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

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

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

Medicare Part D Frequently Asked Questions

If a patient is new to a plan, Medicare Part D plans are required to have an appropriate transition process when the patient has been stabilized on a medication at the time they join the plan. This transition process differs from plan to plan and you, or the patient’s pharmacist, may have to contact the plan for additional information. Plans must also provide coverage for all, or substantially all, drugs in the following drug categories: antidepressants, anti-psychotics, anticonvulsants, HIV/AIDS drugs, immunosuppressants, and antineoplastics. Plans must cover at least a 30 day transition supply of medication during the first 90 days of the beneficiary’s enrollment. In the long term care setting, plans must cover at least a 31 day supply plus all necessary refills throughout the first 90 days of enrollment.
Source: ny.gov

When & how to sign up for Part A & Part B

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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

Part A late enrollment penalty

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Source: medicare.gov

How to Enroll in a Medicare Part D Drug Plan

Medicare Rights Center The Medicare Rights Center, an independent, non-profit group, is the largest organization in the United States (aside from the federal government) that provides information and assistance for people with Medicare. Its site has a section about Medicare Part D drug coverage, including information about programs that could help you pay for your prescription drug costs. A unique feature of the site is the Medicare Interactive Counselor, a tool that walks you through the process of finding the drug plan that makes sense for you.
Source: about.com

Understanding the Medicare Part D Donut Hole

Once you and your Part D drug plan have spent $2,840 for covered drugs, you will be in the donut hole. Previously, you had to pay the full cost of your prescription drugs while in the donut hole. However, in 2011, you get a 50% discount on covered brand-name prescription medications. The donut hole continues until your total out-of-pocket cost reaches $4,550. This annual out-of-pocket spending amount includes your yearly deductible, copayment, and coinsurance amounts.
Source: about.com

Illinois Medicare Advantage and Medicare Supplement Plans 2012

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Mini-COBRA Policies (Small Group) Federal Law requires large businesses to provide health insurance for their former employees up to eighteen months after a split. In most cases, smaller businesses (2-19 employees) are required to cover their employees—mini-Cobra policies. However each state has different eligibility for these “mini-Cobra” companies. In Illinois, the law requires smaller businesses to cover past employees for twenty-four months. It also covers those who are fifty-five and older until they are eligible for Medicare.
Source: medicaresolutions.com

Understanding Medicare in Illinois

Medicare Part A is basically hospital insurance. This is insurance that helps cover the costs of inpatient care in hospitals, skilled nursing facility, hospice, and home health care. Medicare Part A coverage is premium-free for most beneficiaries because it is funded by Social Security payroll taxes. However, Medicare Part A does have a deductible and depending on length of stay, daily charges. Enrollment in most cases is automatic and generally information is sent to your home a few months before you turn 65. You’re eligible for Medicare Part A coverage if you or your spouse paid into Social Security for at least 10 years while employed and you are a citizen or permanent resident of the United States.
Source: ssiinsure.com

2015 Medicare Advantage Plans Available to Residents of Illinois

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

Order a Medicare Replacement Card Online

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california medi-cal dental Drug Plan Health HIV How Social Security Works How to File a Claim for Medicare How to get a new medicare replacement card HUD lost medicare card M.D. Medi-Cal Medicaid medicaid card Medicaid Services Medicare medicare card MedicareCard MedicareCard.com MedicareCard Replacement medicare card replacement medicare coverage Medicare has Two Parts Medicare Help Medicare Part A Hospital Insurance Coverage Medicare Premium Amounts for 2010 Medicare Prescription Drug Coverage Medicare Replacement Cards Meeting Announcement MyMedicare.gov National Institutes of Health Need a Replacement Card? Order a Medicare Card by Phone or Online NIH NIMH Obama Part A (Hospital Insurance) Part B (Medical Insurance) part of the National Institutes of Health protecting my social security number replacement social security card Social Security social security card some disabled people under age 65 ssa.gov Supplier Enrolled in Medicare
Source: medicarecard.com

Medicare ID Card Replacement

If you need proof right away that you have Medicare, you can contact your local Social Security office which you can find by using this page on the Social Security web site, or call the toll-free Social Security number 800-772-1213. The Social Security office can give you proof that you can use until you get your replacement Medicare card.
Source: caring.com

REPLACEMENT MEDICARE CARD

For the Detailed and most elaborate estimate, an individual can download and install a software program on a personal computer (PC). The interactive program allows workers the most flexibility to customize their estimates based on differing scenarios and produces a variety of benefit numbers for retirement, survivors and disability benefits for both workers and their families.
Source: ssa.gov

Do you Need To Replace Your Medicare Card?

