Extra Help with Medicare Prescription Drug Plan Costs

Posted by:  :  Category: Medicare

Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.
Source: socialsecurity.gov

When can I join a health or drug plan?

During the 7-month period that starts 3 months before your 25th month of getting Social Security or RRB disability benefits and ends 3 months after your 25th month of getting disability benefits. Your coverage will begin the first day of the month after you ask to join a plan. If you join during one of the 3 months before you first get Medicare, your coverage will begin the first day of your 25th month of entitlement to disability payments.
Source: medicare.gov

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Medicare Prescription Drug, Improvement, and Modernization Act

The bill came to a vote at 3 a.m. on November 22. After 45 minutes, the bill was losing, 219-215, with David Wu (D-OR-1) not voting. Speaker Dennis Hastert and Majority Leader Tom DeLay sought to convince some of dissenting Republicans to switch their votes, as they had in June. Istook, who had always been a wavering vote, consented quickly, producing a 218-216 tally. In a highly unusual move, the House leadership held the vote open for hours as they sought two more votes. Then-Representative Nick Smith (R-MI) claimed he was offered campaign funds for his son, who was running to replace him, in return for a change in his vote from “nay” to “yea.” After controversy ensued, Smith clarified no explicit offer of campaign funds was made, but that he was offered “substantial and aggressive campaign support” which he had assumed included financial support.
Source: wikipedia.org

Medicare Part D Plans, Prescription Drug Plan (PDP)

First Health Part D First Health Part D is a Medicare-approved Part D sponsor. Enrollment in our plan(s) depends on contract renewal. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. This information is available for free in other languages. Please call our customer service number at 1-855-389-9688 (TTY/TDD 711), 8 a.m. to 8 p.m., seven days, from October 1 – February 14; 8 a.m. to 8 p.m. Monday – Friday, from February 15 – September 30. Medicare beneficiaries may also enroll in Coventry plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.
Source: coventryhealthcare.com

www.Q1Medicare.com Your Source for Medicare Part D Plan Information

You can enroll into a stand-alone Medicare Part D Prescription Drug plan or a Medicare Advantage plan during the Annual Enrollment Period (or AEP) or open enrollment period starting October 15th and continuing for seven weeks through December 7th with your newly selected Medicare plan starting on January 1st of the following year. Please note that if you are just turning 65 or are newly eligible for Medicare, you will be granted a seven (7) month enrollment period when you can join a Medicare Part D or Medicare Advantage plan. The seven month period begins three months before your Medicare eligibility (or birthday) month, includes your eligibility month, and continues for three months after your Medicare eligibility month. However, your Medicare plan can begin no sooner than the first day of your Medicare eligibility month. Enrolling in a Medicare Part D or Medicare Advantage plan is easy and takes little time. : : Click here if you already know       which Medicare Part D plan you want : : Click here to search for a       Medicare Part D plan : : Click here to search for a       Medicare Advantage plan The good news about enrollment is that you always pay the same amount for a Medicare D plan or Medicare Advantage plan, no matter where or how you enroll. As an expanded feature, we now provide enrollment options for all 2015 Medicare Part D plans and Medicare Advantage plans across the country. If you wish, you can also enroll directly with Medicare (1-800-Medicare) or with an insurance agent or the Medicare plan provider. No matter how you enroll in to a Medicare plan, the enrollment result should always be the same and in 7 to 10 business days you should receive your Medicare Part D new Member information. Once enrolled into a Medicare Part D or Medicare Advantage plan, you can contact the plan’s Member Services department with any questions or concerns. The toll-free number will be on the back of your Member ID card. Please note that the Medicare Advantage Dis-Enrollment Period (MADP) for Medicare Advantage Plans beginsJanuary 1st and continues through February 14th — during the MADP members of Medicare Advantage plans can switch back to original Medicare and join a stand-alone Medicare Part D drug plan.
Source: q1medicare.com

