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

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

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

How Part D works with other insurance

While prescription drug coverage is an essential health benefit, prescription drug coverage in a Marketplace or SHOP plan isn’t required to be at least as good as Medicare Part D coverage (creditable). However, all private insurers offering prescription drug coverage, including Marketplace and SHOP plans, are required to determine if their prescription drug coverage is creditable each year and let you know in writing.
Source: medicare.gov

Medicare Part D Plans, Prescription Drug Plan (PDP)

First Health Part D First Health Part D is a Medicare-approved Part D sponsor. Enrollment in our plan(s) 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, premium and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. 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. This information is available for free in other languages. Please call our customer service number at 1-855-389-9688 (TTY/TDD 711), 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.
Source: coventryhealthcare.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

Medicare Part D Plans, Prescription Drug Plan (PDP)

First Health Part D First Health Part D is a Medicare-approved Part D sponsor. Enrollment in our plan(s) 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, premium and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. 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. This information is available for free in other languages. Please call our customer service number at 1-855-389-9688 (TTY/TDD 711), 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.
Source: coventryhealthcare.com

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

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

How Part D works with other insurance

While prescription drug coverage is an essential health benefit, prescription drug coverage in a Marketplace or SHOP plan isn’t required to be at least as good as Medicare Part D coverage (creditable). However, all private insurers offering prescription drug coverage, including Marketplace and SHOP plans, are required to determine if their prescription drug coverage is creditable each year and let you know in writing.
Source: medicare.gov

Compare Medicare Supplement Insurance Plans & Medigap Plans and Rates for 2011. See Plan Chart for AL, AR, AZ, CO, FL, GA, IA, ID, KS, KY, LA, MD, MI, MO, MN, MS, NC, NE, NM, OH, OK, SC, TN, TX, VA & WV. Medigap Insurance Plans including the Popular Plan F & G

Posted by:  :  Category: Medicare

Year after year we have found Medicare Supplement Plan F or Medicare Supplement Plan G to be the best value for the dollar. The new Plan N is a great alternative to a Medicare Advantage plan.  Plan N might be recommended depending on which state you live in and how much the supplement cost in relation to available Medicare Advantage plans. A plan N will provide more coverage and a very reasonable premium. In Florida we have the lowest rate for plan F & plan N. See the Medicare Supplement Plan chart below. In general, the higher you go up in the plan chart the more Gaps the plan fills. Medicare Supplement Plan F is the most comprehensive supplement plan and there is not a better plan than F. Most people will select a Plan F. However, depending on your personal situation there may be a more cost efficient choice.
Source: themedicarechannel.com

Medicare Sustainable Growth Rate

Section 101 of the Tax Relief and Health Care Act of 2006 (MIEA-TRHCA) provided a 1-year update of 0% for the conversion factor for CY 2007 and specified that the conversion factor for CY 2008 must be computed as if the 1-year update had never applied. Section 101 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) provided a 6-month increase of 0.5% in the CY 2008 conversion factor, from January 1, 2008, through June 30, 2008, and specified that the conversion factor for the remaining portion of 2008 and the conversion factors for CY 2009 and subsequent years must be computed as if the 6-month increase had never applied. Section 131 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) extended the increase in the CY 2008 conversion factor that was applicable for the first half of the year to the entire year, provided for a 1.1% increase to the CY 2009 conversion factor, and specified that the conversion factors for CY 2010 and subsequent years must be computed as if the increases had never applied.
Source: wikipedia.org

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 Supplement Rates

Since there is large number of companies providing Medigap insurance at various rates, we suggest you shop around. The good thing is that you can use our quote engine to find all the rates from every top provider from this very site! Fill your details at the top of this page and let MedSupRates do the shopping for you; you may save a lot of money on your premiums. Since these plans are standardized, you will receive the same coverage from all the companies but the premium rates can differ from one company to another.
Source: medsuprates.com

Colorado Medicaid: eligibility, enrollment and benefits

Posted by:  :  Category: Medicare

One of the Affordable Care Act’s primary strategies for reducing the uninsured rate is Medicaid expansion to cover low-income, non-elderly adults without dependent children. Medicaid expansion was a required element of the ACA as originally written. However, a coalition of states challenged Medicaid expansion and several other provisions of the ACA. While the court rejected most of the challenges, it did rule that Medicaid expansion was optional.
Source: healthinsurance.org

Colorado CO Medicaid Dentist Public Dental Provider Health Clinic

Finding an approved dentist in your immediate area can be difficult or frustrating. In general terms, smaller cities have few provider resources that can include general dentists or practices and a variety of specialties. Orthodontists are also listed in a directory at Medicaid Orthodontist.com. The specialty of oral surgery may best be found by finding general dentistry practices that are already enrolled providers. If oral surgery is not available with a particular practice, a referral may be possible from that office. Endodontists (root canal specialists) may also be similarly found. Medicaid recipients may discover they will need to travel to another county or city to find approved practices. Dentists who accept medicaid payment programs for childrens dentistry can be found through the use of a family dental practice that provides general dental care patient of all ages or through Pediatric specialists that are listed, in part, in this directory.
Source: medicaiddentistry.com

