Annual Statistical Supplement, 2011

Posted by:  :  Category: Medicare

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

2014 Medicare Part D Program Compared to 2013, 2012, 2011 and 2010

The 2014 plan year standardized, combined Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) document will be mailed to current members of all Medicare Advantage (MA) plans, Medicare Advantage with Prescription Drug Coverage (MA-PD) plans, Prescription Drug Only (PDP) plans and cost-based plans offering Part D. MA and MA-PD plans must ensure current members receive the combined ANOC/EOC by September 30, 2013. Plans have the option to include Pharmacy/Provider directories in this mailing. All plans offering Part D must mail their Low-Income Subsidy (LIS) riders and abridged or comprehensive formularies with the ANOC/EOC to ensure current member receipt by September 30, 2013. Exception: Dual Eligible Special Needs Plans (SNPs) that are fully integrated with the State must mail an ANOC with the Summary of Benefits (SB) for member receipt by September 30, 2013 and then send the EOC for member receipt by December 31, 2013. Fully Integrated Dual Eligible SNPs that send a combined, standardized ANOC/EOC for member receipt by September 30, 2013 are not required to send an SB to current members. Note: With the exception of the ANOC/EOC, LIS Rider, and abridged or comprehensive formularies, no additional materials may be sent prior to the beginning of when marketing activities may begin on October 1.
Source: q1medicare.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 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

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.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

Cancer clinics are turning away thousands of Medicare patients. Blame the sequester.

“If you get cut on the service side, you can either absorb it or make do with fewer nurses,” said Ted Okon, director of the Community Oncology Alliance, which advocates for hundreds of cancer clinics nationwide. “This is a drug that we’re purchasing. The costs don’t change and you can’t do without it. There isn’t really wiggle room.”
Source: washingtonpost.com

A Medicare scam that just kept rolling

The power-wheelchair scam provided a painful and expensive example of why Medicare fraud works so often. The fault lay partly with Congress, which designed this system to be fast and generous. And it lay partly with Medicare bureaucrats — who were slow to recognize the threat and use the powers they had to stop it. As a result, scammers took advantage of a system that was overwhelmed by its own claims and lacked the manpower and money to check most of those claims before it paid.
Source: washingtonpost.com

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 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

Kaiser Permanente Health Insurance: Get Quotes, View Plans & Apply

Kaiser Permanente offers one of the most advanced systems of integrated care in the world. The Health Plan, the Physicians, the Medical Facilities and the Electronic Medical Record System are all working together to get you well, keep you well, and help you thrive.
Source: kaiserquotes.com

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

More Than Individual & Family Health Insurance

Generally, a special enrollment period lasts 60 days after the triggering event occurs. That means if you’ve experienced a triggering event, you have 60 days from the day of the triggering event to change or apply for health care coverage for yourself and/or your dependent. In some situations, if you are aware of a triggering event that will occur in the future, you may be able to apply for new coverage prior to the triggering event. For example, if you know you will experience a loss of coverage, you have 60 days before your loss of coverage and 60 days after your loss of coverage to apply for health coverage.
Source: kaiserpermanente.org

Kaiser Permanente Group Health Insurance

Kaiser Permanente health insurance members have access to Kaiser’s unique integrated delivery system. Whether you are on an individual health insurance plan or a group health insurance plan, you have the ability to choose your own personal physician, manage your health care online, and utilize Kaiser’s health and fitness programs. Plus, your medical records are electronic –a Kaiser Permanente innovation- which helps doctors coordinate your care closely and efficiently. Getting the care you need is easy and convenient. Most of Kaiser Permanente’s medical offices feature doctor’s offices, lab, x-ray, and pharmacy in one location so you don’t have to visit a separate facility for every need. After-hours, weekend, and urgent care services are also available at many locations.
Source: ekaiserinsurance.com

Compare Medicare Advantage & Supplemental Plans

Posted by:  :  Category: Medicare

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 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

Compare Medicare Supplement (Medigap) Plans and Rates in Your Area

"Times have changed since my mother had an AARP J plan and I was totally confused by the options available. Stan walked me through the process in a very educational, methodical, friendly way, and I feel secure now that we’re making the correct decision to provide the best possible coverage for my husband." – Pat K.
Source: medigap360.com

