Republic of the Philippines Social Security System

Posted by:  :  Category: Medicare

SSS Congressional Branch Inauguration and Blessing Social Security System (SSS) President and Chief Executive Officer Emilio de Quiros, Jr. and Quezon City First District Representative Francisco A. Calalay, Jr. lead the ribbon-cutting ceremony along with QC District 1 Administrator Juan Untalan, Senior Vice President for NCR Operations Group Jose Bautista and SSS Congressional Branch Head Dr. Juanillo Delcalzo III during the inauguration and blessing of the SSS Congressional Branch on September 26. Also in photo is Fr. Nemesio Tolentin, OAR.
Source: gov.ph

Social Security Administration

For some claimants, this program is harder to receive than funds from RSDI. To warrant a processing time of anything more than a day and an immediate denial, certain specific criteria must be met, including citizenship status, having less than $2,000.00 in countable financial resources, or having countable income of less than $718.00 per month from any source. Disposal of a financial resource (i.e., a deliberate spend-down to fall under SSI resource ceilings) can prevent a person from receiving SSI benefits for a period up to 36 months. Every person with or without a Social Security Number is eligible to apply. But if a person does not meet any of the above criteria or is not a documented resident of the United States, his or her claim can only be taken on paper and will be immediately denied. Even documented residents with legal permanent resident status after August 1996 are immediately denied unless they meet some or all of the SSI criteria listed above.
Source: wikipedia.org

Benefits for People with Disabilities

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

Social engineering (security)

The 1999 “GLBA” is a U.S. Federal law that specifically addresses pretexting of banking records as an illegal act punishable under federal statutes. When a business entity such as a private investigator, SIU insurance investigator, or an adjuster conducts any type of deception, it falls under the authority of the Federal Trade Commission (FTC). This federal agency has the obligation and authority to ensure that consumers are not subjected to any unfair or deceptive business practices. US Federal Trade Commission Act, Section 5 of the FTCA states, in part: “Whenever the Commission shall have reason to believe that any such person, partnership, or corporation has been or is using any unfair method of competition or unfair or deceptive act or practice in or affecting commerce, and if it shall appear to the Commission that a proceeding by it in respect thereof would be to the interest of the public, it shall issue and serve upon such person, partnership, or corporation a complaint stating its charges in that respect.”
Source: wikipedia.org

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

Posted by:  :  Category: Medicare

"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 Supplement (Medigap) Insurance Plans

MedSupp plans can help pay Original Medicare’s copayments and deductibles. Each type of plan offers a different level of coverage, and is named with a different letter (such as Plan A). The plans are standardized, so that all plans of the same letter offer the same benefits. In other words, the benefits for a Medicare Supplement Plan D enrollee in Rhode Island are the same for a Medicare Supplement Plan D enrollee in Tennessee. However, the premiums can differ among these private insurance companies.
Source: planprescriber.com

Shop and Compare Medigap Plans at Plan Medigap

STEP 1: Contact PlanMedigap. We have licensed PlanMedigap Specialists ready to discuss your needs with you and get you on the path to the coverage you need. Free phone consultation: 800-750-2407 Free online quote: Request and Quote Online STEP 2: Compare Plans and Rates. Your PlanMedigap Specialist will provide you with the available plans & pricing in your area. Review plan options & compare company rates Provide you with information you need. STEP 3: Review Options Review the options and determine which one fits your needs. STEP 4: Complete Application. Your Plan Medigap Representative will ask you a series of questions which will be used to complete the proper Medicare Supplement Application.
Source: planmedigap.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

Best Medicare Supplement Insurance Quotes

Posted by:  :  Category: Medicare

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 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

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 Plans – Reviewing The Best Medicare Plans and Medicare Insurance

AK  AL  AR  AZ  CA  CO  CT  DC  DE  FL  GA  HI  IA  ID  IL  IN  KS  KY  LA  MA  MD  ME  MI  MN  MO  MS  MT  NC  ND  NE  NH  NJ  NM  NV  NY  OH  OK  OR  PA  RI  SC  SD  TN  TX  UT  VA  VT  WA  WI  WV  WY 
Source: medicare-plans.net

