Medicare.gov Physician Compare Home Page

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Source: medicare.gov

Coventry Medicare: Locate A Provider

The best way to learn which providers are in a plan’s network is to use our online directory tools below. Members can also request a full printed copy of their directory using our online request form. Members will be asked to provide their full name and member ID.
Source: coventryhealthcare.com

Find & compare doctors, hospitals, & other providers

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Source: medicare.gov

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 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

How to Replace a Lost Medicare Card

Posted by:  :  Category: Medicare

While you might not really need to replace a lost Social Security card, as a Medicare beneficiary, your red, white, and blue Medicare card is the most piece of information you own. Your Medicare card is proof that you are enrolled in Original Medicare and will usually be needed in order to receive medical services or medications covered by Medicare.
Source: about.com

California Health Advocates: Medicare Policy, Advocacy and Education

» Ryan Coble from the Office of Inspector General will discuss durable medical equipment (DME) fraud. Topics include: common DME fraud schemes; DME case examples; and trends and hotspots. She will also discuss what SMPs, beneficiaries and their representatives can look for to detect DME fraud, and what information to provide the OIG when referring DME fraud cases. Due to the law enforcement sensitive information, this training will not be recorded. Register today!
Source: cahealthadvocates.org

Medicare Advantage/Part D Contract and Enrollment Data

Posted by:  :  Category: Medicare

The page could not be loaded. The CMS.gov Web site currently does not fully support browsers with “JavaScript” disabled. Please enable “JavaScript” and revisit this page or proceed with browsing CMS.gov with “JavaScript” disabled. Instructions for enabling “JavaScript” can be found here. Please note that if you choose to continue without enabling “JavaScript” certain functionalities on this website may not be available.
Source: cms.gov

Enrollment & Disenrollment in Medicare Advantage Plans

In addition, there are Special Election Periods (SEPs) during which you may be able to enroll in or disenroll from your MA plan, depending on your situation. For example, if you move out of your plan’s service area, you have a Special Election Period (of up to 3 months) to disenroll from your plan and join a plan available in your new location. See Special Election Periods (SEPs).
Source: cahealthadvocates.org

Projecting Medicare Advantage Enrollment: Expect the Unexpected?

It is not entirely clear why enrollment has continued to climb since 2010, or if the trend will continue at the current clip. Analysts believe that the bonus payments have certainly helped to mitigate the effects of payment reductions, and that plans appear to be doing more to reduce their costs. Some speculate that Medicare Advantage plans are benefitting from the slowdown in medical spending, enabling them to keep premiums low. Others ascribe the growth in enrollment to the influx of baby boomers who may have greater comfort with managed care plans than previous generations. As additional payment reductions are phased in over the next few years, the growth in enrollment could stall or even reverse, if plans pull out of the market because they feel they cannot operate profitably. Even if enrollment continues to increase, there is some speculation that plans may scale back benefits and/or increase cost-sharing in response to reductions in Medicare payments and the soon-to-be implemented annual fee on health insurance that was enacted in the ACA, which also applies to Medicare Advantage.
Source: kff.org

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 Spotlight: Enrollment Market Update

While Medicare Advantage enrollment is increasing in many states, in 6 states (AK, DE, MD, NH, VT and WY) less than 10% of beneficiaries are enrolled in Medicare Advantage plans in 2015, which was also the case in at least the prior three years (Figure 5). In contrast, in 22 states (versus 18 states in 2014 and 15 states in 2013) more than 30 percent of beneficiaries are enrolled in Medicare Advantage plans in 2015. Additionally, in 5 states (FL, HI, MN, OR, and PA) more than 40 percent of beneficiaries are enrolled in Medicare Advantage plans, and Medicare Advantage enrollment these states account for 6% of all Medicare beneficiaries and 21% of all Medicare Advantage enrollees. This variation reflects the urban origins of health maintenance organizations (HMOs) in Medicare Advantage and other factors, such as the history of managed care in the state and the prevalence of employer sponsored insurance for retirees. Within states, Medicare Advantage penetration varies across counties. For example, 43 percent of beneficiaries in Los Angeles County, California are enrolled in Medicare Advantage plans compared to only 8 percent of beneficiaries in Santa Cruz County, California.
Source: kff.org

Search and Lookup: ICD 10 Codes, CPT Codes, HCPCS Codes, ICD 9 Codes, Medicare Documents, and more!

Posted by:  :  Category: Medicare

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Source: findacode.com

CMS Releases 2015 HCPCS Codes

The American Orthotic & Prosthetic Association (AOPA) has reported that the Centers for Medicare & Medicaid Services (CMS) has released the new Healthcare Common Procedure Coding System (HCPCS) codes for 2015. AOPA provided the following breakdown of the new codes, code descriptor changes, and code deletions. All changes are effective for claims with a date of service on or after January 1, 2015.
Source: oandp.com

Cigna Medicare Supplement Plans

Posted by:  :  Category: Medicare

Cigna and its predecessor companies have been in business since 1792 when a group of citizens in Philadelphia formed the Insurance Company of North America. Today, Cigna is dedicated to growing within the Medicare market and has introduced Medicare Supplement Plans in many different states.
Source: medicaresupplementshop.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 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 Supplemental Insurance