Medicare.gov Physician Compare Home

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 Part D Prescription Drug Plans Coverage and Comparison

Medicare Part D Prescription Drug Plans, also known as “PDPs,” are stand-alone prescription drug plans that are sold by private insurance companies with a Medicare contract. Medicare beneficiaries can sign up for a PDP if they would like to add Part D drug coverage to their Original Medicare coverage. Certain Medicare Advantage plans, such as Cost Plans, Private Fee-for-Service (PFFS) plans, and Medical Saving Account (MSA) plans might allow you to add a stand-alone PDP to this coverage, although these situations may vary. Anyone enrolled in Medicare Part A and/or Medicare Part B is eligible to enroll in a Medicare Part D plan.
Source: planprescriber.com

Medicare Advantage Plans By State, Plan Comparison

Coventry Health Care* is a Coordinated Care plan with a Medicare contract. Enrollment in our plans depends on contract renewal. Coventry Health Plan of Florida, Inc. also has a contract with the Florida state Medicaid program. Coventry Health Care of Missouri has contracts with the Missouri state Medicaid program. HealthAmerica also has a contract with the Pennsylvania state Medicaid program. 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 co-payments/co-insurance may change on January 1 of each year. 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. Our dual-eligible Special Needs Plans (DSNPs) are available in Florida, Missouri and Pennsylvania to anyone who has both Medical Assistance from the state and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help that you receive. Please contact the plan for further details. Our dual-eligible Special Needs Plans (DSNPs) are available to anyone who has both Medical Assistance from the State and Medicare. You must continue to pay your Medicare Part B premium. The Part B premium is covered for full-dual members where DSNP plans are available. This information is available for free in other languages. Please call Coventry Health Care at 1-877-988-3589, 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. *Coventry Medicare Advantage plans are offered by Coventry Health Care, Inc.’s licensed affiliated companies, which include Altius Health Plans, Inc.; Coventry Health Plan of Florida, Inc.; Coventry Health Care of Georgia, Inc.; Coventry Health Care of Illinois Inc.; Coventry Health Care of Iowa, Inc.; Coventry Health Care of Louisiana, Inc.; Coventry Health Care of Missouri, Inc.; Coventry Health Care of Nebraska, Inc.; Coventry Health and Life Insurance Company; Coventry Health Care of Kansas, Inc.; Coventry Health Care of Texas, Inc.; Coventry Health Care of West Virginia, Inc.; First Health Life & Health Insurance Company; HealthAmerica Pennsylvania, Inc.; and HealthAssurance Pennsylvania, Inc.
Source: coventryhealthcare.com

Medicare Supplement Plans

To be eligible to enroll in a Medicare Supplement plan, you must be enrolled in both Medicare Part A and Part B. The best time to enroll in a plan is during the Medigap Open Enrollment Period, which begins on the first day of the month that you are both age 65 or older and enrolled in Part B, and lasts for six months. During this period, you have the guaranteed issue right to join any plan of your choice, meaning that you may not be denied coverage based on any pre-existing conditions. If you miss this enrollment period and attempt to enroll in the future, you may be denied coverage based on your medical history.
Source: ehealthinsurance.com

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.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

California Health Advocates: Medicare Policy, Advocacy and Education

Bonnie Burns, our Training and Policy Specialist, begins her 23rd term as one of the 20 appointed and funded consumer liaison representatives by the National Association of Insurance Commissioners (NAIC). Ms. Burns spearheaded the standardization of Medicare supplemental insurance, known as Medigap and has provided numerous Congressional testimonies guiding the standardization of long-term care insurance and the policies for financing long-term care.
Source: cahealthadvocates.org