Compare Medicare Part D Prescription Drug Plans

There’s an annual cap on how much you will be asked to pay for Medicare Part D. The Initial Coverage Limit for 2013 is $2,970, meaning that once your Part D plan pays out this amount in prescription costs, you enter the Coverage Gap (also known as the “Donut Hole”). Once you’re in the Coverage Gap, you assume out-of-pocket responsibility for all of your prescription costs until you spend a total of $4,750, at which point your Part D plan will then pay all remaining drug costs for the remainder of the year.
Source: ehealthinsurance.com

Compare All Medicare Plan Options

Coverage is available to residents of the service area and separately issued by one of the following plans: Wellmark Blue Cross and Blue Shield of Iowa,* Blue Cross and Blue Shield of Minnesota,* Blue Cross and Blue Shield of Montana,* Blue Cross and Blue Shield of Nebraska,* Blue Cross Blue Shield of North Dakota,* Wellmark Blue Cross and Blue Shield of South Dakota,* Blue Cross Blue Shield of Wyoming.*
Source: wellmark.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 Health Plan Compare, Find and Compare Medicare Plans

Help is available. If you have limited income and resources, you may qualify for help paying your Medicare health care and/or prescription drug coverage costs. For more information, visit socialsecurity.gov, call Social Security at 1-800-772-1213, or apply for help at your State Medical Assistance (Medicaid) office.
Source: medhpc.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

Medicare claim submission address

Medical Billing Solution, Medical Billing Training Program, About Outsourcing Services, Medical Billing Process and Concept, Tips to Medical Biller, Specialist. Medical Insurance Billing Denial Guidelines. Medical Billing Training Articles and Software Review. Medicare Billing CPT code ,ICD-9 DX Code Update.
Source: whatismedicalinsurancebilling.org

Claims: Contact information

First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.
Source: fcso.com

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

Posted by:  :  Category: Medicare

"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

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 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

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 Supplement Comparison

When you are first going on Medicare, you get inundated with enormous amounts of information – through the mail, on the phone, by email – everyone wants to be your friend when you turn 65! While there is some good information out there, it is easy to allow the clutter to overwhelm you or “turn you off” to the process. Sorting through the supplement plans is actually not as difficult as you may think, however. With the standardization of plan coverage, as well as the fact that all plans can be used at any doctor that takes Medicare nationwide, and all claims are paid through the standardized Medicare “crossover” system, there are not that many variables to consider when comparing companies. The main things that you should compare are Medicare Supplement rates and company ratings. You can do these one of two ways – you can either call the companies themselves to obtain the rates (or more likely set meetings to get the rates – which some companies require) or you can obtain them in a centralized place through a broker. Whether it is us or someone else, we would certainly recommend comparing rates via a broker/agency. By doing so, you can get a centralized comparison of plan options in an unbiased way at no cost or obligation. Either way you do it, the most important thing to do is base your decision on the two factors that vary – monthly premium and company rating.
Source: medicare-supplement-comparison.com

What’s Medicare Supplement Insurance (Medigap)?

Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.
Source: medicare.gov

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 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

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

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

Medicare Part D coverage gap

Posted by:  :  Category: Medicare

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

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

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

Closing the Medicare Part D Donut Hole

The Affordable Care Act (ACA) includes important improvements to Medicare prescription drug coverage (Part D) such as reducing expenses for seniors in the donut hole now and eliminating the gap altogether by 2020.  Seniors receive additional savings each year on their prescription drugs until the donut hole is closed. The ACA also provides additional assistance for low-income beneficiaries.  Since passage of the ACA in 2010, more than 7.9 million people with Medicare have saved over $9.9 billion on prescription drugs.  
Source: ncpssm.org

How to Avoid the Medicare Part D Donut Hole

The Extra Help Program helps low-income Medicare recipients avoid the donut hole completely. According to the Social Security Administration, the program provides about $4,000 in cost assistance to each recipient per year. Income and financial resource limits apply, and both are re-evaluated annually. As of June 2015, annual income limits are $17,655 for an individual or $23,895 for a married couple. Financial resources, which include assets such as bank accounts, stocks and bonds, can’t exceed $13,640 for an individual or $27,250 for a married couple. There are options to apply online, over the telephone or at your local Social Security Office.
Source: ehow.com

