When & how to sign up for Part A & Part B

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Source: medicare.gov

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

EmblemHealth: Family & Individual Health Insurance Plans In New York

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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: ghi.com

EmblemHealth: Medicare Coverage

All Medicare Advantage Plans and Medicare Prescription Drug Plans agree to stay in the program for a full calendar year at a time. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year. Each year, plans can decide whether to continue to participate with Medicare Advantage or Medicare Prescription Drug Plans. A plan may continue in their entire service area (geographic area where the plan accepts members) or choose to continue only in certain areas. Also, Medicare may decide to end a contract with a plan. Even if your Medicare Advantage Plan or Prescription Drug Plan leaves the program, you will not lose Medicare coverage. If a plan decides not to continue for an additional calendar year, it must send you a letter at least 90 days before your coverage will end. The letter will explain your options for Medicare coverage in your area.
Source: emblemhealth.com

EmblemHealth: Resources for Doctors, Hospitals and other Providers

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: ghi.com

GHI and EmblemHealth EPO/PPO Plans

A physician, hospital or other provider who has signed an agreement to covered services to EmblemHealth plan members. A network provider is a member of the EmblemHealth network of network providers applicable to the member’s certificate. Therefore, they are sometimes referred to as participating providers. Payment is made directly to a network provider. Please consult the EmblemHealth Directory or go online to search for network providers.
Source: emblemhealth.com

U.S. Global Health Programs: Home

In the 24 countries where the U.S. Government focuses its maternal and child health efforts, the maternal mortality ratio decreased almost 25 percent from 420 per 100,000 in 2005 to 321 per 100,000 in 2013.
Source: ghi.gov

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

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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

Location of Medicare Offices

If you are seeking office opening hours, the Department of Human Services Service Centre locator contains information updated weekly, a search function and maps. Please visit the Service Centre locator here: humanservices.findnearest.com.au
Source: gov.au

Location of Medicare Offices

The data below is provided for application developers or those wishing to reuse the data for other purposes. It is important that application developers keep the data up to date with the current version available on this website.
Source: gov.au

How to Locate a Medicare Office (6 Steps)

The Social Security Administration handles the U.S. health care program known as Medicare. Medicare helps senior citizens over 65 years of age get the health care and medical supplies they need. According to the Social Security Administration website, ssa.gov, most Medicare related tasks, such as applying for coverage, can be completed online or over the phone. However, there are a few crucial tasks that must be completed in person. Medicare offices are maintained in local Social Security Offices, which can be located through the Social Security Administration in two ways.
Source: ehow.com

Careers at SSA: USA Office Locations

Six program service centers serve the needs of the Social Security public nationwide. Located in New York, San Francisco, Philadelphia, Chicago, Kansas City, and Birmingham, these centers perform a variety of Social Security’s mission-critical tasks, including account maintenance, disability claims review, and benefits determinations.
Source: ssa.gov

Contact Information and Websites of Organizations for Medicare

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Source: medicare.gov

The United States Social Security Administration

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Today, the Social Security Administration proudly celebrates its 80th anniversary. On August 14, 1935, President Franklin D. Roosevelt signed the Social Security Act, landmark legislation that continues to provide hope…
Source: ssa.gov

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

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 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

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

Christie Call for Raising Age for Social Security, Cutting Benefit for Some Seniors

MANCHESTER, N.H.—Gov. Chris Christie called for reduced Social Security benefits for retired seniors earning more than $80,000 and eliminating the benefit entirely for individuals making $200,000 and up in other income, along with raising the retirement age to 69 from 67.
Source: wsj.com

When and How to Apply for Medicare

Posted by:  :  Category: Medicare

If you are not yet receiving Social Security benefits (or benefits from the Railroad Retirement system) you are eligible to sign up for Medicare 3 months prior to the month you turn 65, but your enrollment will not happen automatically. You must call or apply online – details below. It is to your benefit to sign up for Medicare Part A as soon as you are eligible, even if you still have coverage through a group health plan.
Source: about.com

