California

First, it costs us more as a society to cut those incredibly successful, life saving programs than it does to run them. A much, much better way is to cut military defense (we spend more than rest of the world combined) and end the wars. Then, its about raising taxes on the SUPER rich (who are paying less in taxes than they have since 1931…get the connection? And, the top 1% own 40% of the wealth now…Oligarchy anyone?), closing corporate tax loopholes (2/3′s of fortune 500 pay NO INCOME TAXES), end massive corporate welfare programs (like subsidizing the oil industry), and instituting a .25 transaction tax on stock (raises nearly $100 billion a year while also reducing wall street casino gambling). These ideas not only raise the revenue needed, but it avoids sentencing tens of thousands of Americans to death, as eliminating Medicare and Medicaid would.
Source: californiaprogressreport.com

Medicare Health supplement Insurance coverage in Ca

Like protection fundamentally implies the precise same (or significantly much less) Medicare health supplement insurance coverage cover. For instance, customers on Program F can obtain a new Prepare F from a contending insurance coverage firm in order to lower their monthly rates. This may be completed each and every single couple of many years when Medicare complement rates have had an previously regular premium boost.
Source: vitaminfreedom.org

Dave Fluker’s California Health Insurance Blog: Blue Shield CA Continues ‘New to Medicare’ Supplement Discount

Blue Shield of California currently offers a discount of premium for the first 12 months to those who are turning 65 or otherwise “new to Medicare”. The discount is $20.00 per month off of the premium for each of the first 12 months. For those who wish to use the checking deduction payment options (EFT), an additional $2 discount is available. In addition, Blue Shield CA Medicare Supplement plans include Silver Sneakers at no additional cost. Blue Shield is planning to continue the discount for those “new to Medicare” into 2012. This discount combined with the free Silver Sneakers benefit makes Blue Shield Medicare Supplements very competitive in California. For more information, give me a call, e-mail or use the Information Request Form on my web site. Dave
Source: blogspot.com

Investigative Reporters and Editors

Investigative Reporters and Editors, Inc. is a grassroots nonprofit organization dedicated to improving the quality of investigative reporting. IRE was formed in 1975 to create a forum in which journalists throughout the world could help each other by sharing story ideas, newsgathering techniques and news sources.
Source: ire.org

Disability, Medicare/ Medicaid, Social Worker?

Hi, I’m new to this board. Diagnosed Autoimmune Disease in 1998 (rare for a male), attacking liver. Gained 90 lbs on Prednisone, finally got off it by use of Milk Thistle. Was managing well until last year (2010) when I started seeing problems again, pale stool, etc. Diagnosed with cirrhosis Jan 2011 and my MELD score is 22 so I should be on the transplant list, but in the meantime I stopped working. I have no job, no unemployment benefits, no insurance or doctor. My questions are:
Source: supportgroups.com

React & Act: Medicare, money and your hospital experience

Medicare pays hospitals based on the severity of the medical condition, which is determined by the patient’s primary diagnosis, surgical procedures and medical complications. These documents also inform Medicare whether conditions were “present on admission.” This is of interest to Medicare authorities who track whether a patient walked into a hospital with or without an infection or bedsore or other conditions that can arise during a hospital stay as a result of inadequate care.  Hospitals can lose funding in cases in which patients develop medical problems during a hospital stay.
Source: californiawatch.org

Health Care Reform and Medicare

The Organizing For America Tri-Valley Progressives group is sponsoring another informational forum for the general public. Amanda Baldwin, Community Education Coordinator for the Health Insurance Counseling & Advocacy Program (HICAP), will be presenting an informative overview of Health Care Reform and Medicare, and will answer audience questions. This is a good chance to get information to help with your health care enrollment decisions.
Source: patch.com

