2011 Medicare Part D Program Compared to 2010, 2009, 2008 and 2007

Posted by:  :  Category: Medicare

Pharmaceutical manufacturers will be required to provide certain beneficiaries access to discount prices for certain brand drugs purchased under Medicare Part D. The manufacturer discount prices will be equal to 50% of the plan’s negotiated price defined (minus any applicable dispensing fees). These discount prices must be applied prior to any prescription drug coverage or financial assistance provided under other health benefit plans or programs and after any supplemental benefits provided under the Part D plan. The discounted prices will be charged at the pharmacy (point-of-sale). The beneficiary will not have to do additional paperwork, etc. to receive the benefit. These manufacturer discount prices will be made available to Part D enrollees who are in the coverage gap or donut hole (they have reached or exceeded the initial coverage limit and have incurred costs below the annual out-of-pocket threshold). Medicare beneficiaries will not be eligible to receive these discount prices if they are enrolled in a qualified retiree prescription drug plan or are eligible for the low-income subsidy. The costs paid by manufacturers towards the negotiated prices of drugs covered under this manufacturer discount program shall be considered incurred costs for eligible beneficiaries and applied towards their out-of-pocket threshold. This means that the total negotiated retail drug price will be applied to the TrOOP and will count toward getting out of the doughnut hole.
Source: q1medicare.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

Medicare Plan, Medicare Plans

Aetna Medicare is an HMO/PPO/PDP plan with a Medicare contract. Enrollment in Aetna Medicare 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, provider network, premium and/or copayments/coinsurance may change on January 1 of each year.
Source: aetnamedicare.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

Contact Information and Websites of Organizations for Medicare

Posted by:  :  Category: 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

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

Eyeglasses/contact lenses

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.
Source: medicare.gov

Find Contact Information of Organizations for Medicare

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Source: medicare.gov

Contact Your Individual and Employer Groups

Select one of our plans below to find contact information for that specific plan or contact us at 1-877-988-3589 (TDD/TTY: 711 Telecommunications Relay Service) for general information about all of Coventry Health Care’s Medicare products: 8:00 a.m. – 8:00 p.m., local time, seven days a week, from October 1 – February 14 8:00 a.m. – 8.00 p.m., Monday – Friday, from February 15 – September 30  
Source: coventryhealthcare.com

Dental Insurance for Seniors on Medicare

Posted by:  :  Category: Medicare

Senior citizens all across the U.S. are seeking coverage to aid in reducing their dental expenditures. Currently, minimal government assistance is available for seniors who need dental insurance. The majority of Medicare and Medicaid programs do not include dentistry. Even those programs that do include coverage for seniors only contain provisions for extractions of teeth, and exclude the majority of the common oral procedures often required for older patients. Practically no help is available for obtaining primary tooth repair or for having missing teeth replaced. Usually Medicare and Medicaid supply virtually no aid for just about any type of oral care.
Source: medicarewire.com

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

Coventry Medicare: Dental Providers

As you’ve come to expect with Coventry Health Care the foundation of our dental program is disease prevention and maintaining optimal health. As a member, you will receive courteous and accurate responses from front-line staff. Customer support teams can help you with questions about claims, finding a provider or resolving an issue. Please carefully read the information below to determine which provider search to use.  Use the applicable provider search for your plan to find dentists in your local area.
Source: coventryhealthcare.com

Medicare Supplemental Insurance

Posted by:  :  Category: Medicare

Finding the best Medicare Supplemental insurance, Medicare Advantage, and Medicare Part D has gotten more complicated nearly every year. In 2010 Medicare Supplement Insurance added 2 new plans Medigap plan N and Medigap Plan M. At the same time they eliminated several other Medicare Supplement options. Medicare Advantage insurance plans redefine benefits and premiums every year. And, with future Medicare subsidies uncertain due to changing regulation from healthcare reform who can keep up. For many individuals Medicare Supplement Insurance is becoming the best option. Unfortunately, comparing Medicare Supplemental Insurance Plan premiums (Medigap) and Medicare Advantage plans can be a time consuming endeavor. Our highly trained insurance advisors can explain all of your supplemental Insurance options, and assist in finding the best Medicare supplement and Medicare Part D combination that best fits your specific needs. With all the options affecting Supplement insurance and Part D it makes sense to have an expert assist you through the maze.
Source: mysenioradvisorsgroup.com

Your Medicare Supplemental Insurance Information – MedicareSupplemental.com

There are exceptions to the standardization if you live in certain states, such as Massachusetts, Minnesota, and Wisconsin. Depending on your state, you may be able to buy another type of Medigap policy called Medicare SELECT (a Medigap policy that requires you to use specific hospitals and in some cases specific doctors to get full benefits). Who Provides Medicare Supplemental Insurance? Medicare supplemental insurance is provided by private insurance companies such as AARP, BlueCross BlueShield, Globe Life, Humana, Mutual of Omaha, Transamerica Life, United American, UnitedHealthcare and many others. Remember from above that Medigap insurance companies can sell you only a “standardized” Medigap policy. All Medigap policies must have specific benefits so you can compare them easily on the basis of price.
Source: medicaresupplemental.com