If your Medicare card is lost or damaged, you can order a new card at www.socialsecurity.gov on the web. Or, call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. If you get benefits from the Railroad Retirement Board (RRB), call your local RRB office or 1-800-808-0772, or visit www.rrb.gov on the web and select “Benefit Online Services.”
Source: q1medicare.com

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

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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

When & how to sign up for Part A & Part B

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Source: medicare.gov

Medicare Part D and TRICARE

If TRICARE-Medicare beneficiaries enroll in a prescription drug plan that adds prescription coverage to the original Medicare plan, Medicare is primary and TRICARE, as second payer, will pay their out-of-pocket costs for TRICARE-covered medications and the Medicare deductible and cost shares. When beneficiaries become responsible for 100 percent of the drug costs under the Medicare Part D drug plan, the TRICARE pharmacy benefit becomes primary payer and the beneficiary is responsible for applicable TRICARE pharmacy copays and cost shares. Once the TRICARE catastrophic cap is met, TRICARE pays 100 percent for TRICARE-covered medications.
Source: military.com

California Health Advocates: Medicare Policy, Advocacy and Education

Bonnie Burns of California Health Advocates provided oral and written testimony to the Commission on Long-Term Care. She speaks to the urgent, growing need of long-term care services, our current broken system of care, the limits of long-term care insurance, and provides several recommendations for creating a new system. Some recommendations include: looking at what’s working in other countries; drawing ideas from the deceased CLASS Act and the Federal long-term care insurance program; standardizing each element of LTC insurance policies for ease of comparison; and making personal care a mandatory benefit of each state’s Medicaid program. See written testimony (PDF).
Source: cahealthadvocates.org

What is Medicare? What is Medicaid?

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Medicare Part A, or Hospital Insurance (HI), helps pay for hospital stays, which includes meals, supplies, testing, and a semi-private room. This part also pays for home health care such as physical, occupational, and speech therapy that is provided on a part-time basis and deemed medically necessary. Care in a skilled nursing facility as well as certain medical equipment for the aged and disabled such as walkers and wheelchairs are also covered by Part A. Part A is generally available without having to pay a monthly premium since payroll taxes are used to cover these costs.
Source: medicalnewstoday.com

Centers for Medicare and Medicaid Services

The Centers for Medicare & Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (DHHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children’s Health Insurance Program (SCHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov.
Source: wikipedia.org

Summary of Medicare Benefits and Cost

Posted by:  :  Category: Medicare

The chart below is a comprehensive list of Medicare Part A and B costs, including premiums, deductibles and coinsurance. Medicare supplemental insurance, known as Medigap, can help cover some of the gaps in coverage and pay for part or all of Medicare’s coinsurance and deductibles, depending on the policy. Some Medicare Advantage (MA) plans may also help cover these costs. See Medigap: Medicare Supplemental Insurance and Medicare Advantage for more information.
Source: cahealthadvocates.org

Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline, CPT Code Billing: September 2010

MedicarePaymentandReimbursement.com provides Medicare Payments, Billing Guidelines, Fees Schedules 2010, Medicare Eligibility, 2011 Medicare Deductibles, Allowables, CPT Codes for Medicare, Phone Number, Hearing Aids, Denial, Address, Medicare Appeal, PQRI, EOB, Medicare and Medicaid Services.
Source: medicarepaymentandreimbursement.com

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

Reference-Based Pricing – Under these programs, sponsors may require enrollees to pay a defined cost-sharing amount plus supplemental cost-sharing based on the differential in cost between the drug being dispensed and a lower-cost preferred alternative such as a generic equivalent. In contract year 2009, fewer than 10% of Part D contracts used reference-based pricing. Given the complexity of reference-based pricing formulas, it is very difficult to accurately convey the extent of expected out-of-pocket spending for formulary drugs subject to reference-based pricing. For this reason, CMS has been unable to have the Medicare Prescription Drug Plan Finder (MPDPF) calculate correct pricing for drugs subject to reference-based pricing, which may distort projections of out-of-pocket expenditures for some beneficiaries and significantly affect their ability to compare cost-sharing obligations under different plans and choose the plan that best meets their needs. Based on CMS’ experience and the increased complexity, CMS has observed with these programs, CMS will eliminate the option of reference-based pricing in the Part D Prescription Benefit Program (PBP) beginning in CY 2010. The basis for this decision is CMS’ belief that reference-based pricing may be inherently misleading to beneficiaries and inconsistent with their goal of improving transparency with regard to expected beneficiary cost-sharing under the Part D program.
Source: q1medicare.com

Does Obamacare really cut Medicare Benefits to Senior Citizens?

