Understanding Medicare in Illinois

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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

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

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Source: medicare.gov

Claim Status Request and Response

Posted by:  :  Category: Medicare

Providers have a number of options to obtain claim status information from Medicare contractors: •Providers can call the provider help lines for their local Part A and Part B Medicare Administrative Contractor (MAC) and ask to speak to a customer service representative. •Providers can enter data via Interactive Voice Response (IVR) telephone systems operated by Medicare contractors. •Providers can enter claim status queries via direct data entry screens maintained by Medicare contractors. •Providers can send a Health Care Claim Status Request (276 transaction) electronically and receive a Health Care Claim Status Response (277 transaction) back from Medicare. The electronic 276/277 process is recommended since many providers are able to automatically generate and submit 276 queries as needed, eliminating the need for manual entry of individual queries or calls to a contractor to obtain this information. Submission of 276 queries and issuance of 276 responses should be less expensive for both providers and for Medicare. In addition, the 277 response is designed to enable automatic posting of the status information to patient accounts, again eliminating the need for manual data entry by provider staff members. If unsure whether your software is able to automatically generate 276 queries or to automatically post 277 responses, you should contact your software vendor or billing service.
Source: cms.gov

Filing a Medicare Claim and Checking the Status

If you have Original Medicare, the amount you pay at the time you receive a health service will depend on whether your doctor is a Medicare-participating provider and accepts assignment. Medicare-participating providers are on contract with Medicare to accept and treat patients for all Medicare-covered services and supplies. A provider that accepts assignment agrees to accept the Medicare-approved amount as full payment for a covered service or supply. In this instance, the provider is required to file Medicare claims for any services you received, and Medicare will pay the provider directly for those services. The provider is not allowed to charge you to submit the claim.
Source: planprescriber.com

Medicare Eligibility Guidelines

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The patient has either of the following: a) Current pressure ulcer or past history of a pressure ulcer on the area of contact with the seating surface; or b) Absent or impaired sensation in the area of contact with the seating surface or inability to carry out a functional weight shift due to one of the following diagnoses: spinal cord injury resulting in quadriplegia or paraplegia (344.00-344.1), other spinal cord disease (336.0-336.3), multiple sclerosis (340), other demyelinating disease (341.0-341.9), cerebral palsy (343.0-343.9), anterior horn cell diseases including amyotrophic lateral sclerosis (335.0-335.21, 335.23-335.9), post polio paralysis (138), traumatic brain injury resulting in quadriplegia (344.09), spina bifida (741.00-741.93), childhood cerebral degeneration (330.0-330.9), Alzheimer

Consumer Information and Insurance Oversight

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Source: cms.gov

Medigap (Medicare Supplement Health Insurance)

A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will each pay its share of covered health care costs. Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium ($96.40 in 2011 for most beneficiaries). In addition, you will have to pay a premium to the Medigap insurance company. As long as you pay your premium, your Medigap policy is guaranteed renewable. This means it is automatically renewed each year. Your coverage will continue year after year as long as you pay your premium. In some states, insurance companies may refuse to renew a Medigap policy bought before 1992. Insurance companies can only sell you a “standardized” Medigap policy. Medigap policies must follow Federal and state laws. These laws protect you. The front of a Medigap policy must clearly identify it as “Medicare Supplement Insurance.” It’s important to compare Medigap policies, because costs can vary. The standardized Medigap policies that insurance companies offer must provide the same benefits. Generally, the only difference between Medigap policies sold by different insurance companies is the cost. You and your spouse must buy separate Medigap policies.Your Medigap policy won’t cover any health care costs for your spouse. Some Medigap policies also cover other extra benefits that aren’t covered by Medicare. You are guaranteed the right to buy a Medigap policy under certain circumstances. For more information on Medigap policies, you may call 1-800-633-4227 and ask for a free copy of the publication “Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare.” You may also call your State Health Insurance Assistance Program (SHIP) and your State Insurance Department. Phone numbers for these Departments and Programs in each State can be found in that publication.
Source: cms.gov

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

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Source: medicare.gov

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

Extra Help with Medicare Prescription Drug Plan Costs

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: ssa.gov

Medicare and Medicaid Help

For Medicare recepients who are researching whether a specific procedure is covered, there is the Coverage Issues Manual. The manual addresses coverages issues for clinical trials, medical procedures, supplies, diagnostic services, prosthetic devices, and nursing services. Medicaid Expansion State by State discussion provided by Coverage Counts Many low-income adults could gain access to Medicaid “a state-based health program” through a provision in the Affordable Care Act health reform law. Each state determines who is eligible for health care under Medicaid; in most states, people who qualify must have a low income and be under the age of 18, pregnant or have specific diseases. The health reform law gives each state the option to expand Medicaid coverage and include all people who earn less than 133 percent of the federal poverty level; Currently, the costs of Medicaid coverage are split evenly between states and the federal government. Under the expansion, the federal government will reimburse at least 90 percent of states’ Medicaid costs. Medicare Primer This booklet is designed to familiarize individuals with the Medicare program with an emphasis on prescription coverage and utilization. The primer contains:
Source: patientadvocate.org

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

State Health Insurance Assistance Program (Ship), Medicare Claims Union County, Division Of Senior Affairs

• Do you have problems or questions regarding your health insurance? • How much insurance do you really need? • What can you do if Medicare denies payment for a claim? • Who do you call if you have questions about a claim? • What are the gaps in Medicare coverage? • Does Medicare pay for nursing home care? • What is the difference between original Medicare and Medicare   Advantage plans? • What do you need to know before selecting a prescription drug plan?
Source: sageeldercare.org