The Ethics of Health Care Reform: Issues in Emergency

Posted by:  :  Category: Medicare

The Patient Protection and Affordable Care Act (PPACA) is a federal statute signed into law along with its amendment, the Health Care and Education Reconciliation Act, by President Obama in March 2010.[i]  It is designed to take effect in stages over the next 8 years and includes reforms such as prohibiting insurers from denying coverage for pre-existing conditions, expanding Medicaid eligibility, subsidizing insurance premiums, and providing incentives for businesses to provide health care benefits.  It encourages states to create health insurance exchanges where uninsured adults or small businesses can buy insurance from a range of private insurers.  Large businesses will have to pay penalties for their employees who receive subsidized health insurance from insurance exchanges, but they are not required to provide insurance for their employees.   There is also a requirement for the individual purchase of health insurance, a subject of a major challenge to its constitutionality.  The PPACA also provides for the creation several bodies, including a National Prevention, Health Promotion and Public Health Council;  the Patient-Centered Outcomes Research Institute (created to conduct and fund comparative effectiveness research); and the Medicare Independent Payment Advisory Board (authorized to recommend Medicare spending reductions if Medicare spending increases too rapidly).   It extends coverage for children up to the age of 26 under their parents’ insurance even if they do not live with their parents and are not dependents.  Insurance companies will be prohibited from charging deductibles for most preventive care.  Insurance companies will no longer able to drop clients when they become ill.  The growth of Medicare provider reimbursements will be slowed to pay for some of the new expenditures proposed.  The Congressional Budget Office estimates that the number of uninsured persons will drop by 32 million people after all the provisions of the PPACA are in effect in 2019.  This will still leave 23 million people uncovered, including illegal immigrants and those who choose not to enroll in health insurance policies.  People who would be paying greater than 8% of their household incomes for health insurance would be exempt from the requirement to purchase insurance.  This has been projected to raise the proportion of insured non-elderly people (in the US legally) from 83% to 94%. [ii] 
Source: acep.org

Alternative Health, Wellness and Healthy Living Information, Articles and News

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Source: healthy.net

AHRQ Health Care Innovations Exchange

The Innovations Exchange is expanding efforts to scale up and spread innovations by sponsoring three Learning Communities (LCs) focused on the following high-priority topic areas: “Advancing the Practice of Patient- and Family-Centered Care in Hospitals,” “Reducing Non-Urgent Emergency Services,” and “Promoting Medication Therapy Management for At-Risk Populations.” Participants will work together in a collaborative group setting to adapt and implement innovation “clusters” that address their unique quality improvement needs.
Source: ahrq.gov

How to Reform Medicare: First Stage to Fix the Current Program

Posted by:  :  Category: Medicare

[5]The significant differences in official long-term projections, including projections of the program’s unfunded liability, reflect the differences in agency assumptions, particularly about the likelihood of the continuation of current law. The Medicare Trustees and the Congressional Budget Office (CBO) are required to make projections under current law, which assumes, for example, that the large Medicare Part A payment reductions are sustainable and that the projected 29.4 percent reduction in Medicare physician payment will be implemented in 2012. The Office of the Actuary in the Centers for Medicare and Medicaid Services (CMS) makes projections based on the premise that key elements of current law are simply “unworkable.” See John D. Shatto and M. Kent Clemens, “Projected Medicare Expenditures Under an Illustrative Scenario with Alternative Payment Updates to Medicare Providers,” Centers for Medicare and Medicaid Services, Office of the Actuary, May 13, 2011, at https://www.cms.gov/ReportsTrustFunds/downloads/2010TRAlternativeScenario.pdf (September 19, 2011).
Source: heritage.org

2011 Neurology CPT Code Changes

Count every hour of physician attendance: 95961 and 95962. Report 95961 for the first hour of physician attendance. Use modifier 52 with 95961 for 30 minutes or less. Report 95962 for each additional hour of physician attendance.
Source: klahealthcare.com

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

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

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

Medicare.gov Nursing Home Compare

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