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

What is Medicare? What is Medicaid?

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

How Part D works with other insurance

Posted by:  :  Category: Medicare

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

www.Q1Medicare.com Your Source for Medicare Part D Plan Information

You can enroll into a stand-alone Medicare Part D Prescription Drug plan or a Medicare Advantage plan during the Annual Enrollment Period (or AEP) or open enrollment period starting October 15th and continuing for seven weeks through December 7th with your newly selected Medicare plan starting on January 1st of the following year. Please note that if you are just turning 65 or are newly eligible for Medicare, you will be granted a seven (7) month enrollment period when you can join a Medicare Part D or Medicare Advantage plan. The seven month period begins three months before your Medicare eligibility (or birthday) month, includes your eligibility month, and continues for three months after your Medicare eligibility month. However, your Medicare plan can begin no sooner than the first day of your Medicare eligibility month. Enrolling in a Medicare Part D or Medicare Advantage plan is easy and takes little time. : : Click here if you already know       which Medicare Part D plan you want : : Click here to search for a       Medicare Part D plan : : Click here to search for a       Medicare Advantage plan The good news about enrollment is that you always pay the same amount for a Medicare D plan or Medicare Advantage plan, no matter where or how you enroll. As an expanded feature, we now provide enrollment options for all 2015 Medicare Part D plans and Medicare Advantage plans across the country. If you wish, you can also enroll directly with Medicare (1-800-Medicare) or with an insurance agent or the Medicare plan provider. No matter how you enroll in to a Medicare plan, the enrollment result should always be the same and in 7 to 10 business days you should receive your Medicare Part D new Member information. Once enrolled into a Medicare Part D or Medicare Advantage plan, you can contact the plan’s Member Services department with any questions or concerns. The toll-free number will be on the back of your Member ID card. Please note that the Medicare Advantage Dis-Enrollment Period (MADP) for Medicare Advantage Plans beginsJanuary 1st and continues through February 14th — during the MADP members of Medicare Advantage plans can switch back to original Medicare and join a stand-alone Medicare Part D drug plan.
Source: q1medicare.com

Medicare Plans & Coverage: Part A, Part B, Part C, Part D

Medicare is a federal insurance program that covers hospitalization expenses as well as doctor and medical expenses. To be eligible for Medicare, one must be an American citizen 65 years or older, or younger with a qualifying disability.
Source: medicareconsumerguide.com

2015 Medicare Part D Program Compared to 2014, 2013, 2012 and 2011

Proposal in the 2015 Advanced Notice: This rule proposes to revise the definition of negotiated prices to require all price concessions from pharmacies to be reflected in negotiated prices. The proposed rule would provide greater cost savings for beneficiaries in return for offering preferred cost sharing so that sponsors cannot incentivize use of selected pharmacies, including the sponsors’ own related-party pharmacies that charge higher rates than their competitors. Also, CMS may request that Part D plans increase the number of pharmacies offering preferred, or lower, cost sharing as CMS is concerned that some plans that offer preferred cost sharing do not provide beneficiaries with sufficient access to the lower cost sharing at select network pharmacies. The intent of this policy will be to ensure that beneficiaries are not misled into enrolling in a plan only to discover that they do not have meaningful access to the advertised lower cost sharing. From the 2015 Announcement: Although we [CMS] are not adopting any network adequacy standards at this time, sponsors should be aware that we are continuing to monitor beneficiary access to preferred cost sharing in plans that purport to offer it. For the 2014 and 2015 plan years, we [CMS] will continue to review the retail networks of plans offering preferred cost sharing and will continue to take appropriate action regarding any plan whose network of pharmacies offering preferred cost sharing appears to offer too little meaningful access to the preferred cost sharing. For instance, a stand-alone PDP that offers preferred cost sharing at only seven pharmacies in a PDP region may be asked to increase the number of pharmacies offering preferred cost sharing or to restructure its benefit design during the bid negotiation process. The intent of these negotiations will be to ensure that beneficiaries are not misled into enrolling in a plan only to discover that they do not have meaningful access to the advertised lower cost sharing. We [CMS] note that beginning in 2015, we [CMS] will no longer use the terms "preferred" and "non-preferred" to describe network pharmacies, but rather will describe such pharmacies as offering standard or preferred cost-sharing.
Source: q1medicare.com

Understanding the Medicare Part D Donut Hole

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

Benefits for People with Disabilities

Posted by:  :  Category: Medicare

The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. While these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.
Source: ssa.gov