Finding the best Medicare Supplemental insurance, Medicare Advantage, and Medicare Part D has gotten more complicated nearly every year. In 2010 Medicare Supplement Insurance added 2 new plans Medigap plan N and Medigap Plan M. At the same time they eliminated several other Medicare Supplement options. Medicare Advantage insurance plans redefine benefits and premiums every year. And, with future Medicare subsidies uncertain due to changing regulation from healthcare reform who can keep up. For many individuals Medicare Supplement Insurance is becoming the best option. Unfortunately, comparing Medicare Supplemental Insurance Plan premiums (Medigap) and Medicare Advantage plans can be a time consuming endeavor. Our highly trained insurance advisors can explain all of your supplemental Insurance options, and assist in finding the best Medicare supplement and Medicare Part D combination that best fits your specific needs. With all the options affecting Supplement insurance and Part D it makes sense to have an expert assist you through the maze.
Source: mysenioradvisorsgroup.com

How to Apply Online For Social Security Retirement Benefits

Posted by:  :  Category: Medicare

Social Security offers an online retirement application that you can complete in as little as 15 minutes. It’s so easy. Better yet, you can apply from the comfort of your home or office at a time most convenient for you. There’s no need to drive to a local Social Security office or wait for an appointment with a Social Security representative.
Source: ssa.gov

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

Medicare.gov Physician Compare Home Page

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Source: medicare.gov

Database: How much Medicare pays doctors

For the first time, the government is releasing detailed data about medicare payments to doctors, revealing what procedures doctors performed and what they were paid. The trove of billing records shows that thousands of physicians made more than $1 million each from Medicare in 2012. Dozens billed for more than $10 million. Billing for a large amount is not necessarily a sign of wrongdoing.
Source: washingtonpost.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 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

Your Medicare coverage choices

Posted by:  :  Category: Medicare

There are 2 main ways to get your Medicare coverage— Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Some people get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap). Use these steps to help you decide what coverage you want:
Source: medicare.gov

Medicare Care Choices Model

This model will test whether Medicare and dually eligible beneficiaries who qualify for coverage under the Medicare or Medicaid Hospice Benefit would elect to receive the palliative and supportive care services typically provided by a hospice if they could continue to seek curative care from their providers. CMS will study whether access to such services will result in improved quality of care, patient and family satisfaction, and whether there are any effects on use of curative services and the Medicare or Medicaid Hospice Benefit.
Source: cms.gov

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

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

Posted by:  :  Category: Medicare

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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

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

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

Drug Finder: Find which 2015 Medicare Part D plans best covers your drugs

- Copay / Coinsurance – These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in “tiers”. Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on which tier the drug is in. The drug Tier is shown to the left of this column. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. There are two figures shown under this “Cost Sharing” category:
Source: q1medicare.com

Medicare Part D Prescription Drug Plans: The Marketplace in 2013 and Key Trends, 2006

  For 2013, AARP MedicareRx Preferred PDP (offered by UnitedHealth) is the largest PDP in 22 regions, SilverScript Basic PDP is the largest in 9 regions, Humana Walmart-Preferred PDP leads in 2 regions, and MedicareBlue Rx Standard PDP has the largest share of enrollment in one region.  In addition to being the largest plan overall, AARP MedicareRx Preferred PDP has enrolled nearly one-third of all non-LIS enrollees nationally and has the most non-LIS enrollees in 30 of 34 PDP regions (Exhibit 22).  With the help of its acquisition strategy, CVS Caremark’s SilverScript Basic PDP dominates the LIS market with about one-third of national LIS enrollment and the highest share of LIS enrollees in 28 regions.  Like many PDPs with high LIS enrollment, SilverScript Basic PDP has attracted only a small share (14 percent) of non-LIS enrollees.  By contrast, Humana’s Walmart-Preferred PDP has attracted enrollment in nearly equal shares from both non-LIS and LIS beneficiaries, and is among the top five plans by enrollment in each category.
Source: kff.org

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.gov Nursing Home Compare

Posted by:  :  Category: Medicare

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Source: medicare.gov

Nursing home care coverage in Part A

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Source: medicare.gov

2015 Medicare Co Pays for Nursing Home Care

Do you know your rights to nursing home coverage under Medicare? Medicare Part A pays for inpatient hospital care, and then for care in a skilled nursing facility IF the patient has a "qualified" hospital stay of at least 3 days (not counting day of discharge) before being admitted to the skilled nursing facility. Admission to the nursing home must be within 30 days of the hospital discharge. But patients put on Hospital Observation Status end up paying out-of-pocket if they need nursing home care:
Source: masshealthhelp.com

How Medicare Rewards Copious Nursing

During his 2013 California nursing-home stay, Jack Furumura became severely dehydrated and shed more than 5 pounds, partly because staff didn’t follow written plans for his nutrition or the facility’s policies, a state inspection report shows.
Source: wsj.com

Chicago Medicare/Medicaid Nursing Homes and Rehab. FIND IT HERE.

This is a list of the Medicare and Medicaid nursing homes located in the specific state or city according to the Compare Nursing Homes database from CMS (Centers for Medicare and Medicaid Services) at medicare.gov. Use this list only for basic information about nursing homes in your locale. We recommend the Nursing Home Compare feature at www.medicare.gov for detailed information. Due not use this web site as the basis for any decision or action about nursing facilities or care. We are not making any recommendation or giving advice in any way.
Source: dibbern.com

Atlanta Georgia Elder Law Attorney Medicare Medicaid Nursing Home Care Lawyer, Ira M. Leff, Attorney at Law

Since 1989, my practice has concentrated in the area of elder law.  I work with families who are facing the likelihood of having to pay the high cost of long-term care and they do not have sufficient funds or insurance to cover that cost.  I assist the families with incapacity planning (powers of attorney and advance health care directives); estate planning (wills and trusts); retirement planning; Medicare, Medicaid, Medigap, health insurance, pharmaceutical insurance and long-term care insurance; Veteran’s Benefits; housing options; and nursing home malpractice.
Source: iraleff.com