Enroll in SummaCare Medicare

Posted by:  :  Category: Medicare

To enroll in the Topaz (HMO) NE plan, click here. To enroll in the Topaz (HMO) NW plan, click here. To enroll in the Ruby (HMO) NE plan, click here. To enroll in the Ruby (HMO) NW plan, click here. To enroll in the Sapphire (HMO-POS) NE, click here. To enroll in the Sapphire (HMO-POS) NW, click here. To enroll in the Emerald (HMO-POS) NE, click here.
Source: summacare.com

UnitedHealthcare Community Plan

Posted by:  :  Category: Medicare

AmeriChoice is the premier provider in the United States of high quality, personalized public sector health care programs, serving more than three million people in Medicaid, Medicare and Children’s Health Insurance Programs in 25 states and the District of Columbia. AmeriChoice is a business of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company. AmeriChoice has invested in the systems and people to successfully provide quality service to our state customers and we have designed health plans that meet the unique needs of the diverse populations we serve. The unique AmeriChoice Personal Care Model™ features direct member contact by clinical staff who work to build a support network for chronically and acutely ill members involving family, physicians and government and community-based organizations. The goal is to employ practical solutions to improve members’ health and keep them in their communities, with the resources they need to maintain the highest possible functional status. AmeriChoice uses a variety of advanced technology applications to ensure that high quality, timely and appropriate health care is available to all members. We have developed our own software to monitor member access to services. We use a sophisticated clinical risk stratification tool to ensure that our members are receiving optimal care. We emphasize preventive health and education. We regularly encourage members to get annual physicals and routine diagnostic and screening tests, and we often work with community organizations to ensure that there are no cultural or language barriers to our members getting the care they need. AmeriChoice believes that compassion and respect are essential components of a successful health care company. We contract with community-based networks and employ a diverse workforce, with varied backgrounds and extensive practical experience that gives us a better understanding of our members and their needs. Our detailed knowledge of our members and our service areas, the application of cutting-edge technology and the commitment of our employees have made AmeriChoice the leading choice for quality public sector health care.
Source: americhoice.com

kaiserEDU.org is now a part of kff.org

The kaiserEDU.org page you are looking for no longer exists. When the kff.org site was redesigned in 2013, various Foundation websites were consolidated into a single Kaiser Family Foundation site and the stand-alone kaiserEDU.org website was closed.
Source: kff.org

Medicare Supplement Plan G

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: bcbsil.com

Medicare Supplement Plan G

The majority of Medicare Supplement plans do not cover Part B excess charges, which is why Plan G may be of interest for those with frequent medical needs. Excess charges are additional expenses incurred outside of the Medicare-approved charge. For example, if Medicare’s allowed charge for a doctor’s appointment is $100, the physician may choose not to accept that amount, electing instead to charge an additional 15% for the appointment. In this instance, Medicare would pay 80% of the allowed charge, sending the physician $80. The beneficiary would then be responsible for paying not only the remaining $20, but also the excess 15% charge, another $15, making the total out-of-pocket cost $35. Because Plan G covers the Part B excess charges, all of the out-of-pocket costs in this example are covered by this policy.
Source: ehealthinsurance.com

Medicare Supplement Plan G

* 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.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 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

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

Medicare Form, Medicare Forms

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

Handbooks, Forms and Notices

Families will have the opportunity to print the forms, fill them out at home and return them to their child’s school. Please click on the links below to read the Forms and Notices Handbook, then to print out each form. Please sign the forms and return them to your child’s school.
Source: nc.us

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 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

What Medicare health plans cover

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, Demonstration/Pilot Programs, and Programs of All-inclusive Care for the Elderly (PACE).
Source: medicare.gov

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 Supplemental, Advantage, and Part D Plans

Because of the significant amount of out-of-pocket payments required by traditional Medicare, a booming market of private-sector insurance products has grown up around the government programs. These Medicare-related insurance products are one of the fastest-growing segments of the U.S. health insurance industry overall. And they are the part of the market on which a smart consumer should focus his or her attention. Medicare Providers mission is to help seniors understand these products and provide tools assist in the decision making process.
Source: medicare-providers.net

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

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: socialsecurity.gov

Medicare Advantage Insurance Costs

Medicare Advantage plans, also known as Part C plans, are provided by private insurance companies that are contracted by Medicare. Each of these companies has the option to price its plans differently, though each Medicare Advantage plan must offer at least the same amount of coverage as Original Medicare (Part A and Part B). Plans that offer additional coverage such as vision, dental, and prescription drug coverage are more likely to charge higher out-of-pocket costs. Certain types of Medicare Advantage plans may require that beneficiaries use in-network providers or they will not share in the costs of services. In general, Medicare Advantage plans require more cost-sharing than Original Medicare.
Source: ehealthinsurance.com

Medicare Cost Savings Programs

The SLMB program provides payment of Medicare Part B premiums only for individuals who would be eligible for the QMB program except for excess income. Income for this program must be more than 100% of the FPL, but not exceed 120% or 135% of the FPL.
Source: mo.gov

Medicare Fraud Reporting Center

Posted by:  :  Category: Medicare

Medicare Whistleblowers are typically healthcare professionals who are aware of hospitals, clinics, pharmacies, Nursing Homes, Hospices, long term care and other health care facilities that routinely overcharge or seek reimbursement from government programs for medical services not rendered, drugs not used, beds not slept in and ambulance rides not taken. If you have information about a person or a company that is cheating the Medicare program (or any other government run healthcare program), you may be able to collect a large financial reward for reporting it here.
Source: medicarefraudcenter.org