Extra Help with Medicare Prescription Drug Plan Cost Forms and Publications

Appeal the decision we made about your eligibility for Extra Help by completing an Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1021) in English or Español. Find Instructions for Completing the Appeal form in English or Español.
Source: ssa.gov

Medicare Advantage Definition

Posted by:  :  Category: Medicare

Hospital and medical insurance (for senior citizens and others who qualify for Medicare) provided by private companies rather than the federal government. Medicare Advantage plans, also called “Part C” plans, provide the same Part A (hospital) and Part B (medical) coverage that Medicare does, with the exception of hospice care. They usually provide Part D (drug) coverage as well. As of 2014, about one-third of Medicare participants used a Medicare Advantage plan. Medicare pays the premiums for participants in Medicare Advantage plans.
Source: investopedia.com

Medicare.gov: the official U.S. government site for Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Medicare Advantage vs. Medicare Supplement

When you enroll in a Medicare Advantage plan, you move completely into a private health insurance plan. That means your insurance company covers all your healthcare bills. Insurance companies must provide the same level of coverage as Original Medicare with their Medicare Advantage plans, with the exception of hospice care. The end result of the two programs is about the same; they just go through a different setup.
Source: ehealthinsurance.com

Medicare Premiums and Deductibles for 2014

Posted by:  :  Category: Medicare

As you can see, premiums and deductibles can vary depending on the Medicare plans you select; and many costs have changed for Medicare plans in 2015. Would you like to ask me other questions? Learn more about me by clicking the orange button below my photo. There are also links below that let you schedule a phone appointment or have me email you more information. Want to compare plans on your own? Use the blue Find Your Plan button on the right side of this page. Or, for personalized assistance, just call us at 1-844-847-2659 (or TTY users, call 711).
Source: medicare.com

Medicare Advantage Premiums & Costs

By submitting this form, you agree that a licensed sales agent may contact you to discuss the specific types of products listed above and you acknowledge that you have read and understand PlanPrescriber’s Terms and Conditions. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the “gaps” in original Medicare coverage.
Source: planprescriber.com

California Medicare Plans Benefits And Premium Information Publications And Forms

We provide access to plan benefit guides, forms and publications along with general and specific insurance information for all California beneficiaries. You will find many details and links listed on this site. You may also make an instant request for materials or call our Toll-Free Medicare insurance helpline which is 800-458-7805 Need Help Fast?? Click Here  You should seek the advice of an insurance professional if you are not sure how each insurance plan works. You should not have to pay for the consultation since insurance brokers are usually paid directly from insurance companies. A good Broker or Agent should give you a non-biased opinion of many plans and answer your specific questions. We have a staff of insurance professionals available to answer any of your questions and we will provide you with specific enrollment materials or Medicare Plan summary of benefits by request. 2012 Medicare And You Hand Book Please feel free to use any of our resources and don’t hesitate to call our helpline at any time. We are happy to answer questions and provide you with any forms or publications that you may need. Individual Non Medicare Insurance From AETNA For Those Under 65 You may download anything you would like from this site for free or you may also visit our other site at www.todaysmedicare.com check back often. This site will be updated regularly. Check back often for updated information or call our Toll Free Helpline 1-800-683-6729
Source: californiamedicare.org

New York Medicare Advantage Plans for 2015 from Touchstone Health

Posted by:  :  Category: Medicare

We understand that everyone has different health care needs. That is why we have a robust selection of Medicare plans to choose from including plans with or without prescription drug coverage and a plan for those who qualify for Medicaid.
Source: touchstoneh.com

EmblemHealth: Medicare Coverage

All Medicare Advantage Plans and Medicare Prescription Drug Plans agree to stay in the program for a full calendar year at a time. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year. Each year, plans can decide whether to continue to participate with Medicare Advantage or Medicare Prescription Drug Plans. A plan may continue in their entire service area (geographic area where the plan accepts members) or choose to continue only in certain areas. Also, Medicare may decide to end a contract with a plan. Even if your Medicare Advantage Plan or Prescription Drug Plan leaves the program, you will not lose Medicare coverage. If a plan decides not to continue for an additional calendar year, it must send you a letter at least 90 days before your coverage will end. The letter will explain your options for Medicare coverage in your area.
Source: emblemhealth.com

