Medicare Form, Medicare Forms

Posted by:  :  Category: Medicare

Authorize Aetna to automatically withdraw your plan premium from your bank account, or charge the premium to your credit card, on the date it is due. To sign up, call Member Services at 1-888-268-9800 (TTY: 711), available 8 A.M. to 8 P.M, and provide your Checking Account/Savings Account information or Credit/Debit card information. Or use this link to learn more about paying online or paying by phone.
Source: aetnamedicare.com

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

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 Supplemental, Advantage, and Part D Plans

Posted by:  :  Category: Medicare

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

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, Medicare Advantage Plans

This information is available for free in other languages. Please call our customer service number at 1-888-247-1028 (TTY: 711), Monday through Sunday, 8 a.m. to 8 p.m. Esta información está disponible en otros idiomas de manera gratuita. Comuníquese con Servicios al Cliente al 1-800-282-5366 (TTY: 711). Horario de atención: de 8 a.m. a 8 p.m., los siete días de la semana.
Source: aetnamedicare.com

Sequestration Does Not Mandate 2% Medicare Advantage Plan Reduction to be Forwarded to Contracted Providers

Physical therapists and other health care providers that contract with Medicare Advantage plans should check their agreements to make sure their payments aren’t erroneously being cut by 2% as part of sequestration. CMS clarified in a May 1 memo to Medicare Advantage organizations and others that sequestration does not mandate a 2% reduction of reimbursement to Medicare Advantage plan contracted providers. Medicare Advantage plans themselves are subject to the 2% reductions; however, Medicare Advantage plans cannot pass along sequestration cuts to providers unless their contracts with specific providers permit the pass-through. If providers determine that their contracts don’t permit these cuts, they should consider challenging the reductions as contrary to their participation and network agreements.
Source: apta.org

Medicare Advantage Health Plans: Options and Coverage

Medicare Advantage plans are private insurance health plans, regulated by the government. Medicare Advantage is also known as “MA” or Medicare Part C. All individuals enrolled in Original Medicare, Part A and Part B, are eligible to enroll in a Medicare Advantage plan, with the exception of those diagnosed with End Stage Renal Disease (ESRD), there are exceptions.
Source: planprescriber.com

Get Medicare Advantage Plan Quotes

Initial Coverage Election Period: You can enroll in Medicare Advantage or Medicare Advantage with prescription drug coverage when you first become eligible for Medicare. Your Initial Coverage Election Period (ICEP), is a seven-month period that starts 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. If you are under age 65 and you receive Social Security disability, you qualify for Medicare in the 25th month after you begin receiving your Social Security benefits. If you fall into this category, you may enroll in a Medicare Advantage plan 3 months before your month of eligibility, during the month of eligibility, and 3 months after the month of eligibility. For example, if your Medicare Part A and Part B coverage begins in May, your Medicare Advantage IEP is February through August. See Medicare Advantage Plans
Source: ehealthmedicare.com

Extra Help with Medicare Prescription Drug Plan Costs

Posted by:  :  Category: Medicare

Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.
Source: socialsecurity.gov

Turning 65 soon? Transitioning to dual Medicare and Medicaid coverage and getting help with costs

Once you have Medicare and Medicaid coverage, Medicare will cover your Part D prescription drugs and you’ll automatically qualify to get Extra Help paying for your drug costs. If you have limited income and resources, you may also qualify for help paying for your Medicare Part B premium and other Medicare costs, like deductibles and coinsurance. Medicare and your state Medicaid program work together to provide you with this help, called the Medicare Savings Programs.
Source: medicare.gov

Medicare Fraud Reporting Center

Posted by:  :  Category: Medicare

Medicare Whistleblowers are typically healthcare professionals who are aware of hospitals, clinics, pharmacies, Nursing Homes, Hospices, long term care and other health care facilities that routinely overcharge or seek reimbursement from government programs for medical services not rendered, drugs not used, beds not slept in and ambulance rides not taken. If you have information about a person or a company that is cheating the Medicare program (or any other government run healthcare program), you may be able to collect a large financial reward for reporting it here.
Source: medicarefraudcenter.org