Another whistleblower suit alleges Medicare Advantage fraud

Whether her claims hold up in court or not, Silingo’s lawsuit is likely to draw further attention to government oversight of Medicare Advantage plans. The health plans, an alternative to standard Medicare, are mostly run by private insurance companies. They serve more than 15 million Americans, or about one in three elderly and disabled people on Medicare, at a cost to taxpayers that could reach $160 billion this year. The plans are paid based on a “risk score,” which estimates how sick patients are.  Medicare pays higher rates for sicker patients.
Source: publicintegrity.org

LabCorp Cheats Medicare, Costs Billions, Whistleblower Suit Alleges

This summer, the California state attorney general announced a $49.5 million settlement with LabCorp after allegations that it, and other labs, had overcharged the state’s Medicare program while providing kickbacks to doctors, hospitals and clinics that referred MediCal patients. In May, the attorney general settled with Quest Diagnostics for $241 million in what a press release describes as the same alleged practice.
Source: huffingtonpost.com

Ensign Group pays $48 million to settle whistleblower lawsuits alleging Medicare billing…

The “qui tam” (whistleblower) lawsuit alleged skilled nursing facilities operated by Ensign subsidiaries were billing Medicare for treatment of patients that wasn’t actually provided or wasn’t medically necessary. The government also alleged that some patients were admitted for treatment at the nursing homes when they didn’t need to be and that some were kept in the facilities longer than was medically necessary.
Source: prnewswire.com

How to report Durable Medical Equipment fraud (DME fraud) against Medicare and obtain a whistleblower reward

There are many fraudulent schemes by durable medical equipment (DME) companies. One durable medical equipment fraud (DME fraud) schemes consists of providing unnecessary equipment. Another Medicare DME fraud scheme is not supplying the medical equipment at all or providing it to a person not eligible for Medicare or Medicaid. Other durable medical equipment fraud (DME fraud) schemes include paying kickbacks or referral fees for patients. Still, other durable medical equipment fraud (DME fraud) schemes include upcoding or billing for a different and/or more expensive equipment than provided. Each of these fraudulent schemes will be briefly described followed by how to report durable medical equipment fraud (DME fraud) and how to apply for a reward for reporting DME fraud.
Source: howtoreportfraud.com

Report Medicare Fraud and Medicaid Fraud and get a whistleblower reward

The largest area of fraud against the government today is against Medicare fraud and Medicaid fraud. Approximately 10% of all Medicare/Medicaid bills are inflated or fraudulent. That helps explain why the Department of Justice pays such large whistleblower rewards for reporting Medicare fraud.
Source: howtoreportfraud.com

Medicare Advantage HMO Plan Options

Posted by:  :  Category: Medicare

CarePlus offers several Medicare Advantage plan choices*. At CarePlus, we’re ready to help you sort through your choices so you can make decisions with confidence. Not sure which Medicare plan is best for you? Enter your ZIP code at the top of this page to see plans available in your area, except for Special Needs Plans (SNPs). You can compare benefits, estimate costs, and enroll online. Find additional SNP information for your service area.
Source: care-plus-health-plans.com

CarePlus Florida 2015 Medicare Advantage Plans

+ These benefit plans are available to certain dual eligible members depending on the level of Medicaid they receive. These plans are available 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 you receive. CarePlus is an HMO plan with a Medicare contract. Enrollment in CarePlus depends on contract renewal. CareNeeds (HMO SNP) is sponsored by CarePlus and the State of Florida, Agency for Health Care Administration. Please contact the plan for further details.
Source: care-plus-health-plans.com

CarePlus Health Plans, Inc. Medicare Advantage Plans with Part D (Prescription Drug) Coverage

The following CarePlus Health Plans, Inc. plans offer Medicare Advantage and Part D coverage to Florida 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

FL Medicare Plan Wins 5 Stars

The state has such a competitive market that many plans charge no premium, including CarePlus’ five-star plans and some other companies’ plans that won 4 1/2 stars. In fact, in some counties plans with high ratings even reimburse Medicare beneficiaries for some of their Part B monthly premium of $104.90 — a deal that’s almost unheard-of elsewhere in the country.
Source: usf.edu

CarePlus Health Plans, Inc. Medicare Part D (Prescription Drug) Plans

The following CarePlus Health Plans, Inc. plans offer Part D coverage to Florida residents. Medicare Part D plans, also known as prescription drug plans, help cover the cost of prescription medications. Not all plans shown here will be available to you; enter your zip code to see plans in your area. You can also read buying advice for picking a Part D plan, or browse private Medicare plans with drug coverage.
Source: usnews.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

ICS Community Care Plus FIDA

For information on ICS Community Care Plus FIDA-MMP contact ICS Community Care Plus FIDA-MMP or the New York Enrollment Broker. To enroll or for other options for your health care, call the New York Enrollment Broker at 1-855-600-FIDA TTY 1.888.329.1541from Monday-Friday, 8:30 am to 8:00 pm, and Saturday, 10:00 am to 6:00 pm or  visit http://www.nymedicaidchoice.com.
Source: icsny.org

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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: 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

Filing a Medicare Claim and Checking the Status

If you have Original Medicare, the amount you pay at the time you receive a health service will depend on whether your doctor is a Medicare-participating provider and accepts assignment. Medicare-participating providers are on contract with Medicare to accept and treat patients for all Medicare-covered services and supplies. A provider that accepts assignment agrees to accept the Medicare-approved amount as full payment for a covered service or supply. In this instance, the provider is required to file Medicare claims for any services you received, and Medicare will pay the provider directly for those services. The provider is not allowed to charge you to submit the claim.
Source: planprescriber.com