Medicare Advantage Dental, Medicare Advantage Dental Plan

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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.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 Supplemental Insurance

Posted by:  :  Category: Medicare

One major problem that people face after they find and purchase a Medicare Supplemental Insurance plan is that the insurance plan isn’t giving them back what they truly need. This is the very reason that motivated us to come up with a service that will help you in figure out the best Medicare Supplemental Insurance plan for YOU, that will be most beneficial to YOU in the future as your need for medical assistance increases. We can help you in save money while choosing a plan. We do this by helping you find a local Medicare Supplement Insurance agent who will guide you down the right path in purchasing the right Medicare Supplemental Plan.
Source: medicaresupplement-insurance.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

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

Costs in the coverage gap

Mrs. Anderson reaches the coverage gap in her Medicare drug plan. She goes to her pharmacy to fill a prescription for a covered brand-name drug. The price for the drug is $60, and there’s a $2 dispensing fee that gets added to the cost. Mrs. Anderson will pay 45% of the plan’s cost for the drug ($60 x .45 = $27) plus 45% of the cost of the dispensing fee ($2 x .45 = $0.90), or a total of $27.90, for her prescription. $57.90 will be counted as out-of-pocket spending and will help Mrs. Anderson get out of the coverage gap because both the amount that Mrs. Anderson pays ($27.90) plus the manufacturer discount payment ($30.00) count as out-of-pocket spending. The remaining $4.10, which is 5% of the drug cost and 55% of the dispensing fee paid by the drug plan, isn’t counted toward Mrs. Anderson’s out-of-pocket spending.
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

Medicare Supplemental Insurance

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

How Part D works with other insurance

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While prescription drug coverage is an essential health benefit, prescription drug coverage in a Marketplace or SHOP plan isn’t required to be at least as good as Medicare Part D coverage (creditable). However, all private insurers offering prescription drug coverage, including Marketplace and SHOP plans, are required to determine if their prescription drug coverage is creditable each year and let you know in writing.
Source: medicare.gov

Medicare Part D coverage gap

In 2006, the first year of operation for Medicare Part D, the donut hole in the defined standard benefit covered a range in true out-of-pocket expenses (TrOOP) costs from $750 to $3,600. (The first $750 of TrOOP comes from a $250 deductible phase, and $500 in the initial coverage limit, in which the Centers for Medicare and Medicaid Services (CMS) covers 75 percent of the next $2,000.) In the first year of operation, there was a substantial reduction in out-of-pocket costs and a moderate increase in medication utilization among Medicare beneficiaries, although there was no evidence of improvement in emergency department use, hospitalizations, or preference-based health utility for those eligible for Part D.
Source: wikipedia.org

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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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

Medicare Part D Formulary, List of PDP Drugs

Posted by:  :  Category: Medicare

Medicare Part B covered drugs include a limited number of prescription drugs such as those you get in a hospital outpatient department under certain circumstances, injected drugs you get in a doctor’s office, certain oral cancer drugs, and drugs used with some types of durable medical equipment (like a nebulizer or infusion pump).  Medicare Part B drugs include, but are not limited to, the following types of drugs.
Source: coventryhealthcare.com

Medicare Drug List – Drug Formulary

Below are the lists of covered drugs in our Cigna-HealthSpring Medicare Advantage and Rx plans. If your drug appears on the drug list, then it is a covered drug under that plan. However, there may be certain requirements, such as prior authorization or quantity limits that need to be fulfilled as part of your prescription drug coverage. If you have questions, please visit our Drug List Frequently Asked Questions (FAQ) page.
Source: cigna.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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Source: medicare.gov

Coventry Medicare: Formulary (Drug List)

A formulary is a list of prescription medications that are covered by your plan and are available in a booklet format and an online searchable tool.  A pharmacy directory is a listing of pharmacies in your plan’s network, including retail chain pharmacies, preferred and non-preferred mail-order pharmacies, home infusion and long-term care pharmacies. 
Source: coventryhealthcare.com