Medicare Meeting in La Honda

Christina Kahn, Community Outreach Coordinator for the Health Insurance Counseling and Advocacy Program (HICAP) will meet with individuals from the La Honda and Pescadero communities to discuss the upcoming changes in Medicare coverage in 2012.  She will also present comparisons and other information about current supplemental health insurance options (please note that if  you wish to change your Medicare coverage in any way, you can do so between October 15 and December 7, 2011).  The meeting will take place at the Puente Office in Downtown La Honda and is sponsored by the La Honda 55+ Program.  HICAP, an information and counseling service, is supported by the local Agency on Aging.  They do not represent or advocate for particular insurance or healthcare entities and appointments with HICAP Counselors are typically made through senior centers.
Source: pescadero-california.com

NCMS would like to remind physicians that eligible health care professionals who electronically prescribe (eRx) for all patients and report the electronic prescribing measure for at least 25 Medicare eligible visits before the end of the year will qualify for the one percent incentive for 2011 and will be exempt from the payment adjustment for 2013!
Source: ncmedsoc.org

Video: North Carolina Medicare Insurance Quotes | Call: 828-351-9618

North Carolina hospital could lose funding after lawsuit

The matter is at the center of a wrongful death lawsuit filed against the hospital, which alleges that a guard killed the 28-year-old patient after putting him in a choke-hold. The North Carolina Department of Health and Human Services claims the guards were never trained in such therapeutic physical holds. The wrongful death claim also accuses the facility of failing to have enough nursing staff on hand to supervise the security staff’s attempts to restrain the man, claiming that this amounts to negligence on the hospital’s part. Additionally, several other security guards allegedly piled on top of the patient during the hold to make sure he could not move.
Source: northcarolinapersonalinjuryblog.com

Medicare Announces Prepayment Review And Prior Authorization Demonstration Project For Power Mobility Devices

The prior authorization demonstration does not create new documentation requirements for providers and suppliers – it simply requires them to provide the information earlier in the claims process. After receiving the prior authorization request, Medicare will conduct a medical review and communicate the coverage decision (based on Medicare policies such as National Coverage Determinations (NCD) and Local Coverage Determination (LCD) to the patient, provider and supplier within 10 business days of receiving the request. Under rare, emergency circumstances, Medicare must complete this process in 48 hours. Physicians or treating practitioners can make unlimited requests, but Medicare has 30 days to consider any resubmitted requests. Claims with approved prior authorization requests will be paid if all other Medicare coverage and documentation requirements are met.
Source: myedutrax.com

eHealth Technology Now Powering Online Medicare Supplement Sales for IHC Health Solutions in 16 States / eHealth

                                    The IHC Group is an organization of insurance carriers, managing general underwriters, third-party administrators and marketing affiliates that has been providing health, life, disability, dental, vision and medical stop-loss insurance solutions to groups and individuals for nearly 30 years. With over $1.3 billion in assets, members of The IHC Group include Independence Holding Company (NYSE:IHC), American Independence Corp. (NASDAQ: AMIC), Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company.  Each insurance carrier in The IHC Group has a financial strength rating of A- (Excellent) from A.M. Best Company, Inc., a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet policyholder obligations. Collectively, the companies in The IHC Group provide insurance coverage to more than one million individuals and groups. For more information about The IHC Group, visit www.ihcgroup.com.  Madison National Life, Standard Security Life, and the IHC Group are not connected with or endorsed by the U.S. Government or the federal Medicare program.
Source: ehealthinsurance.com

BCBS North Carolina Blue Medicare Advantage Open Enrolment

There are changes coming for Medicare Advantage and Part D plans, benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2013. For Medicare supplement plans, the changes occur on June 1 of each year.
Source: ncflhomeautoinsurance.com

BCBS North Carolina Blue Medicare Advantage Open Enrolment

Seniors 65 and older have the choice to either participate in the original Medicare program or opting for Medicare Advantage through a private insurance company. Medicare Advantage is a guaranteed acceptance plan that is standardized. The plan is standardized which means that any senior that is eligible for Medicare but opts for Medicare Advantage will have at least the minimum coverage that Medicare Part A and Medicare Part B from the original Medicare program provides. Any other benefits above and beyond the minimum are not mandatory. BCBS Medicare Advantage plans go above and beyond the basic mandatory coverage. Source: abchealthplans.com
Source: medicaresupplementalco.com