When & how to sign up for Part A & Part B

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Source: medicare.gov

How to Apply for a CLIA Certificate, Including International Laboratories

NOTE: If you have any questions regarding the completion of the CMS-116 form, contact the appropriate State Agency. You should also contact this State Agency for additional forms that may be necessary to complete the registration process or for any additional questions. For example, the state of California has additional licensure requirements that must be met as a prerequisite to CLIA certification and thus California applicants should contact their local State Agency at (213) 620-6160. Be sure to make contact with your State Agency to ensure that you have all the necessary information that is required for the application.
Source: cms.gov

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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Source: medicare.gov

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

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Source: medicare.gov

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

Tufts Health Plan Medicare Preferred

In 2015, our HMO plans earned 4.5 out of a possible 5 Stars by the Center for Medicare and Medicaid Services. This rating combines the scores our plans received for the various medical and/or prescription drug services our plans offer.
Source: tuftsmedicarepreferred.org

Medicare Supplement Insurance and Plans

Medicare is the federal program the vast majority of Americans 65 and older depend on for their healthcare. People under 65 with disabilities and individuals with end-stage renal disease can also qualify. Medicare is commonly divided into four parts. Original Medicare Part A and Part B help pay costs for hospital care and medical expenses, respectively. Specifically, Part A pays for medically-necessary inpatient hospital services, skilled nursing facility care after a hospital stay, certain home healthcare, and hospice care. Part A does not pay for private hospital rooms, surgery that is not deemed medically-necessary, most care received outside the United States, unskilled personal care, and a variety of other services. Part B, meanwhile, pays only 80% of most Medicare-covered medical costs. Deductible, copayment, and coinsurance costs associated with Original Medicare add up quickly for many people.
Source: medicaremall.com

NEBRASKA MEDICAID PROGRAM

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To apply for medical assistance, an application must be completed and given to the Nebraska Department of Health & Human Services. For more information, contact your nearest Department of Health and Human Services Office; Or, you may download an application form and mail it to the nearest Department of Health and Human Services Office.
Source: ne.gov

Nebraska DHHS: Division of Medicaid & Long Term Care

The State Unit on Aging collaborates with public and private service providers to ensure a comprehensive and coordinated community-based services system that will assist individuals to live in a setting they choose and continue to be contributing members of their community. Nebraska’s aging network includes eight Area Agencies on Aging.
Source: ne.gov

NEBRASKA MEDICAID PROGRAM

The Nebraska Medicaid Program has received approval of a 1915(b) waiver which authorizes the operation of the Nebraska Health Connection, Nebraska’s Medicaid Managed Care Program. The waiver authorizes mental health and substance abuse services for managed care clients statewide in addition to primary care services for Children with Special Health Care Needs and the American Indian/Alaskan Native population in Douglas, Sarpy, and Lancaster Counties.  The balance of the managed care population receives primary care services under the authority of the State Plan.  The Nebraska Medicaid Program also has received approval of several home and community-based waivers under section 1915(c) of the Social Security Act. 
Source: ne.gov

NEBRASKA MEDICAID PROGRAM: Provider Information

A provider is any individual or entity which furnishes Medicaid goods or services under an approved provider agreement with the Department. To be eligible to participate in the Nebraska Medical Assistance Program (NMAP), the provider shall meet the general standards for all providers in Nebraska Administrative Code, Title 471, Chapters 1-000, 2-000, and 3-000 , if appropriate, and the standards for participation for that provider type.
Source: ne.gov

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

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"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

How to compare Medigap policies

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Source: medicare.gov

Should I Buy Supplemental Health Insurance?

Hospital Indemnity Insurance Hospital Indemnity Insurance (also known as Hospital Confinement Insurance) provides a cash benefit if you are “confined” to a hospital due to an illness or serious injury. The cash benefit – doled out in one lump sum or as daily or weekly payments – may not start until after a minimum waiting period. Similar to other types of supplemental insurance, the additional coverage is meant to help you pay for services and needed items not covered by your regular health plan.
Source: about.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 Insurance & Medicare Advantage Personal Service

Medicare Supplement Insurance, also known as MediGap Insurance, is designed to help cover some of the medical costs that are not covered by Medicare.  These Medigap coverage plans are available to anyone enrolled in Part A and B of Medicare.  There is an open MediGap Insurance enrollment period for the first six months after you turn age 65, in which you do not need to qualify or answer any questions about your prior medical history.
Source: medigapadvisors.com