CarePlus Florida 2011 Medicare Advantage Plans

Posted by:  :  Category: Medicare

CareDirect (HMO SNP) Plan in Miami-Dade county and CareComplete (HMO) Plan will not be renewing its Medicare contract effective January 1, 2012. You may choose to enroll in our plan, but your coverage will automatically end on December 31, 2011. Because this plan ends on December 31, 2011, if you decide to join, you are entitled to enroll in a new MA plan or PDP beginning December 8,2011 through February 29,2012. However, if you want your enrollment in the new plan to take effect on January 1, 2012, the new plan must receive your application by December 31st. You may also have the option of enrolling in a Medicare Cost Plan, if one is offered in your area. If you do not enroll in another MA plan, Medicare Cost Plan or PDP by December 31, 2011, you will be disenrolled from our plan and enrolled in Original Medicare on this date.
Source: care-plus-health-plans.com

Annual Statistical Supplement, 2011

Beginning January 1, 2006, upon voluntary enrollment in either a stand-alone PDP or an integrated Medicare Advantage plan that offers Part D coverage in its benefit, subsidized prescription drug coverage. Most FDA-approved drugs and biologicals are covered. However, plans may set up formularies for their drug coverage, subject to certain statutory standards. (Drugs currently covered in Parts A and B remain covered there.) Part D coverage can consist of either standard coverage or an alternative design that provides the same actuarial value. (For an additional premium, plans may also offer supplemental coverage exceeding the value of basic coverage.) Standard Part D coverage is defined for 2006 as having a $250 deductible, with 25 percent coinsurance (or other actuarially equivalent amounts) for drug costs above the deductible and below the initial coverage limit of $2,250. The beneficiary is then responsible for all costs until the $3,600 out-of-pocket limit (which is equivalent to total drug costs of $5,100) is reached. For higher costs, there is catastrophic coverage; it requires enrollees to pay the greater of 5 percent coinsurance or a small copay ($2 for generic or preferred multisource brand and $5 for other drugs). After 2006, these benefit parameters are indexed to the growth in per capita Part D spending (see Table 2.C1). In determining out-of-pocket costs, only those amounts actually paid by the enrollee or another individual (and not reimbursed through insurance) are counted; the exception is cost-sharing assistance from Medicare’s low-income subsidies (certain beneficiaries with low incomes and modest assets will be eligible for certain subsidies that eliminate or reduce their Part D premiums, cost-sharing, or both) and from State Pharmacy Assistance Programs. A beneficiary premium, representing 25.5 percent of the cost of basic coverage on average, is required (except for certain low-income beneficiaries, as previously mentioned, who may pay a reduced or no premium). For PDPs and the drug portion of Medicare Advantage plans, the premium will be determined by a bid process; each plan’s premium will be 25.5 percent of the national weighted average plus or minus the difference between the plan’s bid and the average. To help them gain experience with the Medicare population, plans will be protected by a system of risk corridors, which allow Part D to assist with unexpected costs and to share in unexpected savings; after 2007, the risk corridors became less protective. To encourage employer and union plans to continue prescription drug coverage to Medicare retirees, subsidies to these plans are authorized; the plan must meet or exceed the value of standard Part D coverage, and the subsidy pays 28 percent of the allowable costs associated with enrollee prescription drug costs between a specified cost threshold ($250 in 2006, indexed thereafter) and a specified cost limit ($5,000 in 2006, indexed thereafter).
Source: ssa.gov

Michigan Medicare Health Insurance Plans

Medicare is a health insurance program run by the government for people age 65 and older, and for people under 65 with certain disabilities. Understanding more about Medicare will make it easier to choose the right plan. Our Medicare 101 section has resources to help you do that.
Source: bcbsm.com

