2015 Tennessee Medicare Part D Prescription Drug Plan Highlights www.Q1Medicare.com

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Coverage Gap the Donut Hole: In the CMS Standard Plan, the beneficiary must pay the next $3720 in drug costs (the Donut Hole). The Healthcare Reform provides that for Plan Year 2015, ALL formulary generics will have at least a 35% discount and ALL brand drugs will have at least a 55% discount in the coverage gap. The Gap Coverage Types discussed in this section are in addition to the Healthcare Reform mandated discounts. In our chart, you will see one of the following:
Source: q1medicare.com

The University of Tennessee, Payroll Office

For employees hired on or after July 1st, 2015, the rules regarding the effective date of insurance coverage will change. Coverage will begin the first day of the month following completion of one full calendar month of employment.  For example, an employee hired on March 1st will have coverage effective on April 1st.  An employee hired on March 2nd will have coverage effective May 1st.
Source: tennessee.edu

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

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

Medicare Supplement Plans & Quotes

Turning 65 is stressful, and the amount of information people receive leading up to their birthday is astounding. From the stacks of mail piling up on your desk, to the seemingly endless phone calls and quotes from insurance companies and agents, the task of gathering honest, unbiased information can feel impossible. Our goal is to offer what nobody else will, which is why we provide medicare supplement quotes, financial ratings, benefit information, application fee data, price history, and pricing methodology for all supplemental insurance companies in one clean, concise report. Our free, no obligation service is designed to give you the information you need regarding Part D and Medicare Supplement Plans in order to make an educated purchasing decision. In addition, we offer continued support for all of our customers to ensure they have no claims or billing issues. On an annual basis we review all medicare supplement insurance quotes and plan options in an effort to notify our customers of any new or better plans that may be available.
Source: medicaresupplementshop.com

Compare Medicare 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 Plans

For Texas residents. If a checkmark appears in a column of this Medicare Supplement chart, the Medigap policy covers 100% of the described medicare benefit. If a column lists a percentage, the medicare supplement policy covers that percentage of the described medicare benefit. If a column is blank, the medicare supplement insurance policy doesn’t cover that benefit.
Source: mysenioradvisorsgroup.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

How to compare Medigap policies

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 Supplement Plans

To be eligible to enroll in a Medicare Supplement plan, you must be enrolled in both Medicare Part A and Part B. The best time to enroll in a plan is during the Medigap Open Enrollment Period, which begins on the first day of the month that you are both age 65 or older and enrolled in Part B, and lasts for six months. During this period, you have the guaranteed issue right to join any plan of your choice, meaning that you may not be denied coverage based on any pre-existing conditions. If you miss this enrollment period and attempt to enroll in the future, you may be denied coverage based on your medical history.
Source: ehealthinsurance.com

Medicare Supplement Insurance

Posted by:  :  Category: Medicare

*Plans K-N provide for different cost-sharing than plans A-G. Plans K and L pay 100% of hospitalization and preventive care Basic Benefits. All other Basic Benefits are paid at 50% (Plan K) and 75% (Plan L). Once you reach the annual limit, the plan pays 100% of the Medicare copayments, coinsurance and deductibles for the rest of the calendar year. The out-of-pocket annual limit does NOT include charges from your provider that exceed Medicare-approved amounts, called “excess charges.” You are responsible for paying excess charges. Plan N covers Basic Benefits after a $20 copay for office visits and a $50 copay for emergency room visits. **The out-of-pocket annual limit may increase each year for inflation. (2015 limits shown) † Network restrictions apply
Source: bcbsil.com

About the Blue Cross and Blue Shield Association

Blue Cross Blue Shield Association and Blue Health Intelligence have collaborated and released the Blue Cross Blue Shield, The Health of America Report. This report analyzed three years of independent Blue Cross and Blue Shield (BCBS) companies’ claims data for typical knee and hip replacement surgeries and found that their cost can vary by as much as 313%, depending on where the surgeries are performed. Read the full report.
Source: bcbs.com

Blue Cross Blue Shield Medicare Coverage

In order for medical services to be considered for payment by Medicare, doctors, hospitals and other health care providers that are approved by Medicare must be used. Always check with your doctor or other health care providers to make sure he or she is Medicare-approved.
Source: bcbstx.com

Medicare Information Office

Posted by:  :  Category: Medicare

Scammers are calling Medicare beneficiaries and telling them they need a new Medicare card. They ask for people’s Medicare numbers and banking information. They may have some already, which makes them sound convincing. DO NOT GIVE THIS INFO! Medicare will NEVER call you or stop by and ask for your personal information. Here is a flyer with more information you can print and post.
Source: alaska.gov

Medigap (Medicare Supplement)

