Medicare.gov: the official U.S. government site for Medicare

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Source: medicare.gov

Difference between the Medicare Provider Numbers

Applicable FARSDFARS Restrictions Apply to Government Use. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60654. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
Source: wpsmedicare.com

NPI Entity Type 1/Type 2 and Medicare Provider Numbers

Even if the practice association is an S corporation or a “disregarded entity” (i.e., tax return can be filed in the physician’s name), the above applies. From an NPI perspective, an S corporation is no different from a limited liability corporation or any other type of corporation; if the PA receives payments, it must have its own Type 2 NPI.
Source: texmed.org

How to Get a Medicare Provider Number (7 Steps)

A Medicare provider number is known as a “national provider identifier,” a ten-digit identification number for covered health care providers. The Centers for Medicare and Medicaid Services state that covered health care providers, health care plans and health care clearinghouses are required to have national provider identifiers for administrative and financial transactions under the Health Insurance Portability and Accountability Act (HIPAA). In order to obtain a national provider identifier, you will have to apply. You can download an application and mail it in or fill out the application and apply online.
Source: ehow.com

Medicare Unmasked: Behind the Numbers

This project uses data made public by the Centers for Medicare and Medicaid Services. It shows the dollar amounts that doctors and other medical providers received in Medicare reimbursements in 2012 and 2013, along with other data including their specialties. Only procedures which providers performed on more than 10 Medicare patients were included in the data released. There is some information CMS hasn’t provided. In some cases, procedures attributed to a specific physician may have been performed by other people under that doctor’s supervision. The data doesn’t include information on patients nor does it show doctors’ billings related to durable medical equipment.
Source: wsj.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

Medicare.gov Nursing Home Compare

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Source: medicare.gov

Healthcare business news, research, data and events from Modern Healthcare

A discovery found within saliva may someday lead to a test that can detect the likelihood for developing Alzheimer’s disease before a patient begins to experience deterioration of their cognitive function. That early detection could lead to earlier intervention by providers and better outcomes for…
Source: modernhealthcare.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

About Medicare Supplement

Other Plan Provisions You must satisfy an annual deductible of $300 before the Plan starts paying. If you meet your annual out-of-pocket limit of $3,000, the Plan’s reimbursement level — when combined with Medicare Parts A and B — is 100% of most covered charges for the rest of that calendar year. The Plan covers some items Medicare may not, such as transition benefits from pre-65 medical plans sponsored by ExxonMobil, in-home skilled-nursing care and medical care received outside the United States. See page 18.
Source: exxonmobilfamily.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

New York Medicare Advantage Plans for 2015 from Touchstone Health

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We understand that everyone has different health care needs. That is why we have a robust selection of Medicare plans to choose from including plans with or without prescription drug coverage and a plan for those who qualify for Medicaid.
Source: touchstoneh.com

Medicare Part B at My New York Medicare

If Medicare-eligible beneficiaries do not buy Medicare Part B when they are first eligible, a penalty will be incurred. For each year of delayed enrollment, an extra 10% of the premium will be added to the total. The premium penalty will have to be paid every month as long as a beneficiary has Medicare Part B. Then the penalty is only removed if the beneficiary, who had been enrolled in Part B due to disability, turns 65. Also, this penalty does not apply if the eligible beneficiary has a Special Enrollment Period.
Source: mynewyorkmedicare.net

New York Medicare Advantage Plans with Part D (Prescription Drug) Coverage

The plans below offer Medicare Advantage and Part D coverage to New York 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

Overview of the Medicare Program at My New York Medicare

Because you are buying Medicare Advantage through a private insurance company, the plans can vary. The plan must cover at least what Original Medicare covers, but it may cover those services differently and it may cover even more services. Many Medicare Advantage plans include coverage for prescription drugs, vision care, dental care – even out-of-country care. Further, these plans may offer discount programs for gym memberships, chiropractic care, vitamins and other health-related products and services. These plans may also have network restrictions.
Source: mynewyorkmedicare.net