Medicare Supplement Insurance Quote Engine

In addition to Medicare supplement insurance, we are pleased to be participating in the Medicare Advantage market. The Medicare Advantage policy is a low cost alternative to a Medicare supplement policy and is especially advantageous for those less than 65 years old. The Private Fee For Service (PFFS) is a type of Advantage plan that allows Medicare recipient to visit any doctor, any hospital, anywhere. Therefore, many Medicare recipients are well served by the lower cost Private Fee For Service plan.
Source: bestmedicaresupplement.com

Medicare Supplement Premium Comparison Guide for 2010

PLEASE NOTE:   each rate chart contains rates for only those insurance companies licensed to sell those specific Medicare Supplement insurance plans to individuals in Illinois.  The rates listed are the approximate amount the insurers charge by age for your geographic region of the state of Illinois. This Guide has been categorized into three distinct regions and each respective region has a corresponding color within the rate charts for ease of reference:
Source: illinois.gov

Compare Medicare Supplement Insurance Plans & Medigap Plans and Rates for
2011. See Plan Chart for AL, AR, AZ, CO, FL, GA, IA, ID, KS, KY, LA, MD, MI, MO, MN, MS,
NC, NE, NM, OH, OK, SC, TN, TX, VA & WV. Medigap Insurance Plans including the
Popular Plan F & G

Year after year we have found Medicare Supplement Plan F or Medicare Supplement Plan G to be the best value for the dollar. The new Plan N is a great alternative to a Medicare Advantage plan.  Plan N might be recommended depending on which state you live in and how much the supplement cost in relation to available Medicare Advantage plans. A plan N will provide more coverage and a very reasonable premium. In Florida we have the lowest rate for plan F & plan N. See the Medicare Supplement Plan chart below. In general, the higher you go up in the plan chart the more Gaps the plan fills. Medicare Supplement Plan F is the most comprehensive supplement plan and there is not a better plan than F. Most people will select a Plan F. However, depending on your personal situation there may be a more cost efficient choice.
Source: themedicarechannel.com

Medicare Supplement Options

* Network restrictions apply. ** Policy forms UWMSP(A)-2010, UWMSP(F)-2010, UWMSP(F-HD)-2010, UWMSP(G)-2010, UWMSP(K)-2010, UWMSP(L)-2010, UWMSP(N)-2010, UWMSP-SEL(F)-2010, UWMSP-SEL(G)-2010, UWMSP-SEL(K)-2010, UWMSP-SEL(L)-2010, UWMSP-SEL(N)-2010.
Source: bcbstx.com

Pyramid Life Insurance Company

Posted by:  :  Category: Medicare

Pyramid Life Insurance Company has been meeting America’s insurance needs since 1913. Today, the company remains dedicated to helping older Americans and people with Medicare obtain valuable insurance coverage.
Source: universalamericaninsuranceplans.com

Pyramid Life Insurance Company
Review

To be accredited by BBB, a business must apply for accreditation and BBB must determine that the business meets BBB accreditation standards, which include a commitment to make a good faith effort to resolve any consumer complaints. BBB Accredited Businesses must pay a fee for accreditation review/monitoring and for support of BBB services to the public.
Source: bbb.org

Medicare Advantage Customer Service Rankings

Consumer assessment scores for drug plans are numbers between 0 and 100 (higher is better) based on enrollee responses to the following questions: In the last 6 months, how often did your health plan’s customer service give you the information or help you needed about prescription drugs? In the last 6 months, how often did your plan’s customer service staff treat you with courtesy and respect when you tried to get information or help about prescription drugs? In the last 6 months, how often did your health plan give you all the information you needed about which prescription medicines were covered? In the last 6 months, how often did your health plan give you all the information you needed about how much you would have to pay for your prescription medicine? For health plans, a similar set of questions is asked in the consumer assessment: In the last 6 months, how often did your health plan’s customer service give you the information or help you needed? In the last 6 months, how often did your health plan’s customer service treat you with courtesy and respect? In the last 6 months, how often were the forms for your health plan easy to fill out? Call center hold times were truncated to ten minutes for calls in which the call surveyor was on hold for at least ten minutes. Information on consumer assessment scores for health and drug plans comes from the CMS documents “Medicare 2014 Part C & D Display Measure Technical Notes” last updated December 12, 2013 and “Medicare 2014 Part C & D Star Rating Technical Notes” last updated April 2, 2014.
Source: healthpocket.com