“Write your future plans in pencil…” No truer words were spoken. Never did I think as I stood on the stage of my graduation with a Master degree and high honors that my bright future would be abruptly ended by chronic illness and disability. Yet, here I am. You stated in your article “give them the facts. I think we owe them that much”. We do owe “everyone” that much, and here are the facts. As stated by the site created by Medicare itself “It is important to remember that you may need long-term care at any age…people who have a chronic illness or disability”. It is also likely that these people, a great number who will never recover but whom will live a long life, will require the use of a type of Medicare and Medicare Advantage Plan for much longer than a senior citizen. Therefore, to represent this population, I say, yes, Obamacare frightens us. My most recent stint in the hospital, an unplanned and unexpected illness which resulted in temporary kidney damage, could have resulted in death if not for my Medicare and Medicare Advantage Plan. Even though my husband and I teeter on the brink of bankruptcy, like so many of my middle aged peers whom are suddenly unable to work due to disability, more than “sixty-three million people”, we are still able to AFFORD a medicare advantage plan. Unlike many of my peers who not only cannot afford one, but also cannot even get Medicare due to stringent rules and a long waiting line for court dates. My week long hospital stay, plus home care and rehab resulted in full recovery of my kidney function, and also a bill for nearly $50,000 which was covered primarily by Medicare and then my Medicare Advantage Plan. If not for these programs, I would have died as my husband and I are broke as a result of medical bills not covered by these two entities. This is what terrifies many Americans, disabled and elderly, who live with chronic and disabling illness. We must remember Obamacare may decide not only the future of the elderly who would like to join a gym, but the future of people of ALL ages and their families whom even under the current guidelines are struggling to SURVIVE. Yes, I am here in the trenches with so many struggling to survive with chronic illness in a country that may decided I am not worthy to do so. I think I am owed more at this juncture in my life, after all of the good I contributed to this society, than to die unnecessarily due to the financial inconvenience it may cause. We must REMEMBER them, and I, for one, think we “owe them that much”. “Lest we forget…” http://www.medicare.gov/longtermcare/static/home.asp http://content.healthaffairs.org/content/28/1/64.full
Source: forbes.com

Medicare Benefits Schedule (MBS)

MBS service statistics broken down by Commonwealth Electoral Division (CED) are available in the PDF files below. File 1 details Medicare Safety Net statistics for the 2010 calendar year of service by CED and File 2 details Medicare Bulk Billing statistics for the 2010 – 11 financial year of processing by CED. It is important that you read all notes on these files.
Source: gov.au

2012 Medicare Part D Program Compared to 2011, 2010, 2009 and 2008

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

When & how to sign up for Part A & Part B

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Source: medicare.gov

If you find Medicare sign

If you don’t sign up in your initial enrollment period or when your job-based coverage ends, you will pay a penalty that will raise your premiums for Medicare Part B and Part D for the rest of your life. Every year you delay signing up for Part B, your monthly premium rises by 10 percent — and missing the deadline by just one month is considered a one-year delay. There is also a waiting period for the coverage to kick in, so you could be without any insurance for several months, perhaps even a year, if you miss the deadline. For Part D, the penalty is 1 percent for every month’s delay. So a year’s delay would add 12 percent to the monthly drug premium base, currently set at $32.42.
Source: washingtonpost.com

Hearing and balance exams & hearing aids

Posted by:  :  Category: Medicare

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

Does Medicare Cover Hearing Aids?

Understanding and knowing the details of Medicare and what it covers can be downright confusing and this is why a common question we get at the site is, "Does Medicare pay for hearing aids?" The federal health insurance program covers people who are 65 or older, as well as some younger individuals with disabilities or severe diseases. However, Medicare does not cover all costs of medical services, which is where the rules can get tricky. There are a number of factors that affect coverage, so it is imperative that all individuals take the different kinds of coverage available into consideration. Before we get into answering the question, "Does Medicare cover hearing aids?" we need to understand what it does and does not cover. If you want to skip to the answer, click down to the section below Items not covered by Medicare.
Source: healthyhearing.com

Medicare and Hearing Aids

Some Medicare Advantage plans (Medicare Part C) cover hearing exams and hearing aids. Medicare Advantage plans often offer benefits not typically included with Original Medicare (Part A and Part B), such as routine hearing exams and hearing aids. Since each Medicare Advantage plan is different, you should compare plans carefully to find one that fits all of your medical needs. You can see if any Medicare Advantage plans in your area cover hearing aids and exams by using our Medicare Advantage plan comparison tool.
Source: ehealthmedicare.com

Does Medicare Cover Hearing Aids?

An often overlooked expense with respect to hearing aids is their batteries. Hearing aid batteries are small and they may be actively used for all waking hours unless the hearing aid user has times during the day when wearing hearing aids is unnecessary. Depending on the battery size and daily use of the hearing aid, batteries may last as little as three days. Some hearing aids with very large batteries may have the batteries’ power last around two weeks.
Source: healthpocket.com

Medicare Coverage of Hearing Aids

Despite the fact that Medicare doesn’t offer hearing aid coverage, you may enjoy coverage if fitted with a prosthetic device that improves your hearing, depending on your specific circumstances. According to the Medicare policy manual, a device qualifies as prosthetic if the cochlea, middle ear or auditory nerve is replaced by a device that produces the perception of sound such as an auditory brain stem implant or cochlear implant. An osseo-integrated implant, a device that is implanted into the skull, is also considered a prosthetic device. These options require surgery, so be sure to discuss these options with your doctor, who must approve of any prosthetic procedure.
Source: emedicaresupplements.com

Michigan Medicare Supplements :: Medicare in Michigan

Posted by:  :  Category: Medicare

The agency is also proud to offer the high deductible plan F. Anyone who has had a supplement understands that Plan F is the most popular, however usually the most expensive. For a lower cost, a consumer can have a Plan F, but with a deductible to meet after your Medicare claims have been paid by Medicare themselves first. This is turning out to be one of the best selling plans within the state at this moment. Contact us to learn more about this plan.
Source: michiganhealthbroker.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