Affordable Health Coverage

Posted by:  :  Category: Medicare

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

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

Kaiser Permanente Division of Research

The Virtual Research Office (VRO) is a new tool for physicians, nurses, researchers and staff conducting clinical research at Kaiser Permanente. This one-stop shop connects researchers with potential collaborators, training resources, project assistance and more.
Source: kaiser.org

Kaiser Permanente Careers

Advocating the total health of our members, communities, and planet starts with supporting our 192,000 employees and physicians. We know that when you are at your best, that energy translates into positively changing the world in little ways every day. Let’s work together to motivate health.
Source: kaiserpermanentejobs.org

Affordable Care Act: Obamacare & Health Reform Facts

Choice and the information to make good choices — With Health Insurance Marketplaces and the requirement for easy-to-understand language in a Summary of Benefits and Coverage, Americans will have more information and more options to choose what is best for them.
Source: kaiserpermanente.org

Kaiser Permanente California

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

Medicare Supplement Insurance

Posted by:  :  Category: Medicare

*Plans K-N provide for different cost-sharing than plans A-G. Plans K and L pay 100% of hospitalization and preventive care Basic Benefits. All other Basic Benefits are paid at 50% (Plan K) and 75% (Plan L). Once you reach the annual limit, the plan pays 100% of the Medicare copayments, coinsurance and deductibles for the rest of the calendar year. The out-of-pocket annual limit does NOT include charges from your provider that exceed Medicare-approved amounts, called “excess charges.” You are responsible for paying excess charges. Plan N covers Basic Benefits after a $20 copay for office visits and a $50 copay for emergency room visits. **The out-of-pocket annual limit may increase each year for inflation. (2015 limits shown) † Network restrictions apply
Source: bcbsil.com

Medicare Supplement Plan F

* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. ** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
Source: bcbsil.com

BCBS Medicare Supplement Insurance Plans

"I was very happy with BLUE Cross/Blue Shield of IL through Medigap Advisors as a choice for my supplemental policy. I was happy with the cost, the coverage and to be able to deal with a knowledgeable team like Medigap Advisors, who knows the product and doesn’t drown folks in paper and irrelevancies. .I would definitely recommend HSA–you don’t waste time and everything is quite clear. I also appreciate the tips you’ve been sending me on how to stay alert and abreast to what’s going on in health care today."
Source: medigapadvisors.com

Empire Blue Cross Blue Shield’s New Medicare Supplement Plans Offer More Choice and…

A Medicare Supplement policy (sometimes referred to as Medigap) is a supplemental health insurance plan sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medicare Supplement policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. If an individual is enrolled in the Original Medicare Plan and has a Medicare Supplement policy, then Medicare and Medicare Supplement will pay both their shares of covered health care costs. Empire and its affiliated health plans are the second largest provider of Medicare Supplement health benefit plans in the nation.
Source: prnewswire.com

Blue Cross Blue Shield of Illinois

By law, Medicare Supplement insurance is standardized into twelve plans (Plans A through L). That means Plan F from one company must include the same benefits as plan F from another company. While the benefits must be the same, each company’s rates, reputation, membership features and quality of service can vary. With Blue Cross and Blue Shield of Illinois, you don’t have to sacrifice comprehensive benefits or freedom-of-choice for affordability. Their Medicare Supplement plans provide substantial benefits at rates that can save you money over other plans.
Source: ilhealthagents.com

Compare Medicare Supplement Rates In Your Area

Posted by:  :  Category: Medicare

Brandon Todd has been helping people on Medicare to access quality healthcare since 1997. His undying belief is that all seniors and those with disabilities should have complete access to our healthcare system without restriction and without insurance companies standing between them and their doctors.
Source: medigap360.com

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

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

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

Dental Insurance, Individual Vision Plan, Senior, Medicare Supplement

MWG Insurance Mall is the premier health insurance site online. Here, you’ll find great support in your search for Medicare supplemental insurance, dental insurance, and many other types of coverage. We strive to make our site as accessible as possible. Find a solution for your health insurance needs by relying on us to find the perfect senior life insurance plan, vision plan, or dental coverage. If you require further guidance, reach out to us.
Source: mwginsurancemall.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

Other Medicare health plans

PACE (Program of All-inclusive Care for the Elderly) is a Medicare and Medicaid program that helps people meet their health care needs in the community instead of going to a nursing home or other care facility. PACE covers adult day primary care, dentistry, emergency services, home care, hospital care, laboratory/x-ray services, meals, medical specialty services, nursing home care, nutritional counseling, occupational therapy, physical therapy, prescription drugs, Part D covered drugs, preventive care, social services, caregiver training, support groups, respite care, social work counseling, and transportation if medically necessary.
Source: medicare.gov