2014 Medicare Part D Program Compared to 2013, 2012, 2011 and 2010

The 2014 plan year standardized, combined Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) document will be mailed to current members of all Medicare Advantage (MA) plans, Medicare Advantage with Prescription Drug Coverage (MA-PD) plans, Prescription Drug Only (PDP) plans and cost-based plans offering Part D. MA and MA-PD plans must ensure current members receive the combined ANOC/EOC by September 30, 2013. Plans have the option to include Pharmacy/Provider directories in this mailing. All plans offering Part D must mail their Low-Income Subsidy (LIS) riders and abridged or comprehensive formularies with the ANOC/EOC to ensure current member receipt by September 30, 2013. Exception: Dual Eligible Special Needs Plans (SNPs) that are fully integrated with the State must mail an ANOC with the Summary of Benefits (SB) for member receipt by September 30, 2013 and then send the EOC for member receipt by December 31, 2013. Fully Integrated Dual Eligible SNPs that send a combined, standardized ANOC/EOC for member receipt by September 30, 2013 are not required to send an SB to current members. Note: With the exception of the ANOC/EOC, LIS Rider, and abridged or comprehensive formularies, no additional materials may be sent prior to the beginning of when marketing activities may begin on October 1.
Source: q1medicare.com

Medicare Plans are Confusing, We Make Medicare Less Frustrating.

Medicare Advantage insurance is a replacement to Original or Traditional Medicare Parts A and B – it is offered instead by private insurance companies. Medicare Advantage plans generally feature additional benefits and have less cost-sharing than Traditional Medicare, and you may be required to pay a monthly premium in exchange for the added benefits that the Medicare Advantage plan features. Medicare Advantage plans come in many different flavors and formats such as: HMO plans, PPO plans, PFFS plans, and special needs plans. Seniors may only enroll in Medicare Advantage plans if they already have both Medicare Part A and Medicare Part B and then only during specially designated enrollment periods. The Medicare enrollment periods change often, so please call us at: 1-(866)-866-7951 to find out when the next open enrollment period starts so you can enroll in this type of Medicare Plan.
Source: medicareplanstoday.com

Medicare Advantage 2014 Spotlight: Plan Availability and Premiums

While many organizations offer Medicare Advantage plans, a few – particularly Humana, United Healthcare, and the Blue Cross and Blue Shield (BCBS) affiliates – have particularly large geographic spread and these organizations historically account for a disproportionate share of enrollment. In 2014, 44 percent of available plans are being offered by one of these three firms or affiliates (Table A4).  Plans offered by these firms are available to most beneficiaries.  Nationwide, 83 percent of Medicare beneficiaries will have access to one or more Humana plans, 73 percent will have access to a BCBS affiliated plan (including BCBS plans offered by Wellpoint), and 68 percent will have access to a United Healthcare plan (Exhibit 5; Table A5).  The general availability of these firms’ products has not noticeably changed from 2013 to 2014.  However, the similarities in BCBS offerings from 2013 to 2014 obscure a decline in availability of BCBS branded Wellpoint plans (declining from 88 plans to 55 plans between 2013 and 2014), which is mostly offset by the growth in plans offered by other BCBS affiliates (growing from 205 plans to 233 plans between 2013 and 2014).
Source: kff.org