Member Frequently Asked Questions

Through scientific testing, the Food and Drug Administration (FDA) ensures that generic drugs are safe and effective, contain the same active ingredient and work the same way as the brand name. Colorado Medicaid can pay for a name brand drug if a generic is not available, if your doctor considers the name brand to be medically necessary or if the medication is excluded from the generic mandate (e.g., medications for mental illness, cancer, epilepsy and HIV/AIDS). In cases where your doctor would like you to have the brand name when a generic is available, a prior authorization will need to be completed by your doctor and the prior authorization must be approved by Colorado Medicaid before you will be allowed to receive the brand name.
Source: colorado.gov

UnitedHealthcare Medicare Plans

Posted by:  :  Category: Medicare

A Medicare Advantage Plan (Part C) is a type of Medicare health plan offered by a private insurance company that contracts with Medicare to provide Original Medicare (Parts A and  B) benefits. Medicare Advantage Plans can combine hospital, doctor and drug coverage in one plan, and may include extra benefits not offered by Original Medicare.
Source: uhc.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

United American Medicare Part D

Thank you for your interest in our Medicare Prescription Drug Plans. We are not able to take enrollments into our plans at this time. If you would like to speak to a Customer Service Representative about your current plan, please contact
Source: uamedicarepartd.com

The United States Social Security Administration

Posted by:  :  Category: Medicare

Everyone knows the value of a good friend. They give you advice and console you when you’re in need. On August 3, Friendship Day reminded us to acknowledge the people who are closest to us by thanking, loving, and spending…
Source: socialsecurity.gov

Social Security/Medicare and Self

Under the rules pertaining to the Substantial Presence Test, foreign scholars, teachers, researchers, trainees (including medical interns), physicians, au pairs, summer camp workers, and other nonimmigrants who arrive in the United States on J-1, Q-1, and Q-2 visas are considered to be “exempt individuals” (i.e., exempt from counting days of presence in the United States under the Substantial Presence Test) during the first two calendar years of their physical presence in the United States.  Foreign students who arrive in the United States on F-1, J-1, M-1, Q-1 or Q-2 visas are considered to be exempt individuals during the first five calendar years of their physical presence in the United States. This means that foreign scholars, teachers, researchers, trainees, physicians, au pairs, summer camp workers, and other non-students who enter the United States on J-1, Q-1 or Q-2 visas are considered to be NONRESIDENT ALIENS during their first two calendar years in the United States.  And, foreign students who enter the United States on F-1, J-1, M-1, Q-1or Q-2 visas are considered to be NONRESIDENT ALIENS during their first five calendar years in the United States.
Source: irs.gov

Social Security (FICA) and Medicare Deduction

Social Security (FICA) and Medicare Deduction A taxpayer may claim a deduction for the amount contributed in the taxable year to FICA or a Railroad Retirement Plan, or to a U.S. or Massachusetts Retirement fund up to $2,000. If married filing joint, each spouse may claim up to $2,000 of his or her own contributions. Payment amounts may not be combined or transferred from one spouse to the other. Federal Insurance Contributions Act (FICA) Tax is an amount paid by individuals during the period in which they earn wages for purposes of providing them with benefits when they retire. Social Security benefits are made available to retired workers, their spouses and their dependents as well as to disabled workers, their spouses and their dependents. FICA tax is also known as the Social Security tax. Specifically, this deduction is allowed for the following:
Source: mass.gov

Does Medicare or Medicaid Come With Social Security or SSI Disability Benefits?

Note that SSI recipients in 209(b) states are allowed to spend down even if the state doesn’t have a “medically needy” program, a separate type of Medicaid eligibility program that allows some individuals to spend down their medical expenses. In the 209(b) states that do have a medically needy program, SSI recipients have to spend down only to the 209(b) income standard, not the medically needy income limit (MNIL). (In most 209(b) states, the 209(b) income limits for Medicaid are higher than the income limits for Medicaid’s medically needy program.) 
Source: nolo.com

Social Security (United States)