EmblemHealth: Family & Individual Health Insurance Plans In New York

To view this Web site, you need to have JavaScript enabled in your browser. Don’t worry — you can still sign in to the secure myEmblemHealth Web site or search for a doctor using the links below. If you need help registering for the secure site, please call Customer Service at the number on the back of your ID card.
Source: emblemhealth.com

Medicare.gov: the official U.S. government site for Medicare

Posted by:  :  Category: Medicare

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Source: medicare.gov

Medicare reimbursement rates by state (medical, plan, hospital, doctor)

Your are asking a question that really has no clear answer and even if you had the answer, it would be meaningless to you. What you are asking for is called a Fee Schedule. There are Fee Schedules for Physicians, for different specialties, for procedure, for durable medical equipment, for ambulances, for clinical laboratory services etc. Also Fee Schedules are not based on a State but on smaller geographical areas within the State, using zip code identifiers. So a list of State information that gives some average calculated data from these specific areas will mean nothing. You can bet that fee schedules are much different for Buffalo than for New York City. You must understand that the fee schedule is based on complicated formulas for different aspects of care and geographic area of practice. You would have to understand GPCI, Geographic Practice Cost Index as related to the MPFS (Medicare Physician Fee Scheldule) if you are looking for Physician Fee Schedule. You would have to know the RVU (Relative Value Unit) for different procedures. In addition, all that would be just a part of the issue of acceptance or non-acceptance of original medicare patients. You cannot tell if the physician has the maximum patients that he can handle and what are the percentages he views as economical to his practice. You could not tell if the physician is practicing in an area with a large Medicare or Medicaid base of patients. You could not tell the amount of physicians per population and whether it can sustain a greater patient load. You cannot tell if the the practice is new and is building new patients or if the practice has more elderly patients that they lose to death and need more. If you want to be assured more of being accepted as a patient then add to your original medicare with a supplemental plan that will provide better reimbursement and will have physicians on their plan willing to accept you. In addition all this will change radically, when many more people are eligible for healthcare under the Affordable Care Act, so that a Physician may have more than enough customers, So, you think you have problems now. I will bet that Physicians will not want or even need more customers who do not want to buy more insurance to attach to basic medicare. If you say that is unfair, that is reality. For Americans are deemed to have enough money to buy more insurance if they are not consider poor. If they are poor, then they would qualify for Medicaid on top of Medicare. I am on Medicare and I have extra coverage and I have no problems finding a Physician. Sure it cost more every month; you just have to budget. That is the answer to your question, not hunting around the country for doctors and what will you do when new masses of patients come knocking on the doctor’s door, with a better plan and more money–you will be pushed aside. Livecontent
Source: city-data.com

Sustainable Growth Rates & Conversion Factors

Section 1848 of the Social Security Act requires the Secretary to make available to the Medicare Payment Advisory Commission (MedPAC) and the public by March 1 of each year, an estimated Sustainable Growth Rate (SGR) and estimated conversion factor applicable to Medicare payments for physicians’ services for the following year and the data underlying these estimates. We provide the estimates and information applicable to physician fee schedule payments via this web page.
Source: cms.gov

Medicare Hospital Compare Quality of Care

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Source: medicare.gov

Medicare.gov: the official U.S. government site for Medicare

Posted by:  :  Category: Medicare

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Source: medicare.gov

Contact Information and Websites of Organizations for Medicare

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Source: medicare.gov

Excellus BlueCross BlueShield

The organizer includes a Medicare Timeline highlighting your most important steps and an Understanding Medicare DVD which features answers to commonly asked Medicare questions. If you would like to request your Medicare Organizer online, please fill out the optional form below. By entering your e-mail address below, you will opt-in to receiving future plan information and communications from Excellus BlueCross BlueShield via e-mail. If you do not confirm, you will not receive any additional e-mails. If you do confirm, you will have the choice to opt out of e-mail correspondence at any time. If you would prefer to request your Medicare organizer without providing your e-mail address, you may call one of our representatives toll-free at 1-855-547-7710 or return the business reply card you received in the mail.
Source: excellusbcbs.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