Medicare Part D Formulary Drug List FAQs

We may make certain changes to our list of covered drugs throughout the year. Changes in the drug list may affect which drugs are covered and how much you will pay when filling your prescription. If we remove drugs from our drug list, or add prior authorization, quantity limits and/or step therapy restrictions on a drug or move a drug to a higher cost cost-sharing tier, we will post a notice on this site at least 60 days before the change becomes effective. In addition, you will be notified on your Explanation of Benefits (EOB) mailing, if you are taking the impacted drug.
Source: cigna.com

Medicare Part D Drug Formulary

SilverScript covers both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as their brand-name equivalents. Generic drugs usually cost less than brand-name drugs and are rated by the U.S. Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. We may remove drugs from the SilverScript Medicare Part D formulary, add prior authorization, quantity limits and/or step therapy restrictions on a drug, and/or move a drug to a higher cost-sharing tier during the plan year. If the change affects a drug you take, we will notify you at least 60 days before the change is effective. However, if the U.S. Food and Drug Administration (FDA) deems a drug on our formulary to be unsafe, or if the drug’s manufacturer removes the drug from the market, we may immediately remove the drug from the SilverScript Medicare Part D formulary and notify all affected members as soon as possible.
Source: silverscript.com

Explanation of Benefits (EOB)

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Source: medicare.gov

Oregon Insurance Division: Home

Posted by:  :  Category: Medicare

The Oregon Insurance Division empowers and protects consumers while encouraging a financially stable, innovative, and competitive insurance marketplace. As insurance regulators, we confirm that insurance companies are financially sound so that they can pay claims. We also ensure that policyholders are treated fairly, by making sure claims are handled promptly and accurately, and that insurance companies honor their policies.
Source: oregon.gov

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

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Source: medicare.gov

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

Kaiser Permanente Advantage Plus

Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal. Benefits, formulary, pharmacy network, provider network, premium and/or copayments/coinsurance may change on January 1 of each year. 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. You must reside in the Kaiser Permanente Medicare health plan service area in which you enroll. You must be a Kaiser Permanente Senior Advantage individual plan member to apply, and you must continue to pay applicable Senior Advantage and Medicare Part B premiums and any other applicable Medicare premium(s), if not otherwise paid by Medicaid or another third party. The Silver&Fit Program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH). All programs and services are not available in all areas. Silver&Fit, The Silver Slate, and the Silver&Fit Signature Series Classes are federally registered trademarks of ASH. Other names and logos may be trademarks of their respective owners.
Source: kaiserpermanente.org

Medicare Advantage Fact Sheet

Since 2006, Medicare has paid plans under a bidding process.  Plans submit “bids” based on estimated costs per enrollee for services covered under Medicare Parts A and B; all bids that meet the necessary requirements are accepted.  The bids are compared to benchmark amounts that are set by a formula established in statute and vary by county (or region in the case of regional PPOs).  The benchmarks are the maximum amount Medicare will pay a plan in a given area. If a plan’s bid is higher than the benchmark, enrollees pay the difference between the benchmark and the bid in the form of a monthly premium, in addition to the Medicare Part B premium.  If the bid is lower than the benchmark, the plan and Medicare split the difference between the bid and the benchmark; the plan’s share is known as a “rebate,” which must be used to provide supplemental benefits to enrollees.  Medicare payments to plans are then adjusted based on enrollees’ risk profiles.
Source: kff.org

Kaiser Permanente Advantage Plus

• If you are already a Senior Advantage member, you may add Advantage Plus during the annual election period October 15 – December 7 for coverage to become effective on January 1, 2015. If you don’t enroll during the annual election period, you have until March 31, 2015 to enroll. Coverage is effective the first day of the month following the date we receive your completed enrollment form.
Source: kaiserpermanente.org

Quality Health Care Coverage Provider

We have medical facilities close to where you work and live. Joining Kaiser Permanente means, in many cases, your doctor, specialist, pharmacist, and more are located in one facility, which means you don’t have to spend the day going all over town just to get well.”>What’s in My Area? >
Source: kaiserpermanente.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

Am I Eligible for Medicare?