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

Social Security Tax / Medicare Tax and Self

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The United States has entered into social security agreements with foreign countries to coordinate social security coverage and taxation of workers employed for part or all of their working careers in one of the countries. These agreements are commonly referred to as Totalization Agreements. Under these agreements, dual coverage and dual contributions (taxes) for the same work are eliminated. The agreements generally make sure that social security taxes (including self-employment tax) are paid only to one country. You can get more information on the Social Security Administration’s Web site.
Source: irs.gov

Medicare & Medicaid Cost Report l Owner Administrator Forum Seminar

Posted by:  :  Category: Medicare

Medicare Training & Consulting, Inc., was founded by Jim Plonsey in the Chicago area. After training Medicare auditors for Blue Cross Association, Jim established a business training Medicare auditors. This lead to doing cost reimbursement seminars for providers, most notably, home health agencies. Medicare Training & Consulting, Inc. has become a leader in providing Owners and Administrators with the reimbursement strategies.
Source: medicareconsulting.net

CMA Health Policy Consultants

2015 will also usher in a new Congress. Many of its leaders and members will likely champion plans to further privatize Medicare. These proposals will likely surface despite increasing reports that Medicare costs and the federal deficit are declining, and that traditional Medicare costs less than private Medicare. Once again we will likely hear about plans to transform Medicare to “Premium Support” (a voucher towards the purchase of private insurance). We will probably read about proposals to increase the age of Medicare eligibility, decrease the value of Supplemental Medicare Insurance (Medigap), redesign Medicare to make it “simpler” (but less useful for most beneficiaries). We urge you to listen carefully for these and other such plans. And respond!
Source: cmahealthpolicy.com

Medicare Supplemental Insurance Consultants

We deliver what insurance companies can’t -unbiased, and objective advice. This is critical – Insurance company employees are paid to enroll you in their plan and by definition can not be objective. We can enroll you in any plan you choose, help with plan selection and provide ongoing, expert advice on all Medicare Insurance plans. As Medicare specialist we focus on products for people with Medicare – not generalist offering some medicare products.
Source: mysenioradvisorsgroup.com

Independent Insurance Consultants

Enrolling in part B is your choice. You can sign up for Part B anytime during a 7 month period that begins 3 months before you turn 65. Visit your local Social Security office, or call the Social Security Administration at 1-800-772-1213 to sign up. If you choose to have Part B, the premium is usually taken out of your monthly Social Security, Railroad Retirement, or Civil Service Retirement payment. If you do not get any of the above payments, Medicare sends you a bill for your part B premium every 3 months. You should get your Medicare premium bill by the 10th of the month. If you do not get your bill by the 10th, call the Social Security Administration at 1-800-772-1213, or your local Social Security office. If you get benefits from the Railroad Retirement Board, call your local RRB office or 1-800-808-0772.
Source: iictn.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

Social Security Tax / Medicare Tax and Self

The United States has entered into social security agreements with foreign countries to coordinate social security coverage and taxation of workers employed for part or all of their working careers in one of the countries. These agreements are commonly referred to as Totalization Agreements. Under these agreements, dual coverage and dual contributions (taxes) for the same work are eliminated. The agreements generally make sure that social security taxes (including self-employment tax) are paid only to one country. You can get more information on the Social Security Administration’s Web site.
Source: irs.gov

Medicare Surtax on Wages and Self

The Additional Medicare Tax was legislated as part of the Patient Protection and Affordable Care Act, and amended by the Health Care and Education Reconciliation Act of 2010. These two laws reformed the health care market by requiring individuals to obtain health insurance or pay a tax penalty. The additional Medicare tax was included as a revenue raiser in that legislation. At the time the legislation was passed, the Joint Committee on Taxation estimated that the Additional Medicare Tax and the Unearned Income Medicare Contribution Tax would together generate an additional $20.5 billion in tax revenue in the year 2013, the first year that the Medicare surtax would be in effect. (Source: JCX-17-10 [pdf].)
Source: about.com

Anthem Blue Cross Medicare Advantage Plans

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*All information submitted is private and not shared with third parties. We have a no spam or solicitation policy. All data is used expressly by medicareadvantagecalifornia.com and qualified associated medicare brokers to provide consumers with requested California Medicare Advantage information and assistance. By clicking on ‘Submit’, you consent to receiving a phone call and/or email from a licensed insurance representative representing a top health insurance company such as Aetna, Anthem, Blue Cross Blue Shield, Humana, United Healthcare and WellPoint regarding Medicare Advantage, Medicare Supplement and / or Medicare Drug Plans. When calling our toll free number you will be connected to a qualified associated medicare broker to assist you.
Source: medicareadvantagecalifornia.com

Anthem Blue Cross Medicare

Anthem AdvantageCare plan is a combination of Anthem Senior Classic F plans with the added benefits of the AdvantageCare Rider. AdvantageCare offers affordable care and helps pay for a wide range of health care services that Medicare does not cover. Some services that are covered under the Anthem AdvantageCare plan are residential facility and nursing home care, home health care, and home support services such as personal care services, chore services, transportation services, adult day care, and minor home repair services. Monthly premiums range from $39 to $102.
Source: healthplanone.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

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

2015 Medicare Advantage Plans Available to Residents of Delaware

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

DMMA Medical Assistance Services: Qualified Medicare Beneficiary Programs

If you are entitled to Medicare benefits and have a low income, DMMA may pay your Medicare premiums and, in some cases, other "out-of-pocket" expenses such as deductibles and coinsurance. Individuals must be entitled to Medicare Part A to qualify for any of these programs. Recipients under these programs do not receive regular Medicaid services.
Source: delaware.gov