LabCorp Cheats Medicare, Costs Billions, Whistleblower Suit Alleges

This summer, the California state attorney general announced a $49.5 million settlement with LabCorp after allegations that it, and other labs, had overcharged the state’s Medicare program while providing kickbacks to doctors, hospitals and clinics that referred MediCal patients. In May, the attorney general settled with Quest Diagnostics for $241 million in what a press release describes as the same alleged practice.
Source: huffingtonpost.com

Another whistleblower suit alleges Medicare Advantage fraud

Whether her claims hold up in court or not, Silingo’s lawsuit is likely to draw further attention to government oversight of Medicare Advantage plans. The health plans, an alternative to standard Medicare, are mostly run by private insurance companies. They serve more than 15 million Americans, or about one in three elderly and disabled people on Medicare, at a cost to taxpayers that could reach $160 billion this year. The plans are paid based on a “risk score,” which estimates how sick patients are.  Medicare pays higher rates for sicker patients.
Source: publicintegrity.org

Whistleblower lawsuit: Monroeville nurse to get $15 million for exposing Medicare false claims

- A whistle-blower lawsuit is pending in U.S. District Court in Mobile against Infirmary Health Inc. and Infirmary Medical Clinics, a corporate entity that the nonprofit set up in the 1980s to acquire physician practices. A federal magistrate judge recently recommended that the case be dismissed. The complaint describes a complicated financial relationship between the doctors and Infirmary Health. It lists $521.6 million payments from government health insurance programs from 2004 through 2010 to affiliated doctors. The suit also alleges that doctors’ pay was tied to referrals and that they received more than $18.6 million in bonuses during the time period.
Source: al.com

Whistleblower: Medicare Advantage Padded TX Charges

The private insurance plans offer seniors an alternative to standard Medicare, which pays doctors for each service they render. Medicare Advantage plans receive a set fee monthly for each patient based on a risk score that pays higher rates for sicker people and less for those in good health. Medicare essentially trusts health plans to report these risk scores accurately. The Medicare Advantage plans have grown rapidly in recent years, and now cover almost 17 million people.
Source: texastribune.org

Whistleblower Says Medicare Advantage Plans Padded Charges In Home Visits : Shots

A 2014 Center for Public Integrity investigation found that home visits skyrocketed, even as federal officials struggled to prevent health plans from overcharging Medicare by tens of billions of dollars every year. Federal officials as early as 2013 were concerned the home visits could be a factor in jacking up risk scores improperly and wasting tax dollars. But when the industry objected, the officials backed off a proposal to limit the use of home visits, the investigation found.
Source: npr.org

FL Medicare Plan Wins 5 Stars

Posted by:  :  Category: Medicare

The state has such a competitive market that many plans charge no premium, including CarePlus’ five-star plans and some other companies’ plans that won 4 1/2 stars. In fact, in some counties plans with high ratings even reimburse Medicare beneficiaries for some of their Part B monthly premium of $104.90 — a deal that’s almost unheard-of elsewhere in the country.
Source: usf.edu

Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline, CPT Code Billing: Assistant surgeon billing CPT modifiers

Assistant Surgeon services reported with modifier AS will be eligible for reimbursement at 16% of the allowed amount under the applicable physician extender fee schedule. If there is no applicable physician extender fee schedule, the Assistant Surgeon services will be eligible for reimbursement at 10% of the allowed amount for the primary procedure. Multiple surgery reimbursement rules are applied to subsequent procedures, if applicable.
Source: medicarepaymentandreimbursement.com

How to Process a Claim to Medicare

Posted by:  :  Category: Medicare

Check your Medicare Summary Notice (MSN) when you receive it in the mail. You can also check your Medicare claims online. Every three months Medicare will mail you a Medicare Summary Notice listing any medical services or supplies that were billed to Medicare within that time frame. If a service or supply does not appear on the MSN, the provider or supplier might not have filed a claim. According to Medicare guidelines, a claim form must be submitted within one calendar year after the year in which you received a medical service or supply.
Source: ehow.com

Filing a Medicare Claim and Checking the Status

If you have Original Medicare, the amount you pay at the time you receive a health service will depend on whether your doctor is a Medicare-participating provider and accepts assignment. Medicare-participating providers are on contract with Medicare to accept and treat patients for all Medicare-covered services and supplies. A provider that accepts assignment agrees to accept the Medicare-approved amount as full payment for a covered service or supply. In this instance, the provider is required to file Medicare claims for any services you received, and Medicare will pay the provider directly for those services. The provider is not allowed to charge you to submit the claim.
Source: planprescriber.com