Annual Statistical Supplement, 2011

Posted by:  :  Category: Medicare

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

Medicare Reform Stage 2: Moving to a Premium Support Program

[35]Aaron and Reischauer, for example, opposed using the lowest-cost-plan bid as the benchmark for a “premium free” option. They expressed an understandable concern that it would attract enrollees into a plan that might be efficient but would be characterized by a “Spartan delivery system”; such a plan, they feared, might not be able to absorb the influx of large enrollment of low-income persons without compromising quality of care. Aaron and Reischauer, “The Medicare Reform Debate,” p. 23. But this problem could be alleviated, as noted, by using an average of the three or five lowest-cost bids in a region. In either case, lifting the cap on the government contribution to the lowest-cost plan (or the average of the lowest-cost plans setting the government payment) could generate even greater savings. In the FEHBP, for example, there is a 75 percent cap on the government contribution to employees’ choice of health plan under the existing payment formula. As a practical matter, this means that federal workers and their families must pick up 25 percent of the cost of any plan, no matter how efficient that lower-cost plan is in delivering benefits. An effective consumer-choice system would encourage consumers to secure 100 percent of the costs for picking less expensive plans. Thus, The Heritage Foundation recommended the removal of the 75 percent cap on the defined contribution in the FEHBP. See Angela M. Antonelli and Peter B. Sperry, eds., A Budget for America: A Mandate for Leadership Project (Washington, D.C.: The Heritage Foundation, 2001), pp. 331–332.
Source: heritage.org

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 Is More Efficient Than Private Insurance

It is a flawed argument to assert that Medicare is more efficient because they have a lower percentage of total cost that goes to administrative costs. That percentage is the result of a numerator (admin cost) divided into a denominator (total revenue). The percentage is affected by both numbers and it is clear that Medicare, due to the advanced age of its enrollees, spends more per enrollee on benefits, which lowers the MLR or administrative cost percentage. I also agree that the assertion that Medicare pays for collection of taxes, fraud and abuse protections and building costs is contrary to other sources, and the link provided did not elucidate that assertion. A truer measure of efficiency in administration of Medicare would be the actual cost per enrollee for similar administrative tasks since Medicare does not have all of the required administrative duties that a private company would (marketing, pre-certification, negotiations with providers, claim review, sufficient customer service, sales, etc). Some sources assert that Medicare pays MORE per enrollee for admin, even though they perform fewer administrative tasks.
Source: healthaffairs.org

Regence Medicare Advantage Medical Policy and Review Process

Posted by:  :  Category: Medicare

Medicare Advantage Medical Policies are the property of our Plans and their affiliated or subsidiary companies, but may be used for purposes related to the health care of a Medicare Advantage Plan member.  You are strictly prohibited from using Medicare Advantage Medical Policies for purposes not related to the health care of a Plan member, including but not limited to commercial use.
Source: regence.com

Regence BlueCross BlueShield of Oregon Medicare Advantage Plans with Part D (Prescription Drug) Coverage

The following Regence BlueCross BlueShield of Oregon plans offer Medicare Advantage and Part D coverage to Oregon residents. Medicare Advantage plans, also known as Medicare Part C, are alternatives to original Medicare. These plans help cover the costs of services provided by hospitals, doctors, lab tests and some preventive screenings. These plans’ Part D component helps cover prescription drugs. Even if a plan’s monthly premium is $0, you would still pay the equivalent of the original Medicare premium. Not all plans shown here will be available to you; enter your zip code to see plans in your area. You can read about whether Medicare Advantage is right for you. If you only want plans with drug coverage, browse Prescription Drug (Part D) Plans.
Source: usnews.com

Regence Medicare Advantage Information Meetings

To register for a meeting, click on its underlined time link. You can view location details by hovering over the meeting time with your mouse. You can also register by calling 1-844-REGENCE (1-844-734-3623), Monday through Friday, between 8 a.m. and 5 p.m. Pacific time.  TTY users should call 711.
Source: cvent.com