North Carolina Trial Law Blog: Medicare (CMS) offering new fixed percentage subrogation option for settlements of less than $5,000

The information provided on this blog is of a general legal nature and should not be taken as specific legal advice. No post on this blog creates an attorney client relationship. I’m a NC lawyer, so anything I post applies only to NC. If someone else posts something legal, I can’t take responsibility for what they say. This is all pretty straight forward stuff, but you have to say it if you are a lawyer, right?
Source: nctriallawblog.com

NC Seniors in DC to Fight for Social Security, Medicare

DURHAM, N.C. – Fifty-three North Carolina seniors today are taking a hands-on approach to potential cuts to their Social Security and Medicare benefits. They boarded a bus early this morning for Washington to tell their congressional representatives about the impact cuts would have on their well being. The group is part of nearly 500 seniors on Capitol Hill who intend to share information that half of all Americans age 65 and older earn less than $20,000 a year, according to AARP figures. Helen Featherson, president of the Durham AARP chapter, is on the bus. “If you want to cut, cut someplace else, but don’t balance the budget off the backs of us who are dependent; because we were promised that if you worked, you will get Social Security. ” Under the Budget Control Act, a congressional “super committee” is responsible for trimming $1.5 trillion from the nation’s debt, and changes to Medicare, Social Security and Medicaid could be part of that. If the committee doesn’t reach consensus, automatic cuts take effect in 2013 – and it’s unclear if they will include the three programs. AARP legislative liaison Chip Modlin, 75, of Fayetteville, says Social Security should not be part of the budget debate. “Social Security is something that we earned, we pay into it all of our lives. Social Security hasn’t added one dime to this deficit and it’s not in trouble financially.” According to AARP, half of all Medicare beneficiaries spend at least $3,000 out-of-pocket annually on their health care. The North Carolina group joins seniors from eight other states on Capitol Hill today. AARP says those who couldn’t be part of the bus trip can call 1-888-722-8514 to voice their views.
Source: publicnewsservice.org

Speaker Tillis and GOP join to stop Ms. Colbert of Wilmington from getting new eyeglasses

budget children civil rights consumer protection corporations Crucial Conversation death penalty Duke Energy economy Education Election energy environment federal budget fracking governor Health health care health choice immigration incentives insurance jobless jobs justice legislative agenda Legislature LGBT rights Marriage amendment medicaid mental health NC growth Occupy Wall Street policy pollution poverty preschool progressive movement Reproductive rights republicans right-wing state budget taxes Thom Tillis Wake County schools
Source: ncpolicywatch.org

Your Guide to Part D Medicare

Since then, the beneficiaries were automatically enrolled in certain PDP areas that are less-expensive and randomly chosen by Medicare. In some cases of dual-eligible beneficiaries however, they were directly removed from the MA plan after they’ve already enrolled in PDP. From November – December 2010, a number of Medicare beneficiaries have affirmatively enrolled in Part D coverage. The conscription period for 2011 is expected to last from October to December. Beneficiaries who were qualified but failed to enroll during the Part D enrollment period are required to pay their Late-enrollment Penalty (LEP). Otherwise, they won’t be able to obtain some Part D benefits. The LEP is 1% of the average monthly premium paid by either Medicare or its beneficiaries. In April 2010, the number of Part D enrollees increased to $27 million. The increase stemmed from 1,570 separate Part D plans provided in early 2009. The highest number of Part D beneficiaries was estimated in West Virginia and Pennsylvania. Hawaii and Alaska meanwhile garnered the second and by far, the lowest. The average beneficiary premium for PDPs increased from $29.89 to $38.94 in 2010. The monthly premiums are initially projected to increase by 10% after nearly 8% of Medicare beneficiaries enrolled in PDP chose a single coverage. Among MA-PD beneficiaries, the enrollment plans offering separate coverage rise to 33% (from 27% in 2006). The premiums are said to be more significantly higher than the ones sponsored by PDP providers. Part D was not spared from controversies. After the federal government approved the program, public offices were not permitted to negotiate the prices of prescription drugs. It was only the Department of Veteran Affairs who were given permission to negotiate and pay 59% of the prescription drugs covered by Medicare. Former US Congressman Billy “R-La” Tuazin, who authored the Medicare Drug Treatment Modernization Act, retired after receiving $2 million every year from the American Pharmaceutical Research and Manufacturers Group (APRMG). Thomas Scully, Chairman and CEO of Medicare, threatened to fire his colleague Richard Foster after attempts of reporting the Medicare bill’s cost was revealed by Cong. Tuazin.  
Source: ezinemark.com