Coventry Medicare: Locate A Provider

Need to find a provider?  Our online provider search tools give you flexibility in a simple format.  Just select the type of provider you are looking for from the links below and be connected to the appropriate search tool.
Source: coventryhealthcare.com

Dental Insurance for Seniors on Medicare

Senior citizens all across the U.S. are seeking coverage to aid in reducing their dental expenditures. Currently, minimal government assistance is available for seniors who need dental insurance. The majority of Medicare and Medicaid programs do not include dentistry. Even those programs that do include coverage for seniors only contain provisions for extractions of teeth, and exclude the majority of the common oral procedures often required for older patients. Practically no help is available for obtaining primary tooth repair or for having missing teeth replaced. Usually Medicare and Medicaid supply virtually no aid for just about any type of oral care.
Source: medicarewire.com

Raising the Age of Eligibility for Medicare to 67: An Updated Estimate of the Budgetary Effects

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Outlays for Medicare would be lower under this option because fewer people would be eligible for the program than the number projected under current law. In addition, outlays for Social Security retirement benefits would decline slightly because raising the eligibility age for Medicare would induce some people to delay applying for retirement benefits. One reason is that some people apply for Social Security at the same time that they apply for Medicare; another reason is that this option would encourage some people to postpone retirement to maintain their employment-based health insurance coverage until they became eligible for Medicare. CBO expects that latter effect would be fairly small, however, because of two considerations: First, the proportion of people who currently leave the labor force at age 65 is only slightly larger than the proportion who leave at slightly younger or older ages, which suggests that maintaining employment-based coverage until the eligibility age for Medicare is not the determining factor in most people’s retirement decisions. Second, with the opening of the health insurance exchanges, workers who give up employment-based insurance by retiring will have access to an alternative source of coverage (and may qualify for subsidies if they are not eligible for Medicare). This option could also prompt more people to apply for Social Security disability benefits so they could qualify for Medicare before reaching the usual age of eligibility. However, in CBO’s view, that effect would be quite small, and it is not included in this estimate.
Source: cbo.gov

Raising the Ages of Eligibility for Medicare and Social Security

Raising the ages at which people can collect Medicare and Social Security would reduce federal spending and increase federal revenues by inducing some people to work longer. However, raising the eligibility ages for those programs also would reduce people’s lifetime Social Security benefits and cause many of the people who would otherwise have enrolled in Medicare to face higher premiums for health insurance, higher out-of-pocket costs for health care, or both. This issue brief reviews how ages of eligibility affect beneficiaries under current law and how delaying eligibility would affect beneficiaries, the federal budget, and the economy.
Source: cbo.gov

Medicare Eligibility Requirements

Note: You can qualify for Medicare on your spouse’s work record if he or she is at least age 62 and you are at least age 65. You also may qualify on the work record of a divorced or deceased spouse. Following the Supreme Court’s ruling on the Defense of Marriage Act in June 2013, people in same-sex marriages may qualify on their spouse’s work record if they live in the state where they were wed or in another state that recognizes same-sex marriage, or if they are civilian or military employees of the federal government. It’s currently unclear whether same-sex couples outside of these categories have the same rights — but if you’re in this position, you should apply anyway.
Source: aarp.org

Medicare Eligibility Overview

The Medicare Advantage Disenrollment Period (MADP) allows a person to drop a Medicare Advantage plan purchased during the previous Open Enrollment and return to Original Medicare. It occurs every year from
Source: medicaremadeclear.com

What Age For Medicare Eligibility?

If a person has end stage renal disease (ESRD) or amyotropic lateral sclerosis (ALS, also known as Lou Gehrig’s disease) there is no 24-month waiting period for benefits. A person diagnosed with ESRD can generally begin receiving benefits three months after a course of regular dialysis or after a kidney transplant. As soon as a person diagnosed with ALS begins collecting Social Security Disability benefits, he or she is enrolled in Part A and Part B Medicare benefits.
Source: investopedia.com

Compare Medicare Advantage & Supplemental Plans

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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