DMEPOS Competitive Bidding

Posted by:  :  Category: Medicare

Under the program, a competition among suppliers who operate in a particular competitive bidding area is conducted. Suppliers are required to submit a bid for selected products. Not all products or items are subject to competitive bidding. Bids are submitted electronically through a web-based application process and required documents are mailed. Bids are evaluated based on the supplier’s eligibility, its financial stability and the bid price. Contracts are awarded to the Medicare suppliers who offer the best price and meet applicable quality and financial standards. Contract suppliers must agree to accept assignment on all claims for bid items and will be paid the bid price amount. The amount is derived from the median of all winning bids for an item.
Source: cms.gov

Competitive Bidding Program

The Competitive Bidding Program replaces the outdated prices Medicare has been paying with lower, more accurate prices. Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare now pays for these items. Medicare uses these bids to set the amount it pays for those equipment and supplies under the Competitive Bidding Program. Qualified, accredited suppliers with winning bids are chosen as Medicare contract suppliers.
Source: medicare.gov

DME Competitive Bidding Program

The Competitive Bidding Program replaces the outdated prices Medicare has been paying with lower, more accurate prices. Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare now pays for these items. Medicare uses these bids to set the amount it will pay for those equipment and supplies under the competitive bidding program. Qualified, accredited suppliers with winning bids are chosen as Medicare-contract suppliers.
Source: medicare.gov

H.R. 284, Medicare DMEPOS Competitive Bidding Improvement Act of 2015

Under current law, Medicare pays for some DME (including items like wheelchairs, hospital beds, and oxygen tanks and related supplies) using prices that are set through a two-stage process. In the first stage, firms submit bids to furnish a category of DME items to Medicare beneficiaries in a geographic area. The Medicare program uses those bids to exclude from the second stage the firms that submitted the highest bids. The remaining firms are invited to contract, for a period of three years, to supply that category of DME in that geographic area. The contractual price, or single payment amount (SPA), is the median bid of all the firms that are invited to participate in the second stage. Firms are free to decline to accept the contract.
Source: cbo.gov

DMEPOS Competitive Bidding

Today President Obama signed into law H.R. 2, the “Medicare Access and CHIP Reauthorization Act of 2015″ (MACRA), which reforms Medicare payment policy for physician services and adopts a series of policy changes affecting a wide range of providers and suppliers. Most notably, MACRA permanently repeals the statutory Sustainable Growth Rate (SGR) formula, achieving a goal that has eluded Congress for years. Now, after a period of stable payment updates, MACRA will link physician payment updates to quality, value measurements, and participation in alternative payment models.… Continue Reading
Source: healthindustrywashingtonwatch.com

Cost Report Data provides hospital financial information from Medicare cost reports filed by hospitals and contained in the CMS HCRIS file

Posted by:  :  Category: Medicare

CostReportData.com provides online Medicare cost report data to healthcare financial and reimbursement professionals. Our database of more than 6,000 hospitals is built from Medicare cost report information obtained from the federal Centers for Medicare and Medicaid Services (CMS).
Source: costreportdata.com

Costs for Medicare Advantage Plans

If you’re in a Medicare plan, review the “Evidence of Coverage” (EOC) and “Annual Notice of Change” (ANOC) your plan sends you each fall. The EOC gives you details about what the plan covers, how much you pay, and more. The ANOC includes any changes in coverage, costs, or service area that will be effective in January.
Source: medicare.gov

Medicare Administrative Costs Are Higher, Not Lower, Than for Private Insurance

When administrative costs are compared on a per-person basis, the picture changes. In 2005, Medicare’s administrative costs were $509 per primary beneficiary, compared to private-sector administrative costs of $453. In the years from 2000 to 2005, Medicare’s administrative costs per beneficiary were consistently higher than that for private insurance, ranging from 5 to 48 percent higher, depending on the year (see Table 1). This is despite the fact that private-sector "administrative" costs include state health insurance premium taxes of up to 4 percent (averaging around 2 percent, depending on the state)–an expense from which Medicare is exempt–as well as the cost of non-claim health care expenses, such as disease management and on-call nurse consultation services.
Source: heritage.org