Advice on Medicare and Medicaid from a Wills and Trusts Lawyer in Cary

This website is made available for general information and educational purposes only and should not be construed as legal advice on any subject matter. By using this website or sending an email to the website publisher, you understand that there is no attorney-client relationship between you and the website publisher. The website should not be used as a substitute for competent legal advice from a licensed professional attorney in your state of residence. Any liability that might arise from your use or reliance on this website or any links from this website is expressly disclaimed. This website is not legal advice, is not to be acted on as such, may not be current and is subject to change without notice. Jackie Bedard is licensed to practice law in the State of North Carolina only.
Source: ncwillsandtrusts.com

Like the Q1Medicare stand-alone Medicare Part D prescription drug plan finder or PDP-Finder, the Medicare Advantage plan finder is designed as a simple alternative to other more complicated online Medicare plan search tools. Using the Q1Medicare.com/MA-Finder, Medicare beneficiaries enter their ZIP Code, choose their county if necessary, and view all 2012 Medicare Advantage plans available in their area. Alternatively, MA-Finder users can start on a state level and browse through the counties within a state to see highlighted plans showing the lowest cost plans with $ 0 deductible prescription drug coverage for each type of health plan (such as HMO, PPO, or PFFS), along with a link to a complete list of Medicare Advantage plans in the specific county.
Source: bestlongtermcare.org

Video: Florida Medicare Advantage | Florida Health Agency

What Is Medicare Advantage, In Particular Florida Medicare

When you are thinking about retiring and considering out there health benefits, many individuals wonder what is Medicare advantage. Medicare is often called the federal government health insurance coverage plan for many who have retired or over the age of 65. Nevertheless, most people don’t perceive that throughout the Florida Medicare program, there are several various kinds of Medicare plans and forms of coverage obtainable. The different types of Florida Medicare plans point out various levels of protection that ranges from hospital visits, emergency companies, and other sorts of healthcare coverage. For many who are questioning what is Medicare advantage, it is vital to first understand that Medicare is cut up into several different types of plans and that the comprehensiveness of Medicare advantage depends on the plan.
Source: directconsolidationloans.net

Florida Medicare Advantage Plans

[...] [...] Florida has a large number of Medicare Advantage plans available.  One reason could be the large population of seniors that retire to the state.  The first thing to consider if you are looking for a Medicare Advantage plan in Florida is that the plans are NOT state specific.  The are in fact county specific.  Check here to look up Medicare Advantage plans by state for 2012.  Chances are you will find a company in South Florida that is not at all available in the Northern part of the state.  One exception to this is United Healthcare.  They offer a plan that is identical across the state.  This is probably because of the size of the company.  They also offer a large network across the state.Source: medicare-plans.net [...]Source: medicare-plans.net [...]
Source: medicare-plans.net

Health First Health Plans Expands Across Florida

Located in the Brevard County, Florida, Health First Health Plans serves nearly 65,000 members, including 23,000 Medicare members. Serving residents of Brevard County and part of Sebastian in Indian River County for 15 years, Health First Health Plans was founded as part of Health First, Inc. a not-for-profit family of healthcare services that also includes Viera Hospital, Cape Canaveral Hospital, Holmes Regional Medical Center, Palm Bay Hospital and Health First Physicians. For more information, visit www.HealthFirstHealthPlans.org or call 321-434-5665.
Source: spacecoastmedicine.com