Posted by:  :  Category: Medicare

Whether and when you should elect COBRA coverage can be a very complicated decision. When you lose employer coverage and you have Medicare, you need to be aware of your COBRA election period, your Parts B and D enrollment periods and your Medigap Open Enrollment Period. These may all have different deadlines that overlap, so be aware that what you decide about one type of coverage (COBRA, Part B, Part D and Medigap) might cause you to lose rights under one of the other types of coverage.
Source: mymedicarematters.org

Costs in the coverage gap

Posted by:  :  Category: Medicare

Mrs. Anderson reaches the coverage gap in her Medicare drug plan. She goes to her pharmacy to fill a prescription for a covered brand-name drug. The price for the drug is $60, and there’s a $2 dispensing fee that gets added to the cost. Mrs. Anderson will pay 45% of the plan’s cost for the drug ($60 x .45 = $27) plus 45% of the cost of the dispensing fee ($2 x .45 = $0.90), or a total of $27.90, for her prescription. $57.90 will be counted as out-of-pocket spending and will help Mrs. Anderson get out of the coverage gap because both the amount that Mrs. Anderson pays ($27.90) plus the manufacturer discount payment ($30.00) count as out-of-pocket spending. The remaining $4.10, which is 5% of the drug cost and 55% of the dispensing fee paid by the drug plan, isn’t counted toward Mrs. Anderson’s out-of-pocket spending.
Source: medicare.gov

Medicare Part D coverage gap

In 2006, the first year of operation for Medicare Part D, the donut hole in the defined standard benefit covered a range in true out-of-pocket expenses (TrOOP) costs from $750 to $3,600. (The first $750 of TrOOP comes from a $250 deductible phase, and $500 in the initial coverage limit, in which the Centers for Medicare and Medicaid Services (CMS) covers 75 percent of the next $2,000.) In the first year of operation, there was a substantial reduction in out-of-pocket costs and a moderate increase in medication utilization among Medicare beneficiaries, although there was no evidence of improvement in emergency department use, hospitalizations, or preference-based health utility for those eligible for Part D.
Source: wikipedia.org

Medicare Part D Doughnut Hole Is a Gap in Coverage

"If you have high drug costs, you may consider which plans offer additional coverage until you spend $3,600 out-of-pocket. In some plans, if your costs reach an initial coverage limit, then you pay 100% of your prescription costs. This is called the coverage gap. This "gap" in coverage is generally above $2,250 in total drug costs until you spend $3,600 out-of-pocket. Some plans might offer some coverage during the gap. Even in plans where you pay 100% of covered drug costs after a certain limit, you would still pay less for your prescriptions than you would without this drug coverage", according to Medicare.gov.
Source: about.com

Medicare Part D Donut Hole – Prescription Drug Coverage Gap

Most Medicare Part D plans have a coverage gap, sometimes called the Medicare donut hole. This means that after you and your Medicare drug plan have spent a certain amount of money for covered prescription drugs, you then have to pay all costs out-of-pocket for the drugs, up to a certain limit. The yearly deductible, co-insurance, or co-payments, and what you pay while in the coverage gap, all count toward this out-of-pocket limit. The limit doesn’t include the drug plan’s premium.
Source: ehealthmedicare.com

Enroll in Medicare Advantage

Posted by:  :  Category: Medicare

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Source: cigna.com

CIGNA Medicare Supplemental Insurance

There are many different CIGNA Medicare plans that seniors can choose from in their quest for the best type of health insurance. For those who may need prescription drug coverage, these benefits can be acquired via a few different CIGNA plans such as CIGNA Medicare Access Plus Rx and CIGNATURE Rx to name two of the main types. No matter what seniors are searching for with regard to Medicare health plans they are sure to find the answer with CIGNA Medicare.
Source: seniors-health-insurance.com