Medicare.gov: the official U.S. government site for Medicare

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Washington Medicare Plans

To qualify for any one of these programs, participants must have assets below $6,600 or be part of a couple with assets below $9,910. State Health Insurance Assistance Program Washington’s Statewide Health Insurance Benefits Advisors (SHIBA) HelpLine provides free, unbiased information about healthcare coverage and access to help improve the lives of all Washington State residents. Assistance is offered to consumers of all ages and walks of life through a network that includes over 519 volunteers, 20 non-profit organizations who sponsor the program at the local level, and numerous community-based partners. A cadre of bi-lingual volunteers, translated publications, and the AT&T Language Line are available to help all clients regardless of English language literacy. http://www.insurance.wa.gov/shiba/index.shtml High-Risk Pool The Washington State Health Insurance Pool offers individual insurance plans on the basis of medical eligibility. Washington is unusual in offering a plan to both adults and Medicare recipients. Medicare recipients must prove that they have limited access to Medicare Supplement and Medicare Advantage plans to qualify for the latter plan. For adults under sixty-five, the high-risk pool is open on the basis of medical eligibility. https://www.wship.org/default.asp Low-Income Subsidy (“extra-help”) for Prescription Drugs This program is a subsidy for Part D recipients with resources under $13,070 (or $26,120 for a couple) to receive money towards a Medicare prescription drug plan. The benchmark of support is different depending on which region of the country you live in. In Washington in 2012, the low-income subsidy was $36.45 per month.
Source: medicaresolutions.com

Kaiser Permanente California

Posted by:  :  Category: Medicare

WASHINGTON, D.C. — Nearly all Kaiser Permanente hospitals (pdf) have been given an A rating for patient safety — and none lower than a B — in a new national report card issued Wednesday by The Leapfrog Group. While Kaiser Permanente hospitals were rated among the safest in the country, hospitals nationwide fared far worse. Of the more than 2,600 hospitals that were graded in the report, nearly half (47 percent) received a C grade or lower. In California, it was a similar story. Of the 264 hospitals in California that were rated, 109 (or 41 percent) received a C grade or lower. The complete list of Leapfrog Hospital Safety Score results can be found at www.hospitalsafetyscore.org.
Source: kaiserinsuranceonline.com

Affordable Health Coverage

Rating and national average are based on Controlling High Blood Pressure 2013 ratings from the Healthcare Effectiveness Data and Information Set (HEDIS) for commercial plans published by the National Committee for Quality Assurance. HEDIS is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service. HEDIS is a registered trademark of the National Committee of Quality Assurance (NCQA). For more information, visit ncqa.org.
Source: kaiserpermanente.org

Kaiser Permanente Health Insurance: Get Quotes, View Plans & Apply

Kaiser Permanente offers one of the most advanced systems of integrated care in the world. The Health Plan, the Physicians, the Medical Facilities and the Electronic Medical Record System are all working together to get you well, keep you well, and help you thrive.
Source: kaiserquotes.com

Georgia Health Care Plans

How much sugar is really in that granola bar? Just because a drink is orange, does that mean it’s orange juice? Is it Fruit, or False?  And how many roads must a man walk down before he reaches 10,000 steps?  Find out these answers and more with “What’s in that Lunch, Anyway?!?” and get the recipe to be a healthier you.
Source: kaiserpermanente.org

Quality Health Care Coverage Provider

Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. received the highest numerical score among commercial health plans in the Mid-Atlantic region (VA, MD, D.C.) in the proprietary J.D. Power and Associates 2014 U.S. Member Health Plan Study℠. Study based on 34,315 total member responses, measuring six plans in the Mid-Atlantic region (excludes Medicare and Medicaid). Proprietary study results are based on experiences and perceptions of members surveyed December 2013-January 2014. Your experiences may vary. Visit jdpower.com.
Source: kaiserpermanente.org

Dental Health Plans & Services

We believe in preventive care, so it’s natural that we’d design plans with this in mind. Since mid-2008 we’ve offered PreventaMax with some Oregon and Washington Traditional Dental and PPO plans. With PreventaMax, preventive and diagnostic care does not apply toward annual benefit maximums. Currently, it’s the only plan design of its kind in our area that puts an emphasis on preventive care.
Source: kaiserpermanentedentalnw.org

Preferred Provider Organization Plan PPO

Care Management—Permanente Advantage (PA) brings the values and experience of Permanente medicine to our POS members. With PA providing care coordination and member support, you will experience better outcomes, lower medical bills and decreased number of days spent in the hospital or recovering.  PA is accredited by URAC, previously known as the Utilization Review Accreditation Commission. URAC ensures that health programs meet national quality standards.
Source: kaiserpermanente.org

