Summary of Key Changes to Medicare in 2010 Health Reform Law   

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This brief provides a detailed look at the improvements in Medicare benefits, changes to payments for providers and Medicare Advantage plans, various demonstration projects and other Medicare provisions in the law. It includes a timeline of key dates for implementing the Medicare-related provisions in the law.
Source: kff.org

2010 Medicare Part D Program Compared to 2009, 2008 and 2007

Reference-Based Pricing – Under these programs, sponsors may require enrollees to pay a defined cost-sharing amount plus supplemental cost-sharing based on the differential in cost between the drug being dispensed and a lower-cost preferred alternative such as a generic equivalent. In contract year 2009, fewer than 10% of Part D contracts used reference-based pricing. Given the complexity of reference-based pricing formulas, it is very difficult to accurately convey the extent of expected out-of-pocket spending for formulary drugs subject to reference-based pricing. For this reason, CMS has been unable to have the Medicare Prescription Drug Plan Finder (MPDPF) calculate correct pricing for drugs subject to reference-based pricing, which may distort projections of out-of-pocket expenditures for some beneficiaries and significantly affect their ability to compare cost-sharing obligations under different plans and choose the plan that best meets their needs. Based on CMS’ experience and the increased complexity, CMS has observed with these programs, CMS will eliminate the option of reference-based pricing in the Part D Prescription Benefit Program (PBP) beginning in CY 2010. The basis for this decision is CMS’ belief that reference-based pricing may be inherently misleading to beneficiaries and inconsistent with their goal of improving transparency with regard to expected beneficiary cost-sharing under the Part D program.
Source: q1medicare.com

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

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Source: medicare.gov

What’s Medicare Supplement Insurance (Medigap)?

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Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.
Source: medicare.gov

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

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Source: medicare.gov

Your Medicare Supplemental Insurance Information

Every Medicare Supplemental insurance policy, in order to be designated a “Medicare supplemental” or “Medigap” insurance plan, plan has to follow federal and state laws designed to make the buying process easier for the consumer. Medigap insurance companies can only sell you a “standardized” Medigap policy identified by letters A, B, C, D, F, High-Deductible F, G, K, L, M and N. Each standardized Medigap policy must offer the same basic benefits, no matter what insurance company sells it. Cost is usually the only difference between Medigap policies sold by different insurance companies. (You should, however, compare insurance companies on other measures such as customer service and reputation.)
Source: medicaresupplemental.com

Medicare Supplemental Insurance — Which policy is best?

Our recommendation: After picking the benefit combination (Plan A through L) that best suits your needs, buy the issue-age or community-rated Medigap policy with the lowest premium. Even though they are a bit more expensive at the start, your premiums won’t go up every year just because you get older. (AARP’s Medigap plans use a combination of issue-age and community-rated methods; their premiums don’t increase as you get older, but their younger retirees do receive a discount.)
Source: todaysseniors.com

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

"Times have changed since my mother had an AARP J plan and I was totally confused by the options available. Stan walked me through the process in a very educational, methodical, friendly way, and I feel secure now that we’re making the correct decision to provide the best possible coverage for my husband." – Pat K.
Source: medigap360.com

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

Medicare Card: Applying for a New Medicare Card and Replacing a Lost Medicare Card

Once you have enrolled in the Medicare program, your red, white, and blue Medicare card should arrive in the mail about three months before your coverage begins. For U.S. citizens and legal permanent residents approaching their 65th birthday, enrollment in Medicare could be automatic. This happens if you receive Social Security Administration (SSA) benefits or Railroad Retirement Board (RRB) benefits. In these cases, you are enrolled in Medicare Part A beginning on the first day of the month in which you turn 65, and your card should arrive three months prior to this.
Source: planprescriber.com

REPLACEMENT MEDICARE CARD

For the Detailed and most elaborate estimate, an individual can download and install a software program on a personal computer (PC). The interactive program allows workers the most flexibility to customize their estimates based on differing scenarios and produces a variety of benefit numbers for retirement, survivors and disability benefits for both workers and their families.
Source: ssa.gov