Humana Medicare Dental Plans For 2014

DISCLAIMER: This website is for informational and educational purpose only. The information may be incorrect or may have changed, limitations and restrictions may apply. It is not a complete listing of plans and plans may not be available in your service area. For a complete listing please contact 1-800-MEDICARE or consult www.medicare.gov. This is not a solicitation of insurance and we are not affiliated with any insurance company. The information provided in this post was taken from the official Humana Medicare Website. It is a brief summary, not a comprehensive description of plans or benefits at the time of this post. Limitations, copayments and restrictions may apply, and benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may have changed since this post was published. Please visit the official website for current plans and details.
Source: medicareadvantagesupplementplans.com

Medicare Initial Enrollment Period

Posted by:  :  Category: Medicare

Making your Medicare selections early can help you avoid rushing to make decisions as your enrollment window closes. Also, you can get your Medicare coverage started faster, even on the first day that you are eligible. And remember, if you sign up after your enrollment period ends you may have to pay more unless you qualify for a
Source: medicaremadeclear.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 Open Enrollment Period

Beneficiaries receive information from their current plans on cost and coverage changes for the upcoming year before the Open Enrollment Period begins through a document called the Annual Notice of Change (ANOC). Plan changes may affect out-of-pocket costs prescription drugs coverage, the plan’s formulary, and offered or discontinued benefits. Beneficiaries can then analyze their life circumstances and health statuses to determine whether their current plan is right for their needs and if they need to switch plans.
Source: planprescriber.com

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

Posted by:  :  Category: Medicare

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

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

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

Medicare Advantage Dental, Medicare Advantage Dental Plan

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

Medicare Fraud Whistleblower Qui Tam Cases

Posted by:  :  Category: Medicare

Another common example of coding fraud is called “unbundling.” When procedures or lab tests involve a number of related services or tests that are typically performed together, Medicare and Medicaid have specific billing codes that must be used to obtain reimbursement for all of the associated services or tests as a whole, rather than allowing reimbursement for each of the related services or tests billed separately. For instance, blood and clinical laboratories often perform “Complete Blood Count” (“CBC”) testing as ordered by physicians. These “CBCs” usually involve up to a dozen or more tests for various enzymes, minerals, platelets, etc. However, because these CBCs are so common, the lab companies have a standard automated test that is used, rather than having to test for each component separately. Accordingly, Medicare billing codes include specific codes that must be billed to obtain a single reimbursement for all of these tests together. In the “unbundling” scheme, lab companies billing for each do not use the composite billing code, but instead bill multiple codes as though they had performed separate tests for each of the blood components. In this unbundling scheme, the lab fraudulently obtains much higher overall reimbursement than it is entitled to.
Source: warrenbensonlaw.com

Medicare & Medicaid Fraud :: Medicare Whistleblower Lawyer The Whistleblower Law Firm

If you have witnessed Medicare or Medicaid fraud, you can file an action under the False Claims Act (FCA). This federal law imposes liability on anyone who knowingly submits an inaccurate statement or record to induce the government to pay a claim. The FCA also gives individuals the right to file an action on behalf of the government for violations of its rules. This is known as a qui tam lawsuit, which is submitted to the court under seal. The Department of Justice has 60 days to decide whether or not to proceed with the claim. Depending on whether or not the government intervenes in the matter, you may receive between 15 and 30 percent of any money recovered from the defendant if the action is successful. If you are exposing unlawful conduct by your own employer, the FCA also provides protection against any retaliatory action, such as demotion or termination. Many states have similar laws that encourage whistleblowers to come forward to report any incidents of fraudulent activity.
Source: federalwhistleblowerlawyers.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

2015 Medicare Advantage Plans in Washington

Washingtonians have an opportunity to preview 2015 Medicare Advantage plans in Washington a few weeks before open enrollment, and it is always a good idea to find out if anything important has changed. As you take the time to compare Medicare Advantage, you might notice that insurers have altered the list of covered prescriptions, plan doctors, or even benefits. While no major changes are expected in 2015, some prices may go up slightly in response to increased regulations and rising health costs. 
Source: medicareadvantageplans2015.net

Medicare Consulting, Medicare Resources

Posted by:  :  Category: Medicare

Your health insurance will likely improve by going into the Medicare health system!  There are great benefits in store for you and options like Medicare Advantage has great preventive care and wellness benefits you need to explore.  Plus, the Part D RX plan is a great benefit to many Medicare beneficiaries.
Source: mymedicarequestion.com

Understanding Medicare Part A, Part B, Part C and Part D

But as complicated as all that sounds, there’s a single key choice at the core of all your decision-making: Will you go with the Original Medicare plan, which is run by the federal government and consists of Parts A and B, or a Medicare Advantage plan (also called Part C) that is offered by a private insurer and approved by Medicare? Medicare Part A — Your Hospital Coverage When you apply to Medicare, you are automatically enrolled in the Part A plan. Part A is your hospital insurance plan. It covers nursing care and hospital stays, although not doctors’ fees. Part A also covers some home health services, skilled nursing care after a hospital stay and hospice care. You likely won’t have to pay a monthly premium for Medicare Part A, thanks in part to all the payroll taxes you paid while you were employed. You must, however, pay a yearly deductible before Medicare will cover any hospitalization costs. For 2011, the Part A deductible is $1,132.
Source: aarp.org