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 Advantage, Medicare Advantage 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 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

Medicare Part C Advantage

A program which allows you to enroll in private health insurance that offers both Medicare Part A and Part B benefits. Medicare Advantage plans are not supplemental insurance, but rather health insurance plans of their own. Medicare Advantage can also include prescription drug coverage in addition to vision, hearing, and dental. In most cases, you can join even if you have been diagnosed with a pre-existing condition, except for final stage renal disease. Advantage plans must follow guidelines established by Medicare but also vary in terms of costs and rules.
Source: medicaresolutions.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 premium increases, Part B premiums in 2014

Posted by:  :  Category: Medicare

There is no question Medicare premiums are going up and up as are Medicare taxes. But to blame that on Obamacare is misdirected. Premiums are going up primarily because of the underlying use of health care services by a growing Medicare population and by the cost of each of those services.
Source: quinnscommentary.com

Medicare Advantage 2014 Spotlight: Plan Availability and Premiums

While many organizations offer Medicare Advantage plans, a few – particularly Humana, United Healthcare, and the Blue Cross and Blue Shield (BCBS) affiliates – have particularly large geographic spread and these organizations historically account for a disproportionate share of enrollment. In 2014, 44 percent of available plans are being offered by one of these three firms or affiliates (Table A4).  Plans offered by these firms are available to most beneficiaries.  Nationwide, 83 percent of Medicare beneficiaries will have access to one or more Humana plans, 73 percent will have access to a BCBS affiliated plan (including BCBS plans offered by Wellpoint), and 68 percent will have access to a United Healthcare plan (Exhibit 5; Table A5).  The general availability of these firms’ products has not noticeably changed from 2013 to 2014.  However, the similarities in BCBS offerings from 2013 to 2014 obscure a decline in availability of BCBS branded Wellpoint plans (declining from 88 plans to 55 plans between 2013 and 2014), which is mostly offset by the growth in plans offered by other BCBS affiliates (growing from 205 plans to 233 plans between 2013 and 2014).
Source: kff.org

Annual Statistical Supplement, 2011

d. Standard premium rate for voluntary enrollment by certain aged and disabled individuals not otherwise entitled to Hospital Insurance (HI). (Most individuals aged 65 and older and many disabled individuals under age 65 are insured for HI benefits without payment of any premium.) Beginning in 1994, a reduced premium is available to premium-paying HI enrollees with at least 30 quarters of Medicare-covered employment (either their own or through a current or former spouse if the marriage meets certain duration criteria). In most cases, a surcharge applies for beneficiaries who enroll after their initial enrollment period.
Source: ssa.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

Contact Information and Websites of Organizations for Medicare

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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

Application to copy or transfer from one Medicare card to another form (3170)

Complete this form to copy or transfer someone on to your own Medicare card or another Medicare card. Where the transfer or copy is to another person’s Medicare card that cardholder must also sign the form.
Source: gov.au

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 Texas Medicare Plans

Coverage in the Texas Health Insurance Pool, which was the high-risk pool for individuals in the state who were unable to obtain insurance coverage because of a pre-existing condition, expired on March 31, 2014. Individuals who were covered under the Texas Health Insurance Pool were eligible to apply for coverage under the Health Insurance Marketplace operated via HealthCare.gov. Coverage under the pool was deemed minimum essential coverage in accordance with the provisions of the Affordable Care Act.
Source: medicaresolutions.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

Boomer Benefits Medicare Supplements

Once you are enrolled in a Medicare insurance plan, our caring agents provide lifetime claims service for your policy. This means when claims occur, you are not alone. You will have experts on hand to help you sort through your statements, and even assist with appeals.
Source: boomerbenefits.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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Source: medicare.gov

Medicare Supplement Plan N Rates & Information

Disclaimer: Medigap Advisors is not connected with or endorsed by the U.S. Government or the federal Medicare program. Medicare has neither reviewed nor endorsed the information contained on this website. This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE or consult www.medicare.gov (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week.
Source: medigapadvisors.com

Medicare Supplement Plan N

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

Medicare Supplement Plans & Quotes

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

Medicare Supplement Plan N

Because Medicare Supplement plans are sold by private insurance companies, the premiums associated with each plan may differ by location and carrier. Companies may use one of three price rating systems to set their premium prices: community-rated, issue-age-rated, or attained-age-rated. Community-rated plans set premiums that are the same for all beneficiaries, regardless of age. Issue-age-rated plans set premiums based on the age of beneficiaries when they are “issued” their Medicare Supplement plan. Attained-age plans are said to be the most expensive, with premiums initially set based on beneficiaries’ issue age that increase as beneficiaries age. Premiums may widely differ depending on the rating system used to set these prices.
Source: ehealthinsurance.com

Compare Medicare Supplement Plans A

If an insurance company wants to sell Medicare Supplement Insurance, they are required by law to offer Medigap Plan A. If they wish to offer any additional plans, then they must sell either Plan C or Plan F in addition to any other plans they would like to sell. Providers do not have to offer every Medicare Supplement plan.
Source: ehealthinsurance.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