Retirement Planner: Benefits By Year Of Birth

As a general rule, early or late retirement will give you about the same total Social Security benefits over your lifetime. If you retire early, the monthly benefit amounts will be smaller to take into account the longer period you will receive them. If you retire late, you will get benefits for a shorter period of time but the monthly amounts will be larger to make up for the months when you did not receive anything.
Source: socialsecurity.gov

Social Security Survivors Benefits: Protection You and Your Family Can Count On

If you are working and paying into Social Security, some of the taxes you pay go toward survivors insurance. In fact, if you currently have life insurance, the value of your private policy is probably less than the value of the survivors insurance you have under Social Security.
Source: socialsecurity.gov

Disability Planner: Social Security Protection If You Become Disabled

While we spend a great deal of time working to succeed in our jobs and careers, few of us think about ensuring that we have a safety net to fall back on should we become disabled. This is an area where Social Security can provide valuable help to you.
Source: ssa.gov

Supplemental Security Income

topics, e.g., living arrangements, and are designed to supplement the guidelines in Understanding SSI (see above). You may link directly to each of the spotlights, or you may link to them from the text of the guidelines. In addition, Spanish versions of the spotlights are available at Puntos Importantes de Seguridad de Ingreso Suplementario (SSI).
Source: ssa.gov

International Social Security Association

By joining  the ISSA you will have access to technical support, advice and expertise from social security specialists around the world, and unparalleled opportunities to network and collaborate with peers in the development and promotion of social security.
Source: issa.int

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

Health Care Innovation Awards Round Two

AZ*/initiatives/Health-Care-Innovation-Awards-Round-Two/Arizona.html^CA*/initiatives/Health-Care-Innovation-Awards-Round-Two/California.html^CO*/initiatives/Health-Care-Innovation-Awards-Round-Two/Colorado.html^CT*/initiatives/Health-Care-Innovation-Awards-Round-Two/Connecticut.html^DC*/initiatives/Health-Care-Innovation-Awards-Round-Two/Washington-DC.html^FL*/initiatives/Health-Care-Innovation-Awards-Round-Two/Flordia.html^GA*/initiatives/Health-Care-Innovation-Awards-Round-Two/Georgia.html^IL*/initiatives/Health-Care-Innovation-Awards-Round-Two/Illinois.html^IA*/initiatives/Health-Care-Innovation-Awards-Round-Two/Iowa.html^KS*/initiatives/Health-Care-Innovation-Awards-Round-Two/Kansas.html^MD*/initiatives/Health-Care-Innovation-Awards-Round-Two/Maryland.html^MA*/initiatives/Health-Care-Innovation-Awards-Round-Two/Massachusetts.html^MI*/initiatives/Health-Care-Innovation-Awards-Round-Two/Michigan.html^MN*/initiatives/Health-Care-Innovation-Awards-Round-Two/Minnesota.html^MO*/initiatives/Health-Care-Innovation-Awards-Round-Two/Missouri.html^NE*/initiatives/Health-Care-Innovation-Awards-Round-Two/Nebraska.html^NH*/initiatives/Health-Care-Innovation-Awards-Round-Two/New-Hampshire.html^NM*/initiatives/Health-Care-Innovation-Awards-Round-Two/New-Mexico.html^NY*/initiatives/Health-Care-Innovation-Awards-Round-Two/New-York.html^NC*/initiatives/Health-Care-Innovation-Awards-Round-Two/North-Carolina.html^OH*/initiatives/Health-Care-Innovation-Awards-Round-Two/Ohio.html^OR*/initiatives/Health-Care-Innovation-Awards-Round-Two/Oregon.html^PA*/initiatives/Health-Care-Innovation-Awards-Round-Two/Pennsylvania.html^SD*/initiatives/Health-Care-Innovation-Awards-Round-Two/South-Dakota.html^TX*/initiatives/Health-Care-Innovation-Awards-Round-Two/Texas.html^VA*/initiatives/Health-Care-Innovation-Awards-Round-Two/Virginia.html^WA*/initiatives/Health-Care-Innovation-Awards-Round-Two/Washington.html^WI*/initiatives/Health-Care-Innovation-Awards-Round-Two/Wisconsin.html^
Source: cms.gov

About Medicare health plans

Generally, a plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits to people with Medicare who enroll in the plan. Medicare health plans include all Medicare Advantage Plans, Medicare Cost Plans, and Demonstration/Pilot Programs. Programs of All-inclusive Care for the Elderly (PACE) organizations are special types of Medicare health plans that can be offered by public or private entities and provide Part D and other benefits in addition to Part A and Part B benefits.
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.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

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 Drug List – Drug Formulary

Posted by:  :  Category: Medicare

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 Part D Formulary, List of PDP Drugs

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

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

Browse Any 2015 Medicare Part D or Medicare Advantage Plan Formulary

- Copay / Coinsurance – These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in “tiers”. Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on which tier the drug is in. The drug Tier is shown to the left of this column. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. There are two figures shown under this “Cost Sharing” category:
Source: q1medicare.com

Does Medicare pay for hospice services?