Regence MedAdvantage + Rx Classic (PPO) 2014

The plan offers national in-network prescription coverage (i.e., this would include 50 states and the District of Columbia). This means that you will pay the same cost-sharing amount for your prescription drugs if you get them at an in-network pharmacy outside of the plan’s service area (for instance when you travel). Total yearly drug costs are the total drug costs paid by both you and a Part D plan. Some drugs have quantity limits. Your provider must get prior authorization from Regence MedAdvantage + Rx Classic (PPO) for certain drugs. You must go to certain pharmacies for a very limited number of drugs, due to special handling, provider coordination, or patient education requirements that cannot be met by most pharmacies in your network. These drugs are listed on the plan’s website, formulary, printed materials, as well as on the Medicare Prescription Drug Plan Finder on Medicare.gov. If the actual cost of a drug is less than the normal cost-sharing amount for that drug, you will pay the actual cost, not the higher cost-sharing amount. If you request a formulary exception for a drug and Regence MedAdvantage + Rx Classic (PPO) approves the exception, you will pay Tier 4: Non-Preferred Brand cost sharing for that drug. In-Network $235 annual deductible. Initial Coverage After you pay your yearly deductible, you pay the following until total yearly drug costs reach $2,850: Retail Pharmacy Contact your plan if you have questions about cost-sharing or billing when less than a one-month supply is dispensed. You can get drugs the following way(s): Tier 1: Preferred Generic
Source: healthpocket.com

Medicare Advantage at The Polyclinic

To compare your current Medicare or Medicare Advantage health plan to the health plans we currently accept, please visit www.medicare.gov and select Medicare Health Plans – 2015 Plan Data to begin your search. Additional information about Medicare options, including what is covered under Medicare Parts A and B for 2015, may be found at the Washington State Office of the Insurance Commissioner web site, http://www.insurance.wa.gov/about-oic/what-we-do/advocate-for-consumers/shiba/ or call 1-800-562-6900.
Source: polyclinic.com

Medicare Supplement Plans & Quotes

Posted by:  :  Category: Medicare

Turning 65 is stressful, and the amount of information people receive leading up to their birthday is astounding. From the stacks of mail piling up on your desk, to the seemingly endless phone calls and quotes from insurance companies and agents, the task of gathering honest, unbiased information can feel impossible. Our goal is to offer what nobody else will, which is why we provide medicare supplement quotes, financial ratings, benefit information, application fee data, price history, and pricing methodology for all supplemental insurance companies in one clean, concise report. Our free, no obligation service is designed to give you the information you need regarding Part D and Medicare Supplement Plans in order to make an educated purchasing decision. In addition, we offer continued support for all of our customers to ensure they have no claims or billing issues. On an annual basis we review all medicare supplement insurance quotes and plan options in an effort to notify our customers of any new or better plans that may be available.
Source: medicaresupplementshop.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

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 Plan F

Medicare Supplement Plan F may offer expansive coverage, but it does not cover everything. Under Plan F, beneficiaries are still required to pay their Medicare Part B premium payments each month. Additionally, it is possible to have Medicare Part A without a monthly premium if the beneficiary has worked and paid Social Security taxes for at least 40 calendar quarters (10 years). Otherwise, a monthly premium for Part A coverage is also required. These costs are not covered under Medicare Supplement Plan F.
Source: ehealthinsurance.com

Medicare Supplement Plan F

Under Fire: Many politicians and health economists believe plan F should be eliminated or modified because it provides first dollar coverage for people who purchase the plan. They believe people who do not have co-payments or deductibles to pay use medical services more often, which hurts the Medicare system as there are more claims submitted. There have been many attempts by various political figures to modify these plans by adding co-payments or a small deductible. However, a study completed by the National Association of Insurance Commissioners found people who have plans that offer first dollar coverage (Plan F & Plan C) do not seek more medical services than those who have a co-pay or deductible. For now, it seems Medicare Supplement F is safe.
Source: medicaresupplementshop.com

Best Medicare Supplement Insurance Quotes

Every Medicare supplemental insurance plan must follow federal and state laws designed to protect you. Medicare supplement plan insurance companies can only sell you a “modernized” Medicare supplemental insurance plan identified by letters A through N. Each modernized Medicare supplemental insurance plan must offer the same basic benefits, no matter which insurance company sells it.
Source: medicaresupplementplans.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

Welcome to Maine Medicare Options!