Medigap insurance companies in Alaska sell “standardized” policies which means companies can only sell 10 plans identified by the letters A, B, C, D, F, G, K, L, M, and N. A company does not have to sell all 10 plans, but every company must sell Plan A (Basic Benefits only). If the insurance company offers any plan in addition to Plan A, the company must also offer Plan C or F. Each company decides which Medigap policy it wants to sell. As long as you compare the same alphabet letter the benefits are the same, the only difference is the company and the monthly (premium) cost.
Source: alaska.gov

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

American Indian/Alaska Native

Since 2004, there have been significant changes in Federal healthcare legislation. The American Reinvestment and Recovery Act (ARRA) codified the TTAG/CMS relationship, strengthening the already well-established collaboration between CMS and I/T/Us. The Children’s Health Insurance Program Reauthorization Act (CHIPRA) added new provisions to eliminate barriers and fund innovative strategies to increase enrollment in Medicaid and CHIP, specifically for AI/AN beneficiaries. And most recently, the Patient Protection and Affordable Care Act of 2010 (PPACA) was enacted, representing historic reform by expanding health coverage to millions of the uninsured, strengthening the coverage of those already insured, and dramatically expanding programs like Medicaid, CHIP, and Medicare. Within the vast reforms in PPACA, AI/AN populations will be affected not only by the general provisions, but through specific, explicit provisions, including the permanent reauthorization of the Indian Health Care Improvement Act.
Source: cms.gov

Noridian Healthcare Solutions, LLC

Part A claims processing covers services provided through hospitals and post-hospital care. Noridian administers Part A for ‘)” onmouseout=”UnTip()”>Jurisdiction F and ‘)” onmouseout=”UnTip()”>Jurisdiction E.
Source: noridianmedicare.com

The Role of Medicare and the Indian Health Service for American Indians and Alaska Natives: Health, Access and Coverage

This report, divided into four sections, examines these disparities and describes the roles of both the Indian Health Service (IHS) and Medicare in providing access to health care for American Indians and Alaska Natives.  The first section draws from recent surveys and other data sources to compare health and other socioeconomic indicators among elderly American Indians and Alaska Natives to the overall population age 65 and older.  The second section of this report describes the ways that IHS and other sources of coverage (including Medicare, Medicaid, and private insurance) may and may not provide access to health care services for elderly and disabled American Indians and Alaska Natives.  The third section explores the intersection of Medicare and the IHS in health service reimbursement, patient cost sharing, and access to care, and then discusses the implications of potential barriers to enrollment in federal or state programs that could assist American Indians and Alaska Natives with out-of-pocket expenses for health care.  The report concludes with a discussion of some of the future challenges and opportunities for improving access to care for American Indians and Alaska Natives through Medicare and the IHS.
Source: kff.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

BCBS Medicare Supplement Insurance Plans

Your state officials control which Medigap plans are available in your state, but you can see the benefits of all 10 forms of Medigap insurance by clicking here. And, our instant quotes will show you a selection of Medigap plans for your state offered by leading insurance companies that have been prescreened for financial soundness. We rely on A.M. Best, an independent financial rating organization, and represent insurers with some of the highest ratings.
Source: medigapadvisors.com

Medicare Supplement Plan F

* 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

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 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

Texas Medicare Part D & Medicare Advantage Plans

Posted by:  :  Category: Medicare

Choosing a Texas Medicare Part D plan that fits your circumstances is very important as there are many plans to choose from. Texas Medicare Part D plans are offered by private insurance companies so there are plans with different deductibles, copays and premiums. Before you choose a Medicare Part D plan in Texas you should determine your annual out-of-pocket expenses for prescription medications. Make sure the Texas Medicare Part D plan you select covers all of your prescriptions. You should consider the copays, deductibles and premiums of each plan to determine which Medicare Part D plan offers the most savings. You can compare Texas Medicare Part D plans by using the PlanPrescriber Medicare Part D plan comparison tool to find a plan in Texas that works for you.
Source: mytexasmedicare.net

Medicare Supplement Quotes in Texas

First, we hope this website provides you a better understanding of what is about to happen like the fact that regardless of what you do or don’t do most if not all seniors automatically become enrolled in Part A of Medicare, this is the part of Medicare that provides your basic coverage. Also you should know that you should automatically have eligibility in Part B of Medicare, that’s the part that provides out patient benefits like doctor charges and testing. There is a small fee for Part B that is deducted from your Social Security benefits. We have provided more detailed information on Texas Medicare Eligibility to hopefully assist in understanding more about it. 
Source: medicareinsurancetexas.com