How to Replace a Lost Medicare Card

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

Texas Medicare Eligibility and Enrollment Requirements

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Texas Medicare eligibility and enrollment requirements state that you or your spouse needed to work at least 10 years in order for the Part A hospital insurance to be free and if not, well you should be able to buy into the program. Contact the Social Security Department to get the current rate. It’s not a bad price but rather expensive for folks on a fixed income. The Part B, out patient part or medical insurance as the government calls it does have a monthly premium that changes almost every year however for 2013 the premium is $104.90 a month for new enrollees. Oh, that could also be more if your loaded financially.
Source: medicareinsurancetexas.com

Texas Medicare Eligibility Requirements

To qualify to receive Medicare Part A without having to pay a monthly premium, you must be 65 years old and entitled to receive either Social Security or Railroad Retirement Board benefits. You also qualify if either you or your spouse worked in government with Medicare covered employment. If you have End-Stage Renal Disease, you automatically qualify. While Part A coverage is generally free, you will have to pay a small monthly premium to receive Part B benefits. In 2013, most people paid $104. 90. 
Source: texasmedicarehealth.com

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

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Source: medicare.gov

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

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Source: medicare.gov

Medicare Information, Help, and Plan Enrollment

Humana is a Medicare Advantage [HMO, PPO and PFFS] organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or member cost-share may change on January 1 of each year.
Source: medicare.com

Medicare Eligibility and Enrollment

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re already getting Social Security checks, you will be automatically enrolled in traditional Medicare. You’ll get your Medicare card three months before your 65th birthday. The benefits kick in on the first day of the month of your 65th birthday. Traditional Medicare, which is also called original Medicare, includes Medicare Parts A and B. Part A is hospital coverage. Part B covers doctor visits, lab tests, and other outpatient services.
Source: webmd.com

Medicare Eligibility Requirements

In purchasing a Medigap Supplemental Insurance Policy, getting enrolled by the initial enrollment period is very crucial. If you apply during the IEP, by law, you are guaranteed that all insurers selling Medigap coverage in your state must offer you all the Medigap Supplemental Policy coverage plans that they sell. In addition, this guarantees, by law, that the insurance rate premiums offered to you will be the same as a person considered to be in good health. This applies, regardless of the fact that your current or past health history may not have been good or you have ongoing health issues.
Source: medicare.net

Qualifications for Medicare

Medicare will cover a limited amount of home health care services as an alternative to entering a nursing home when certain criteria are met. A home health agency must be Medicare certified, and a doctor must make the decision whether or not home care is needed. Medicare does not cover custodial care (non-nursing personal care) unless it is needed in combination with skilled nursing care for the recovery or rehabilitation of a short-term illness.
Source: careathomefl.com

What Does Medicare Part J Cover?

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Unfortunately, there is no such thing as Medicare Part J.  Medicare consists of 4 parts – Part A (hospital insurance), Part B (medical insurance), Part C (Medicare advantage), Part D (prescription drug coverage).  In addition to these 4 parts, there are also Medicare supplement programs available for individuals to provide coverage for the gaps in benefits that Original Medicare (Parts A & B) do not cover. There used to be a Medicare Supplement Plan J, however, in 2010, this plan was taken off the market along with plans E, H, and I.
Source: insurancelibrary.com

Medicare Supplement Plan J for AL, AR, AZ, CO, DC, FL, GA,
KS, KY, LA, MD, MO, MS, NC, OH, OK, SC, TN, TX, VA & WV.