Federal Retirement Benefits: Federal Medicare

Enrolling in Senior Advantage for Federal Members or Medicare Plus for Federal Members will not affect the benefits you receive through the Federal Employee Health Benefits (FEHB) Program, although the network and other rules of Medicare may apply. FEHB Program coverage is described in FEHB brochures RI 73-003 (Northern California), RI 73-889 (Northern California: Fresno), RI 73-822 (Southern California), RI 73-019 (Colorado), RI 73-321 (Georgia), RI 73-005 (Hawaii), RI 73-047 (Mid-Atlantic States), and RI 73-004 (Northwest).
Source: kaiserpermanente.org

Kaiser Permanente Medicare Advantage Plans with Part D (Prescription Drug) Coverage

The following Kaiser Permanente plans offer Medicare Advantage and Part D coverage to California 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

Denver/Boulder Federal Retiree Health Benefits

Enrolling in Senior Advantage for Federal Members will not affect the benefits you receive through the Federal Employee Health Benefits (FEHB) Program, although the network and other rules of Medicare may apply. FEHB coverage is described in FEHB brochure RI 73-019.
Source: kaiserpermanente.org

Quality Health Care Coverage Provider

Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. received the highest numerical score among commercial health plans in the Mid-Atlantic region (VA, MD, D.C.) in the proprietary J.D. Power 2015 U.S. Member Health Plan StudySM. Study based on 31,543 total member responses, measuring six plans in the Mid-Atlantic region (excludes Medicare and Medicaid). Proprietary study results are based on experiences and perceptions of members surveyed November-December 2014. Your experiences may vary. Visit jdpower.com.
Source: kaiserpermanente.org

Kaiser Permanente Senior Advantage Medicare Medi

Plan website: kp.org/medicare Plan Phone Number: (800) 777-1238 U.S. News Preferred Broker Phone: (888) 245-3931 This is a Special Needs Plan (SNP). You can enroll in this plan if you qualify – call the Plan Phone Number at (800) 777-1238 for more information.
Source: usnews.com

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

Kaiser Permanente Division of Research

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

Noridian Clients, Medicare, Medicaid

Posted by:  :  Category: Medicare

Represents suppliers in Washington, Oregon, Idaho, Nevada, California, Arizona, Utah, Wyoming, Montana, North Dakota, South Dakota, Nebraska, Kansas, Iowa, Missouri, Alaska, Hawaii and the territories of Guam, American Samoa and N. Marina Islands.
Source: noridiansolutions.com

Local Coverage Determinations (LCDs) for Noridian Healthcare Solutions, LLC (19003, DME MAC)

NOTE: You either have javascript disabled or have saved the page locally. Your experience may not be optimal due to these factors. Please consider enabling javascript or revisiting this page to get an optimal MCD experience. (Due to browser security settings, directly clicking the previous link may not work, so you may need to copy and paste the following link [http://www.cms.gov/medicare-coverage-database/indexes/lcd-list.aspx?Cntrctr=139&name=Noridian%20Administrative%20Services%20(19003,%20DME%20MAC)&DocStatus=Active&&ContrVer=1&CntrctrSelected=139*1&LCntrctr=139*1&bc=AgACAAIAAAAA&] into your browser.)
Source: cms.gov

Local Coverage Determinations (LCDs) for Noridian Healthcare Solutions, LLC (02402, MAC

NOTE: You either have javascript disabled or have saved the page locally. Your experience may not be optimal due to these factors. Please consider enabling javascript or revisiting this page to get an optimal MCD experience. (Due to browser security settings, directly clicking the previous link may not work, so you may need to copy and paste the following link [http://www.cms.gov/medicare-coverage-database/indexes/lcd-list.aspx?Cntrctr=247&ContrVer=1&CntrctrSelected=247*1&name=Noridian+Administrative+Services%2C+LLC+(02402%2C+MAC+-+Part+B)&s=56&DocType=All&bc=AggAAAAAAAAAAA%3D%3D&] into your browser.)
Source: cms.gov

Medicare Supplement High Deductible Plan F

Posted by:  :  Category: Medicare

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

Medicare Supplement High Deductible Plan F

* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. ** This high deductible plan pays the same benefits as Plan F after one has paid a calendar-year $2,180 deductible. Benefits from High Deductible Plan F will not begin until out-of-pocket expenses are $2,180. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the plan’s separate foreign travel emergency deductible. *** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
Source: bcbsil.com

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

Tennessee Commission on Aging and Disability

If you have Medicare, you do not need to purchase health insurance through the Marketplace. Your Medicare coverage, whether received through a Medicare Advantage plan or through original Medicare, isn’t changing because of the Affordable Care Act and the Marketplaces. You will still need to review your Medicare coverage during the Annual Enrollment Period, October 15-December 7th for your 2014 coverage. TN SHIP is available to help you compare plans available in your area.
Source: tn.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

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