Compare Medicare Advantage & Supplemental Plans

Posted by:  :  Category: Medicare

Medicare Advantage insurance is offered by private insurance companies with a Medicare contract, and replaces Original Medicare Part A and Part B. You must continue to pay your Part B premiums. Medicare Advantage plans typically offer additional benefit options and have less cost-sharing than Original Medicare, and you may have to pay a monthly premium in return for the extra benefits. Medicare Advantage plans come in a variety of formats, such as HMO, PPO and PFFS plans, as well as special needs plans. Medicare beneficiaries can enroll in Medicare Advantage plans if they have Medicare Part A and Part B, but only during designated enrollment periods. These enrollment periods change from time-to-time, so please call us to get the most-up-to-date information.
Source: medicaresolutions.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Compare Medicare Supplement (Medigap) Plans and Rates in Your Area

"Times have changed since my mother had an AARP J plan and I was totally confused by the options available. Stan walked me through the process in a very educational, methodical, friendly way, and I feel secure now that we’re making the correct decision to provide the best possible coverage for my husband." – Pat K.
Source: medigap360.com

Medicare.gov: the official U.S. government site for Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Compare Medicare Supplement Insurance Plans

Every Medicare supplemental plan must follow federal and state laws designed to protect you. Medicare supplement plan insurance companies can only sell you a “modernized” Medicare supplemental plan identified by letters A through N. Each modernized Medicare supplemental plan must offer the same basic benefits, no matter which insurance company sells it.
Source: medicaresupplementplans.com

Compare All Medicare Plan Options

Coverage is available to residents of the service area and separately issued by one of the following plans: Wellmark Blue Cross and Blue Shield of Iowa,* Blue Cross and Blue Shield of Minnesota,* Blue Cross and Blue Shield of Montana,* Blue Cross and Blue Shield of Nebraska,* Blue Cross Blue Shield of North Dakota,* Wellmark Blue Cross and Blue Shield of South Dakota,* Blue Cross Blue Shield of Wyoming.*
Source: wellmark.com

Medicare Supplement Plans & Quotes

Turning 65 is stressful, and the amount of information people receive leading up to their birthday is astounding. From the stacks of mail piling up on your desk, to the seemingly endless phone calls and quotes from insurance companies and agents, the task of gathering honest, unbiased information can feel impossible. Our goal is to offer what nobody else will, which is why we provide medicare supplement quotes, financial ratings, benefit information, application fee data, price history, and pricing methodology for all supplemental insurance companies in one clean, concise report. Our free, no obligation service is designed to give you the information you need regarding Part D and Medicare Supplement Plans in order to make an educated purchasing decision. In addition, we offer continued support for all of our customers to ensure they have no claims or billing issues. On an annual basis we review all medicare supplement insurance quotes and plan options in an effort to notify our customers of any new or better plans that may be available.
Source: medicaresupplementshop.com

Compare Medicare Supplement Plans A

If an insurance company wants to sell Medicare Supplement Insurance, they are required by law to offer Medigap Plan A. If they wish to offer any additional plans, then they must sell either Plan C or Plan F in addition to any other plans they would like to sell. Providers do not have to offer every Medicare Supplement plan.
Source: ehealthinsurance.com

Compare 2014 / 2015 Medicare Part D PDP Plans

AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN IS KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY
Source: q1medicare.com

Medicare.gov: the official U.S. government site for Medicare

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

West Virginia Bureau for Children and Families

West Virginia Bureau for Children and Families NOTE: You are using an outdated browser. In order to view, use, and enjoy this site to the fullest, we strongly recommend upgrading your browser to one that supports web standards.
Source: wvdhhr.org

Does Medicare Cover Children?