Medicare Supplement Plans (Medigap Plans) and other Medicare / Health Insurance Plans

Posted by:  :  Category: Medicare

A Medicare Supplement plan is a health insurance policy sold by private insurance companies in your state. It provides additional protection for what is not covered by Original Medicare. This insurance is specifically designed to fill the “gaps” in Medicare Part A and Part B coverage.
Source: libertymedicare.com

Coventry Medicare: Advantra (HMO/PPO)

Whether you are an employer, health care provider, someone interested in enrolling, or already a current member, our goal is to provide you with valuable and convenient online resources and information. Come explore the ways in which we can help you take charge of your Medicare Advantage coverage.
Source: coventryhealthcare.com

Medicare Part C Appeals > Home

Attention Medicare Health Plans- Updated Medicare Advantage Process Manual, Appendix, Reconsideration Background Data Form, and Dismissal Case File Data Form are now available under the ‘Health Plans’ section. Plans should begin using the new Reconsideration Background Data Form for appeals submitted to MAXIMUS Federal Services effective 1/1/2015. For dismissal review cases files submitted to MAXIMUS upon request after 1/1/14, health plans must use the Dismissal Case File Data Form.
Source: medicareappeals.com

Find a 2015 PA Medicare Part D Plan

- Cost Sharing – 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. Plans can form their own tiers, so you should contact the plan or reference it’s summary of benefits to find out what copays and limitations are associated with each tier. 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. (Search Tip: If you would like to reduce the plans shown to just plans that have a tier 1 (Generics) co-pay of up to a certain value (ex: $0 co-pay), enter the value (ex: 0) in the “Max. Co-pay Tier 1 (Generics)” field.)
Source: q1medicare.com

Medicare News and Updates

Posted by:  :  Category: Medicare

Many people have a hard time getting around town as they get older. There are several reasons for this. They may not be able to drive due to declining health or eyesight. Or they can no longer afford owning a vehicle due to the costs of maintenance or insurance premiums.
Source: medicaremadeclear.com

Comparing Medicare HMO, PPO, & POS Plans

HMO plans cover health care services provided within a network of contracted physicians and hospitals. Except for emergencies, these plans do not cover care received outside the network. If you have a doctor that you want to keep seeing, then it’s important to make sure that doctor is “in-network” for any HMO you’re considering. Most HMOs require you to have or choose a primary care physician (PCP) in the plan network. Your PCP provides general medical care and authorizes referrals to in-network specialists.
Source: medicaremadeclear.com

Comparing Medicare HMO, PPO, & POS Plans

Posted by:  :  Category: Medicare

HMO plans cover health care services provided within a network of contracted physicians and hospitals. Except for emergencies, these plans do not cover care received outside the network. If you have a doctor that you want to keep seeing, then it’s important to make sure that doctor is “in-network” for any HMO you’re considering. Most HMOs require you to have or choose a primary care physician (PCP) in the plan network. Your PCP provides general medical care and authorizes referrals to in-network specialists.
Source: medicaremadeclear.com

Medicare Plans for Different Needs

Your health is important. Find a UnitedHealthcare Medicare Advantage plan or Medicare prescription drug plan that may be right for you before Open Enrollment ends December 7. With a Medicare Supplement Insurance plan* you may apply at any time throughout the year.  
Source: uhcmedicaresolutions.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

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 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

Medicare Supplemental Insurance Policies at Mutual of Omaha

Every Medigap policy must follow federal and state laws designed to protect you, and it must be clearly identified as Medicare supplement insurance. Medigap insurance companies can only sell you a standardized Medigap policy identified by letters A through N. Each standardized Medigap policy must offer the same basic benefits, no matter which insurance company sells it. Cost is usually the only difference between Medigap policies sold by different insurance companies
Source: mutualofomaha.com

Medicare Supplement Insurance

The Part A hospital deductible – you’re responsible for paying a deductible if you are admitted into the hospital. In 2014 this deductible is $1184. Many people think that this is a one time or a annual deductible and it is not. This deductible is based on benefit periods of 60 days. This means if you are admitted to the hospital and then released and you stay out of the hospital for 60 days or more, that is considered one benefit period. If you are admitted again after that 60 day period you must pay this deductible again.
Source: medisupps.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