Due to changing needs or personal preferences, a person may go back to work after retiring. In this case, it is possible to get Social Security retirement or survivors benefits and work at the same time. A worker who is of full retirement age or older may (with spouse) keep all benefits, after taxes, regardless of earnings. But, if this worker or the worker’s spouse are younger than full retirement age and receiving benefits and earn “too much”, the benefits will be reduced. If working under full retirement age for the entire year and receiving benefits, Social Security deducts $1 from the worker’s benefit payments for every $2 earned above the annual limit of $15,120 (2013). Deductions cease when the benefits have been reduced to zero and the worker will get one more year of income and age credit, slightly increasing future benefits at retirement. For example, if you were receiving benefits of $1,230/month (the average benefit paid) or $14,760 a year and have an income of $29,520/year above the $15,120 limit ($44,640/year) you would lose all ($14,760) of your benefits. If you made $1,000 more than $15,200/year you would “only lose” $500 in benefits. You would get no benefits for the months you work until the $1 deduction for $2 income “squeeze” is satisfied. Your first social security check will be delayed for several months—the first check may only be a fraction of the “full” amount. The benefit deductions change in the year you reach full retirement age and are still working—Social Security only deducts $1 in benefits for every $3 you earn above $40,080 in 2013 for that year and has no deduction thereafter. The income limits change (presumably for inflation) year by year.
Source: wikipedia.org

New or Replacement Social Security Number Card

You need a Social Security number to get a job, collect Social Security benefits and get some other government services. But you don’t often need to show your Social Security card. Do not carry your card with you. Keep it in a safe place with your other important papers.
Source: socialsecurity.gov

Social Security Amendments of 1965

The groups previously opposed to the legislation switched their focus from opposing the bill to creating new versions of it. As a result, three forms of the bill emerged: John Byrnes’, the American Medical Association’s, and the administration’s bill (known as Medicare). Byrnes was a Republican committee member who proposed that doctors’ services and drugs be financed; participation in coverage would be voluntary for the aged. If an elderly patient did need the help, his or her financing would be “scaled to the amounts of the participant’s Social Security cash benefits” and the financing would come from the government’s revenues. The AMA proposed Eldercare, which provided government financing for physician’s services, surgical charges, drugs, nursing home costs, x-ray and lab services. When brought back to the Ways and Means committee, three bills were presented: Byrnes,’ Eldercare, and Medicare.
Source: wikipedia.org

Medicare plans from Independence Blue Cross

Posted by:  :  Category: Medicare

To file an appeal or grievance for your medical benefit coverage or your prescription drug coverage, contact Keystone 65 Customer Service at 1-800-645-3965; Personal Choice 65 Customer Service at 1-888-718-3333; Select Option Customer Service at 1-888-678-7009. TTY/TDD users should call 711, 7 days a week, 8 a.m. to 8 p.m.
Source: ibxmedicare.com

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 Advantage 2015 Data Spotlight: Overview of Plan Changes

When SNPs were authorized, there were few requirements beyond those otherwise required of other Medicare Advantage plans. The Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 established additional requirements for SNPs, including requiring all SNPs to provide a care management plan to document how care would be provided for enrollees and requiring C-SNPs to limit enrollment to beneficiaries with specific diagnoses or conditions. As a result of the new MIPPA requirements, the number of SNPs declined in 2010. The ACA required D-SNPs to have a contract with the Medicaid agency for every state in which the plan operates, beginning in 2013. Additionally, in 2013, joint federal-state financial alignment demonstrations to improve the coordination of Medicare and Medicaid for dually eligible beneficiaries began to enroll beneficiaries. Today, financial alignment demonstrations are underway in 12 states: California, Colorado, Illinois, Massachusetts, Michigan, Minnesota, New York, Ohio, South Carolina, Texas, Virginia, and Washington. The financial alignment demonstrations could influence the availability of D-SNPs in these states, either increasing or decreasing the availability of SNPs, depending on the design of the demonstration.
Source: kff.org

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 Plans 2015Compare Medicare Supplement Plans 2015

With ever increasing numbers of people turning 65 and needing Medicare health care benefits, the choices are numerous. Is a Medicare Supplement plan the best option, or perhaps a Medicare advantage plan? Several people have turned to supplemental insurance for Medicare Part A and Part B and have been extremely happy with their coverage. We’ll help you to compare Medicare Supplement Plans in 2015 so you can choose the best coverage to fit your needs, as well as not overpay for it.
Source: comparemedicaresupplementplans2015.com

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

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

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

Compare Medicare Advantage Plans in 2015

The Kaiser Family Foundation also says that plans and costs are bound to differ wildly in different areas of the country or even regions of the same state. Available plans and premiums can differ when you cross a ZIP code boundary or into a new county. The key is to find different options in your local area and select the one that suits your needs and budget the best. Your own right choice will depend upon the premium, options available in your town or city, the network of medical providers, covered benefits and benefit amounts, and the potential for out of pocket costs.
Source: medicareadvantageplans2015.net

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 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

Health Insurance, Dental Insurance & Other Insurance Plans

Saving money on health care can be a challenge. But we’re here to help. There are a number of ways to reduce your out-of-pocket costs. For example, choose an in-network doctor or hospital instead of one that’s out of network. Another good way to save is to choose a plan that is compatible with a tax-advantaged health savings account.
Source: aetna.com