* A benefit period begins on the first day you receive service 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. ** We do not recommend The High Deductible plan J. Plan J without the high deductible is very recommended. This high deductible plan pays the same or offers the same benefits as Plan J after you have paid a calendar year $2000 deductible. Benefits from the high deductible Plan J will not begin until out-of-pocket expenses are $2000. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the plan’s separate foreign travel emergency and prescription drug deductibles.
Source: themedicarechannel.com

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

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Source: medicare.gov

Medicare Explained: Understanding the Basics from Part A to Part D

Health care is one of the toughest financial challenges you’ll face in retirement. For millions of retirees, Medicare coverage that takes effect for most people at age 65 is the key to being able to afford health care costs that would otherwise quickly sap their retirement savings. But over the years, Medicare has gotten increasingly complicated, and with the emergence of Obamacare, Americans are struggling to understand exactly how to get their health care covered. To help you get a handle on Medicare, let’s run through the different types of coverage the program provides. The Medicare Alphabet Since 1965, Medicare’s two original components have helped cover basic health needs. The first, known as Part A, focuses on the costs of health care at medical facilities, providing coverage for medically necessary care at hospitals while you’re receiving inpatient care. Under some circumstances, it also covers costs for home health services, hospice care, and skilled nursing facilities. However, nursing home costs are covered only for limited purposes and time periods. Medicare Part B covers the costs of health care outside medical facilities, such as doctors’ visits, outpatient procedures, and lab tests. It also helps cover the cost of services related to health care, such as wheelchairs and scooters, oxygen tanks, and ambulance services. In addition to providing coverage for health care needs that qualify as medically necessary, Part B also covers certain preventive-care services, such as screening for heart conditions, diabetes, and certain types of cancer. In addition to government-provided Parts A and B, Medicare Part C is optional private insurance that Humana (HUM), Aetna (AET), UnitedHealth (UNH), and others provide. Better known as Medicare Advantage Plans, Part C involves paying premiums to those insurers, which then provide coverage for charges that Parts A and B don’t pay for. Medicare Advantage Plans vary greatly both in cost and in scope of coverage, so you have to look closely at all your options to make sure they fit what you want from a plan. Finally, Medicare Part D provides prescription drug coverage. Like Medicare Advantage Plans, Part D plans are offered through private insurance companies, and the coverage that different policies offer can vary widely from insurer to insurer and from plan to plan. In fact, many Part C Medicare Advantage Plans include Part D options within a single package. How You Pay for Medicare Each part of Medicare has different charges associated with it. For Part A, those who’ve had Medicare taxes withheld from their pay for at least 40 calendar quarters during their lifetime are eligible for free coverage.
Source: dailyfinance.com

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

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

Frequently Asked Questions

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Source: medicare.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

Learn, Compare and Save on Supplemental Medicare Plans

MedicareFAQ (Elite Insurance Partners) is a learning resource center for individuals 65 and older to learn about Medicare options and plans. We help individuals understand all Medicare options, whether it’s just learning about original Medicare Parts A or B or any of the other Supplemental Medicare plans like; Medicare Supplements (Medigap), Medicare Advantage (Part C) or Prescription Drugs (Part D).
Source: medicarefaq.com

Frequently Asked Questions (FAQs)

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Source: cms.gov

CIGNA Medicare Rx Customer Center

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This booklet will tell you how your benefits and costs will change in 2012 if you are enrolled in Plan Two in 2011. Plan One and Plan Two will be joining together in certain states. To see if this change applies to your state, click on the drop-down menu below.
Source: cigna.com

Local Coverage Determinations (LCDs) for CGS Administrators, LLC (18003, DME MAC)

NOTE: You either have javascript disabled or have saved the page locally. Your experience may not be optimal due to these factors. Please consider enabling javascript or revisiting this page to get an optimal MCD experience. (Due to browser security settings, directly clicking the previous link may not work, so you may need to copy and paste the following link [https://www.cms.gov/medicare-coverage-database/indexes/lcd-list.aspx?Cntrctr=140&name=CIGNA+Government+Services+(18003,+DME+MAC)&ContrNum=18003&CntrctrType=DME] into your browser.)
Source: cms.gov