Access Healthcare Awarded an Additional Medicare Advantage Contract

Spring Hill, Florida (November 2011) – Access Healthcare announces that it was recently awarded a Medicare Advantage contract from Optimum Health. The awarding of this contract enables Access Healthcare providers to accept those who choose Optimum Health during the current open enrollment period.
Source: madduxpress.com

Much of the disparity occurs due to the rising cost of physician preference items. According to the report, hospitals spend $17.4 billion annually on PPIs, which is 40 percent or more of the procedure cost. The report gathered data on high-volume procedures from not-for-profit hospitals around the country. Here is the difference between the low Medicare payment and high cost to the hospital of top orthopedic and spine procedures: •    Spinal fusions: $13,092 •    Spinal procedures: $6,361 •    Cervical spinal fusions: $4,532 •    Back and neck procedures: $3,324 •    Hip/knee replacements: $5,623 Approximate total payment shortage, or loss, for hospitals on each procedure in 2010: •    Spinal fusions: $45.6 million •    Spinal procedures: $25.2 million •    Cervical spinal fusions: $85.5 million •    Back and neck procedures: $75 million •    Hip/knee replacements: $665.9 million Related Articles on Orthopedics: AAOS Grooms Orthopedic Surgeon Public Office Candidates for 2012 AAOS Hosts Comparative Effectiveness Symposium in Washington DC AAOS Joins Campaign to Stop Medicare Meltdown Source: beckersorthopedicandspine.com
Source: medicaresupplementalco.com

Video: 2011- 4/19 MEDICARE PATIENTS HAVE SHORTER HOSPITAL STAY AFTER HIP REPLACEMENT BUT

BLOG: Fight Cuts to Medicare So Hardworking Families Can Focus on Living Their Lives

My mother, who raised 8 children on her own, was diagnosed with breast cancer at the age of 70. In addition to breast cancer she struggles with diabetes and a heart condition. She depends on Medicare and Medi-Cal to live, but her access to life saving medication is limited. After a lifetime of hard work, she should be enjoying her life. Her biggest worry should be about what she is going to make for Thanksgiving dinner and how she is going to get all her presents wrapped before Christmas. Unfortunately her medical and financial worries distract her from what is truly important to her.
Source: seiu-uhw.org

Proposed Plan for 20% Reduction in Hip Fractures Could Save $5B Annually

The plan was unveiled at a best practices sharing event at the Kaiser Permanente Center for Total Health on Capitol Hill. Currently, 90 percent of the 325,000 hip fractures reported in the United States every year are in patients age 65 or older, according to the report. In 2005, osteoporosis-related fractures were responsible for $19 billion in costs, a figure expected to rise to $25 billion by 2025, which makes the effort particularly crucial for lowering the cost burden to the healthcare system. The proposal to decrease hip fractures includes the establishment of a fracture liaison service facilitated by NBHA within Medicare and other health systems. The service would assess patients for osteoporosis fracture and provide treatment and follow-up to manage the disease and prevent repeat fractures. The Kaiser Permanente Healthy Bones Program reduced hip fracture rates by 37 percent and could save 100,000 fractures and $5 billion annually. Related Articles on Healthcare Costs: 10 Statistics on Hospital Loss for Orthopedic and Spine Surgery on Medicare Patients Cost-Effective Spine Surgery: 8 Things to Know Report Breaks Down Costs of Osteoarthritis Care in United States
Source: beckersorthopedicandspine.com

Higher Hospitalization Rates for Medicaid Residents : South Carolina Nursing Home Blog

For those with the state-funded assistance program, a hospital stay means several things for the facility where the patient resides. In most states, facilities are able to offer a “bed-hold,” meaning they will promise to save a space during a resident’s hospitalization. Medicaid will continue to pay an agreed upon rate.  For a nursing home resident, a new 3-day hospital stay may regenerate their Medicare benefits, increasing their daily reimbursement rate in the facility by nearly double in some cases.
Source: scnursinghomelaw.com