Maslow’s hierarchy of needs

In one study, exploratory factor analysis (EFA) of a thirteen item scale showed there were two particularly important levels of needs in the US during the peacetime of 1993 to 1994: survival (physiological and safety) and psychological (love, self-esteem, and self-actualization). In 1991, a retrospective peacetime measure was established and collected during the Persian Gulf War and US citizens were asked to recall the importance of needs from the previous year. Once again, only two levels of needs were identified; therefore, people have the ability and competence to recall and estimate the importance of needs. For citizens in the Middle East (Egypt and Saudi Arabia), three levels of needs regarding importance and satisfaction surfaced during the 1990 retrospective peacetime. These three levels were completely different from those of the US citizens.
Source: wikipedia.org

Medicare Advantage Premiums & Costs

Posted by:  :  Category: Medicare

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

Compare Medicare Advantage & Supplemental Plans

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 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

How Medicare Advantage Plans work

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. You’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare.
Source: medicare.gov

Compare $0 Premium Medicare Advantage Plans PPO or HMO

Medicare Advantage Plans offer all of the benefits covered under Original Medicare and more. Also, most plans include Medicare Part D prescription drug coverage. To enroll in a plan, you must be eligible for Medicare Part A and B. You usually pay one monthly premium to the Medicare Advantage plan, if any, and continue to pay your Medicare Part B premium, unless otherwise paid for under Medicaid or by another third party. Medicare Advantage enrollment periods
Source: medicareoptions4u.com

Medicare Advantage 2013 Spotlight: Plan Availability and Premiums

This data spotlight report examines trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2013, premium levels and other plan features. It finds almost all plans offered this year will be available again in 2013, despite concerns that reductions in payments to plans under the Affordable Care Act would result in widespread pullouts from Medicare Advantage plans. If all beneficiaries choose to remain in their current plans, monthly premiums would increase about 10 percent, or $4, on average.
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

Medicare Facts, information, pictures

Medicare is organized into parts A through D, each of which corresponds to a different service type with a different financing scheme. Part A is a program of inpatient hospital insurance available to all Medicare beneficiaries; there is no premium, although beneficiaries are required to pay deductibles and co-payments when they use covered services. Part A is financed through a payroll tax of 2.9 percent, paid half by employers and half by employees. Part B provides coverage for outpatient services, including physician visits, therapies, and laboratory tests. Enrollment is voluntary, and beneficiaries pay a monthly premium for coverage and deductibles and co-payments at the point of service. Part B is financed through premiums and general tax revenues. Part C concerns itself with managed care plans. Part D, passed in 2003, represents the largest expansion of Medicare benefits since 1965; as of January 1, 2006, it covers some of the cost of prescription drugs for beneficiaries who enroll. In a departure from earlier Medicare policy, enrollees receive Part D benefits through private insurance plans that offer coverage for different drugs (within limits set by the government) at different premium amounts. Like Part B, Part D is financed through premiums and general revenue funds. Medicare beneficiaries may also purchase private supplementary, or Medigap, insurance policies to cover deductibles, co-payments, and uncovered services.
Source: encyclopedia.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

More Medicare Information

If you live in Puerto Rico you will not receive Medicare Medical Insurance (Medicare Part B) automatically. You will need to sign up for it during your initial enrollment period or you will pay a penalty. To sign up, please call our toll-free number at 1-800-772-1213 (TTY 1-800-325-0778). You also may contact your local Social Security office. You can find your local Social Security office by using our Office Locator.
Source: ssa.gov

Amerigroup Medicare Plans

Posted by:  :  Category: Medicare

Amerigroup was founded in 1994 to meet the needs of those enrolled in the public programs like Medicare and Medicaid. There was a rapidly growing need for private help in managing the healthcare programs for lower income and disabled Americans. Amerigroup created the Senior and Special Services Organization (SSO)in 2006. Amerigroup’s SSO initiative concentrates on utilizing Amerigroup’s assets to produce unique improved health care services for seniors and the disabled.  Products offered are targeted towards the elderly and those with disabilities. In 2007 Amerigroup was the first in the healthcare industry to develop a National Advisory Board. The focus of the Board is on meeting the needs of seniors and disabled members. The Board is chaired by Lex Frieden who was also involved in the creation of the Disabilities Act of 1990.
Source: medicaresolutions.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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

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 Advantage & Supplemental Plans

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

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

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

Medicare Supplement Plan D

To be eligible to enroll in a Medicare Supplemental Plan D policy, you must be enrolled in Original Medicare (Part A and Part B) and live in the plan’s network. The best time for an eligible beneficiary to enroll in a Medicare Supplemental Plan D policy is during their six-month Medicare Supplement Open Enrollment Period (OEP). During this period, you have the guaranteed issue right to enroll in a Plan D policy of your choosing, meaning that companies may not use medical underwriting to deny you coverage. If you have End-Stage Renal Disease (ESRD), you may only enroll in a Plan D policy during this six-month period, or else you will be subject to medical underwriting and may be denied coverage because of your pre-existing condition.
Source: ehealthinsurance.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