Covering the Cost of Medicare

If you cannot afford the additional expense of purchasing a Medicare supplement policy to supplement your Medicare coverage, there are a couple of programs you should be aware of. The Medicaid-sponsored Medicare Savings Programs (MSP) may pay Medicare premiums, deductibles, and coinsurance amounts for eligible Medicare beneficiaries. These programs allow you to better direct your savings to cover health care expenses.
Source: texas.gov

Centers for Medicare & Medicaid Services (CMS) Forms and Publications

Posted by:  :  Category: Medicare

The Medicare Savings Programs (MSP) Model Application for Medicare Premium Assistance. If you think you might be able to get help from your state with Medicare costs, or if you are not sure, call your state medical assistance (Medicaid) office or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048).
Source: ssa.gov

Medicare Health Outcomes Survey

Medicare Part D Data Linked with the Health Outcomes Survey: Association between Quality of Care using Prescription Drugs and Mortality as Outcomes among those Enrolled in the Medicare Advantage Program (PDF, 715 KB). 2010 This report examines the relationship between use of medications based upon nationally recognized clinical practice guidelines and health outcomes using mortality among Medicare Advantage (MA) patients enrolled in the Medicare Part D program. The analysis utilized the linked data from the Medicare Health Outcomes Survey (HOS) 2006-2008 Cohort 9 and the 2006-2007 Medicare Part D prescription benefit files to calculate the medication based performance indicators for five high volume chronic conditions: diabetes, coronary artery disease (CAD), congestive heart failure (CHF), chronic obstructive lung disease (COPD)/asthma, and depression. The investigators examined the variations of the performance indicators across plans and examined the associations of performance indicators and mortality at the patient and the plan levels.
Source: hosonline.org

Extra Help with Medicare Prescription Drug Plan Cost Forms and Publications

Appeal the decision we made about your eligibility for Extra Help by completing an Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1021) in English or Español. Find Instructions for Completing the Appeal form in English or Español.
Source: ssa.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 2015 Data Spotlight: Overview of Plan Changes

Posted by:  :  Category: Medicare

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

To Switch or Be Switched: Examining Changes in Drug Plan Enrollment among Medicare Part D Low

During the Medicare Part D annual enrollment period from October 15 to December 7, people on Medicare can review and compare stand-alone prescription drug plans (PDPs) and Medicare Advantage plans and switch plans if they choose.  Low-income beneficiaries who receive premium and cost-sharing assistance through the Part D Low-Income Subsidy (LIS) program have a subset of premium-free PDPs (benchmark plans) available to them, but can also choose to enroll in a non-benchmark plan and pay a premium. Each year, the list of premium-free PDPs changes. When PDPs lose their premium-free status, the Centers for Medicare & Medicaid Services (CMS) automatically reassigns many of their LIS enrollees to another premium-free PDP; however, CMS does not reassign LIS enrollees who have chosen a plan other than their assigned PDP.  LIS Part D plan enrollees, unlike non-LIS enrollees, are also permitted to switch plans at any time outside the annual enrollment period.
Source: kff.org

Modest Changes in Echo Professional Fees But Significant Changes in Hospital Outpatient Echo Payment Proposed by Medicare for 2016 (7/10/15)

The Centers for Medicare and Medicaid Services (CMS) recently released proposed changes to the Medicare allowances for physicians’ services paid under the Physician Fee Schedule (PFS) and services provided by hospital outpatient departments paid under the Hospital Outpatient Prospective Payment System (HOPPS). If the changes are adopted as proposed, the amounts paid for physicians services (Professional and Technical Components) under the PFS would remain relatively unchanged in 2016, but hospitals would experience significant changes in the amounts paid by Medicare for the overhead, supplies, equipment, and non-physician personnel costs associated with outpatient echos. Read more here.
Source: asecho.org

How to Change My Address for Medicare

Medicare Part D patients will need to call the issuing insurer before the move to make sure the plan will remain valid in the new location. Patients moving across town shouldn’t have any problems with the address change, but those moving out of state could lose coverage. Part D members without insurance changes can often change the address online through the issuer’s website. For more information, or if you have reason to question your coverage, call Medicare itself at 1-800-633-4227.
Source: ehow.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 HMO and PPO Coverage and Options

For example: George C. lives in Massachusetts and has a Medicare Advantage Plan through Fallon Community Health, one of the highest-rated health plans in the country. He has an HMO plan with drug coverage. His monthly premium cost for the plan is $208.40 (the Medicare Part B premium of $96.40 plus $112 charged by Fallon). Also, his out-of-pocket expenses include a $15 copay for each PCP visit, $20 for each specialist visit, 10% coinsurance for durable medical equipment, and an annual deductible of $310 for prescription medications.
Source: about.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

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 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