Community CCRx Prescription Drug Plans

This entry was posted on Monday, November 21st, 2011 at 8:46 am and is filed under Medicare Part D, prescription drug card, prescription drug coverage, Senior Health Insurance. You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site.
Source: healthinsurancesort.com

Every person with a Medicare Advantage or a Part D drug plan will also see better value in those plans for the second year in a row. Average Part D drug plan premiums will remain virtually unchanged in 2012. In New Jersey, 95.5 percent of people have access to a plan with a lower premium than they paid in 2011. Those in the Part D coverage gap, or donut hole, will continue to be able to get discounts on covered brand name drugs in the donut hole. People with Medicare will get deeper discounts in the years ahead until the gap is closed in 2020. On average, Medicare Advantage premiums will be 4 percent lower in 2012 than in 2011, and plans project enrollment to increase by 10 percent.
Source: newjerseynewsroom.com

Video: New Jersey Medicare Advantage Plans

Elizabeth Doctor Sentenced To Prison For Medicare Fraud

The fake physicians ordered tests and prescribed medications for patients, often using a pre-signed prescription pad Yousuf Masood provided. Yousuf Masood paid the unqualified individuals as little as $10 an hour, and directed them to spend no more than five to 10 minutes with patients. On some days, more than 100 patients visited the medical practice for treatment, and the majority were treated only by unqualified individuals. While they treated patients, Yousuf Masood was often either not in the office at all, or in his personal office watching TV or browsing the Internet.
Source: njtoday.net

Medicare Eligibility: Start with the Basics

Moreover, the spouse of the person eligible for the benefits of Medicare should also have been regularly paying Medicare taxes for the same period given. On the other hand, to accommodate those who are not able to regularly pay for Medicare taxes, both the beneficiaries and their spouses, Medicare still has another option for this group since as much as possible, this medical group wants to cater to every kind of medical need of all citizens of the country. For this group of people, those who are 65 years old and above should pay a certain monthly premium so that they will be remained enrolled in Medicare. If this condition will not be met, unfortunately, beneficiaries will be cut off from the Medicare list, unless other conditions will come up in the future. After learning some of the basic information on Medicare, such as knowing some points in Medicare eligibility, the person can now move on to the next step, which is to make sure that all payables are regularly paid. Although there are two options when it comes to payment scheme, it is important to weigh which is lighter to pay and more relevant.
Source: ezinemark.com

The Medicare Insurance Store

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Source: jobsinnewjerseyusa.com

Viewpoints: Private Vs. Public Medicare; N.J. Medicaid Tough Choices; IPAB’s Cost Controls

Detroit Free Press: Ending Medicare As We Know It Over the course of their working lives, an American couple earning the median household income will pay about $140,000 into Medicare; after turning 65, the same couple will collect, on average, more than three times that much in Medicare benefits. You don’t need a Ph.D. in actuarial science to recognize that this is unsustainable, especially as the ratio of retirees to workers grows. So far, though, neither major party has advanced an alternative that will preserve seniors’ access to quality health care without bankrupting the country (6/11).  Kaiser Health News: A Health Policy Reality Check (Guest Opinion)  When the Republican House voted earlier this year to repeal the health law, their slogan was “repeal and replace.” Last month, House Ways and Means Chairman Dave Camp, R-Mich., admitted the House would offer no replacement. … Two final questions: Do any Republicans still believe in the goal of universal coverage? What is the basis for moving forward together from here? (John McDonough, 6/12).
Source: kaiserhealthnews.org

How to fight against Medicare fraud?

CONTACT US If you have a Medicare question, please submit it in the comments section below. For help finding a Medicare Supplement ( Medigap ), Medicare Advantage, and a Medicare Prescription Drug Plan contact Medicare-PA-NJ-DE at 877-657-7477.
Source: medicare-pa-nj-de.com