The benefit to you is that I am a “One-Stop Shop.”   When you sit down with me we will review your specific needs and match you up with the plans that best meet those needs.  I will help you narrow down those choices to one plan by answering all your questions so you can make the best choice for you and feel confident knowing that you have chosen the right plan.  I will also help you enroll in the plan and as your agent, I will be there with you during the entire process of enrollment.  I am also available to you during the year any time you have questions or need direction.  Medicare is very complex and it is a great relief to know you have someone in your corner every step of the way.   Every year Medicare Advantage and Part D Prescription Drug plans can change and as your agent, I will talk with you or meet with you before your plan changes.  We will review all changes and if necessary help you to find a new plan that suits your needs best.  I will never pressure you or suggest you change plans.  That decision is always yours to make.   I am simply here as a guide to help you make an informed decision.  I am well respected among my peers and maintain a good reputation. I build meaningful relationships with the people I meet and offer exceptional customer service.
Source: mainemedicareoptions.com

Electronic Billing & EDI Transactions

Posted by:  :  Category: Medicare

The information in this section is intended for the use of health care providers, clearinghouses and billing services that submit transactions to or receive transactions from Medicare fee-for-service contractors. EDI is the automated transfer of data in a specific format following specific data content rules between a health care provider and Medicare, or between Medicare and another health care plan. In some cases, that transfer may take place with the assistance of a clearinghouse or billing service that represents a provider of health care or another payer. EDI transactions are transferred via computer either to or from Medicare. Through use of EDI, both Medicare and health care providers can process transactions faster and at a lower cost. Please see pages on specific types of EDI conducted by Medicare for related links and downloads as applicable.
Source: cms.gov

Medicare DME: Documentation, Billing and Collections training

MEDICARE DME REIMBURSEMENT The nation’s population is aging dramatically thanks to the Baby Boomers. Approximately 8,000 to 10,000 Americans turn 65 EVERY DAY and this trend is projected to continue through the next decade. This should spell nothing but opportunity for DME providers to the tune of 14% estimated annual growth. There are, however, forces working against today’s DME providers that make it increasingly harder to compete and stay compliant, the most dramatic being COMPETITIVE BIDDING. This, coupled with waves of CERT, RAC, ZPIC and DMEMAC audits, PECOS, accreditation, compliance, ICD-10, and increased cost of goods will force most DME providers to find new and innovative ways to decrease their dependency on Medicare to shore up their bottom line and remain profitable. Today’s DME provider faces the challenge of providing low cost, high quality services while maintaining compliance with all federal, state, local, and corporate regulations. This course will not only cover the entire reimbursement process from intake and insurance verification to billing and accounts receivable management, but will also outline time-proven methods to distance DME providers from Medicare as well as maximizing revenue with a provider’s current patient base. Participants will also receive in-depth information on the latest changes affecting the Home Medical Equipment industry and strategies to react to them while maintaining a viable and profitable DME company.
Source: findaseminar.com

Medicare Billing: Wheelchairs, Scooters, Lift Chairs

We understand that the process of submitting claims to Medicare can be difficult and time consuming. To help make the process easier, SpinLife offers what is known as “courtesy billing”. This means that after you purchase an eligible product from SpinLife and request at checkout that we courtesy bill Medicare, we send you all of the documentation required by Medicare for you to complete with your physician. Once medically qualifying documentation is submitted into SpinLife, we can submit a claim to Medicare on your behalf. If your claim is approved by Medicare, they will reimburse you directly for their portion of your claim via mail.
Source: spinlife.com

Getting Paid: Billing Medicare for Diabetes Self

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Source: aafp.org

Medical Billing Course Programs

LEVEL – MEDICAL BILLING FROM HOME  –  60 HOURS This is our most popular, comprehensive and most economical program Medical Billing Certification (CMBP).  Understanding HIPAA Certification Free Student Registration Chapters, Study Guides, Examinations for Chapters 1 – 9 Chapter AC1:  Understanding HIPAA, Exam & Separate Certification Chapter AC2:  Calculating Copays & Deductibles Practice Manager X3 Medical Billing Software Program Medical Billing Business Marketing Guide – Chapters 1-4 24/7 Online Student Support Board Telephone, Email & Live Chat Support Medical Billing Newsletter Medical Billing Course Certification CMBP Designation (Certified Medical Billing Professional) Register Now
Source: medicalbillingcourse.com