Medicaid, however, is a different federal health insurance program which can cover children if their families have low income and few assets other than their home. If a family qualifies for Medicaid coverage, almost all of a child’s health care needs can be paid for, with only very small copayments by the family. To find out more about eligibility for Medicaid for children, and to find out about specific programs that expand coverage to children beyond standard Medicaid coverage, go to the Medicaid page of the web site of the Centers for Medicare and Medicaid Services.
Source: caring.com

Contact Information and Websites of Organizations for Medicare

You have the option of downloading the data used by the Helpful Contacts tool onto your computer. The data will be downloadable as zipped Microsoft Access databases. Health policy researchers and the media primarily use this function. For information about contacts in a particular geographical area, you should use the Helpful Contacts tool instead of downloading the data.
Source: medicare.gov

Annual Statistical Supplement, 2011

Posted by:  :  Category: Medicare

Beginning January 1, 2006, upon voluntary enrollment in either a stand-alone PDP or an integrated Medicare Advantage plan that offers Part D coverage in its benefit, subsidized prescription drug coverage. Most FDA-approved drugs and biologicals are covered. However, plans may set up formularies for their drug coverage, subject to certain statutory standards. (Drugs currently covered in Parts A and B remain covered there.) Part D coverage can consist of either standard coverage or an alternative design that provides the same actuarial value. (For an additional premium, plans may also offer supplemental coverage exceeding the value of basic coverage.) Standard Part D coverage is defined for 2006 as having a $250 deductible, with 25 percent coinsurance (or other actuarially equivalent amounts) for drug costs above the deductible and below the initial coverage limit of $2,250. The beneficiary is then responsible for all costs until the $3,600 out-of-pocket limit (which is equivalent to total drug costs of $5,100) is reached. For higher costs, there is catastrophic coverage; it requires enrollees to pay the greater of 5 percent coinsurance or a small copay ($2 for generic or preferred multisource brand and $5 for other drugs). After 2006, these benefit parameters are indexed to the growth in per capita Part D spending (see Table 2.C1). In determining out-of-pocket costs, only those amounts actually paid by the enrollee or another individual (and not reimbursed through insurance) are counted; the exception is cost-sharing assistance from Medicare’s low-income subsidies (certain beneficiaries with low incomes and modest assets will be eligible for certain subsidies that eliminate or reduce their Part D premiums, cost-sharing, or both) and from State Pharmacy Assistance Programs. A beneficiary premium, representing 25.5 percent of the cost of basic coverage on average, is required (except for certain low-income beneficiaries, as previously mentioned, who may pay a reduced or no premium). For PDPs and the drug portion of Medicare Advantage plans, the premium will be determined by a bid process; each plan’s premium will be 25.5 percent of the national weighted average plus or minus the difference between the plan’s bid and the average. To help them gain experience with the Medicare population, plans will be protected by a system of risk corridors, which allow Part D to assist with unexpected costs and to share in unexpected savings; after 2007, the risk corridors became less protective. To encourage employer and union plans to continue prescription drug coverage to Medicare retirees, subsidies to these plans are authorized; the plan must meet or exceed the value of standard Part D coverage, and the subsidy pays 28 percent of the allowable costs associated with enrollee prescription drug costs between a specified cost threshold ($250 in 2006, indexed thereafter) and a specified cost limit ($5,000 in 2006, indexed thereafter).
Source: ssa.gov

Medicare Is More Efficient Than Private Insurance

It is a flawed argument to assert that Medicare is more efficient because they have a lower percentage of total cost that goes to administrative costs. That percentage is the result of a numerator (admin cost) divided into a denominator (total revenue). The percentage is affected by both numbers and it is clear that Medicare, due to the advanced age of its enrollees, spends more per enrollee on benefits, which lowers the MLR or administrative cost percentage. I also agree that the assertion that Medicare pays for collection of taxes, fraud and abuse protections and building costs is contrary to other sources, and the link provided did not elucidate that assertion. A truer measure of efficiency in administration of Medicare would be the actual cost per enrollee for similar administrative tasks since Medicare does not have all of the required administrative duties that a private company would (marketing, pre-certification, negotiations with providers, claim review, sufficient customer service, sales, etc). Some sources assert that Medicare pays MORE per enrollee for admin, even though they perform fewer administrative tasks.
Source: healthaffairs.org