Posted by:  :  Category: Medicare

Room and board Medicare doesn’t cover room and board for hospice care. It does not cover the cost of rent or fees for a home, nursing home or assisted living. However, if the hospice medical team determines that your loved one needs short-term inpatient or respite care services that they arrange, then the stay in the nursing home or assisted living facility is covered. If your loved one’s permanent home was already in the nursing home, hospice care is covered. Your loved one may have to pay a small copayment for the respite stay.
Source: agingcare.com

Hospice Saves Medicare Dollars

Led by Amy S. Kelley, MD, MSHS, from the Brookdale Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mt. Sinai, researchers looked at the most common hospice enrollment periods: 1 to 7 days, 8 to 14 days, 15 to 30 days, and 53 to 105 days. Within all enrollment periods studied, hospice patients had significantly lower rates of hospital and intensive care use, hospital readmissions, and in-hospital death when compared to the matched non-hospice patients.
Source: nhpco.org

Welcome to Arkansas Medicaid

Posted by:  :  Category: Medicare

Private Option enrollees will not receive Medicaid ID cards but will receive insurance cards from their private health plan issuers. Private Option enrollees will use their private insurance cards to access medical services. Medicaid will provide limited supplemental services for Private Option enrollees, including Early and Periodic Screening, Diagnosis, & Treatment (EPSDT) for 19 and 20 year olds and non-emergency transportation. These services can be accessed using the Medicaid ID number that was sent to the Private Option enrollee in the plan enrollment notice. The Medicaid ID number can be used for retroactive coverage and interim coverage from the eligibility approval date until the date that the qualified health plan takes effect.
Source: ar.us

Arkansas Medicaid Eligibility

Benefits include ambulance service (emergency only), ambulatory surgical center, chiropractor, dental care, doctor’s services, emergency room services, home health services, hospice care, hospital care, immunizations, lab tests and x-rays, medical equipment, medical supplies, non-emergency transportation (net) program, nurse-midwife (certified), podiatrist, pregnancy termination, prescription drugs, rural health clinic, therapy (physical, occupational, or speech), vision care.
Source: medicaidoffice.net

Rep. Josh Miller, recipient of significant government assistance, opposes Medicaid expansion in Arkansas

Miller sees it differently. He said some who qualify for the private option aren’t working hard enough. He claims many want health insurance just so they can get prescription drugs to abuse. He draws distinctions with government help for catastrophic occurrences such as he suffered. He falls back, too, on a developing defense from private option holdouts that they prefer an alternative that wouldn’t end coverage for the 100,000 people currently signed up, at least until next year. This is disingenuous. He and other opponents have made clear that they want to strip Obamacare from government root and branch. Here’s how Miller boiled his opposition down:
Source: arktimes.com

Office of the Medicaid Inspector General

The Arkansas Medicaid Inspector General marked its first anniversary on July 1, 2014.  Created by Act 1499 of the Arkansas General Assembly, the Office of Medicaid Inspector General (OMIG) is tasked with preventing, detecting, and investigating fraud, waste, and abuse in the Arkansas Medicaid program and recovering improperly paid …   Read More >
Source: arkansas.gov

Lie of the Year: 'If you like your health care plan, you can keep it'

Posted by:  :  Category: Medicare

In 2009 and again in 2012, PolitiFact rated Obama’s statement Half True, which means the statement is partially correct and partially wrong. We noted that while the law took pains to leave some parts of the insurance market alone, people were not guaranteed to keep insurance through thick and thin. It was likely that some private insurers would continue to force people to switch plans, and that trend might even accelerate.
Source: politifact.com

We have a plan for fixing health care

When the court rules in King v. Burwell, we anticipate that it will hold the administration to the laws Congress passed, rather than the laws the administration wishes Congress had passed, and prohibit subsidies in states that opted not to set up their own exchanges, as the language in the law clearly states. Such a ruling could cause 6 million Americans to lose a subsidy they counted on, and for many the resulting insurance premiums would be unaffordable.
Source: washingtonpost.com

Better Health and You: Tips for Adults

To keep a food diary, write down all the food you eat in a day. Also write down the time you eat and your feelings at the time. Writing down your feelings may help you identify your eating triggers. For example, you may notice that you sometimes overeat when you are in a big group, simply because everyone around you is eating. The next time you are eating with a big group, be mindful of that trigger and try to limit how much you eat.
Source: nih.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