The Medicare & Medicaid Center: What’s the Difference Between Medicare and Medicaid?

Posted by:  :  Category: Medicare

Insurance companies are constantly trying to improve the level of service they provide to customers even if it means a lot of work on new products and services. In 2012 Medicare is trying to improve service on their website with the “Blue Button” that should help with navigation. Your information and previous records will be much easier to access with this tool. You can logon from anywhere at any time and be able to access your medical history, health care providers and medications. Continue reading
Source: medicare-medicaid.com

Medicare Supplement Insurance Plans

Medicare wouldn’t be insurance if there weren’t regulations governing their every move and Medicare Supplement Insurance (Medigap) is no different. In order for each state to offer Medigap coverage there are some guidelines that they have to abide by, with the exception of Massachusetts, Minnesota and Wisconsin that offer other guidelines. Here are the requirements for each state that offers Medicare Supplement Insurance, let you representative know if you are not receiving one of the benefits or coverage options listed below: continue reading "What Makes a Medicare Supplement Insurance Policy Standard?"
Source: medicaresupplementinsurances.com

How Medicare works with other insurance

The BCRC will gather information about any conditional payments Medicare made related to your pending settlement, judgment, award, or other payment. Once a settlement, judgment, award or other payment is final, you or your representative should call the BCRC. The BCRC will get the final repayment amount (if any) on your case and issue a letter requesting repayment.
Source: medicare.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

Supplements & other insurance

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

Best Dental Insurance Provider in USA

So please compare dental insurance rates. Many excellent, good dental insurance programs available here can help you obtain the professional dental care your household requires. With so many outstanding nationwide dental insurance values, no reasonable excuse exists for waiting. Check out these programs and obtain the qualified, expert professional attention required to keep your teeth healthy and vibrantly beautiful. You will be so glad you found this website!
Source: dentalinsurancenova.com

Medicare Supplement Plan F

Posted by:  :  Category: Medicare

Medicare Supplement Plan F may offer expansive coverage, but it does not cover everything. Under Plan F, beneficiaries are still required to pay their Medicare Part B premium payments each month. Additionally, it is possible to have Medicare Part A without a monthly premium if the beneficiary has worked and paid Social Security taxes for at least 40 calendar quarters (10 years). Otherwise, a monthly premium for Part A coverage is also required. These costs are not covered under Medicare Supplement Plan F.
Source: ehealthinsurance.com

Medicare Supplement Plan F

* 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. **This high deductible plan pays the same or offers the same benefits as Plan F after you have paid a calendar year $2110 deductible. Benefits from the high deductible Plan F will not begin until out-of-pocket expenses are $2110. 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 deductible.
Source: medigap360.com

Boomer Benefits Medicare Supplements

Our caring agents provide lifetime claims service for your policy. This means when claims occur, you are not alone. You will have our experts on hand to help you sort through your statements, and even assist with appeals if necessary.
Source: boomerbenefits.com

HHSC, TWH, Part A, Determining Eligibility, Section 800, Medicaid Eligibility

Posted by:  :  Category: Medicare

A child is continuously eligible for six months of the 12-month certification period. If a household fails to report required information at application that would have caused a child to be ineligible for Medicaid, the EDG is denied and the advisor must send a fraud referral to the Office of Inspector General. This does not apply if the household provides verification required by policy. For example, the household applies for Medicaid for a child, provides one pay stub, and is determined eligible. If providing more income verification would result in the child being ineligible, the Medicaid EDG is not denied. The child remains continuously eligible for the six-month period, because policy requires only one pay stub to verify income for a child’s Medicaid EDG. Advisors must address the income discrepancy when the child’s six months of continuous eligibility ends and the child is in a period of non-continuous eligibility.
Source: tx.us

Understanding the Medicare Part D Donut Hole

Posted by:  :  Category: Medicare

Once you and your Part D drug plan have spent $2,840 for covered drugs, you will be in the donut hole. Previously, you had to pay the full cost of your prescription drugs while in the donut hole. However, in 2011, you get a 50% discount on covered brand-name prescription medications. The donut hole continues until your total out-of-pocket cost reaches $4,550. This annual out-of-pocket spending amount includes your yearly deductible, copayment, and coinsurance amounts.
Source: about.com

Closing the Medicare Part D Donut Hole

The Affordable Care Act (ACA) includes important improvements to Medicare prescription drug coverage (Part D) such as reducing expenses for seniors in the donut hole now and eliminating the gap altogether by 2020.  Seniors receive additional savings each year on their prescription drugs until the donut hole is closed. The ACA also provides additional assistance for low-income beneficiaries.  Since passage of the ACA in 2010, more than 7.9 million people with Medicare have saved over $9.9 billion on prescription drugs.  
Source: ncpssm.org

Medicare Part D Donut Hole

It’s important to continue to stick with your prescription drug plan and pharmacy once you hit the coverage gap. If you have a Medicare prescription drug plan that already includes coverage in the gap, you may get a discount after your plan’s coverage has been applied to the price of the drug. The discount for brand-name drugs will apply to the remaining amount that you owe.
Source: walgreens.com

Medicare Part D Donut Hole – Prescription Drug Coverage Gap

Most Medicare Part D plans have a coverage gap, sometimes called the Medicare donut hole. This means that after you and your Medicare drug plan have spent a certain amount of money for covered prescription drugs, you then have to pay all costs out-of-pocket for the drugs, up to a certain limit. The yearly deductible, co-insurance, or co-payments, and what you pay while in the coverage gap, all count toward this out-of-pocket limit. The limit doesn’t include the drug plan’s premium.
Source: ehealthmedicare.com

Medicare Part D coverage gap

The Medicare Part D coverage gap (informally known as the Medicare donut hole) is a period of consumer payment for prescription medication costs which lies between the initial coverage limit and the catastrophic-coverage threshold, when the consumer is a member of a Medicare Part D prescription-drug program administered by the United States federal government. The gap is reached after shared insurer payment – consumer payment for all covered prescription drugs reaches a government-set amount, and is left only after the consumer has paid full, unshared costs of an additional amount for the same prescriptions. Upon entering the gap, the prescription payments to date are re-set to $0 and continue until the maximum amount of the gap is reached: copayments made by the consumer up to the point of entering the gap are specifically *not* counted toward payment of the costs accruing while in the gap.
Source: wikipedia.org

Medicare Advantage plans strive to deliver value in the face of cuts

Posted by:  :  Category: Medicare

3rd Party Studies ACOs Admin Costs affordability Age Rating Delivery System Reform drug prices Essential Benefits Exchanges GRP Health Insurance Tax Health Plan Innovations Health Plan Satisfaction House hearings House legislation KI MA Medical Prices Medical Tests medicare Medicare Advantage MLR Patient Safety premiums Profits Provider Consolidation Quality Rate Review Reform RZ Senate hearings Senate legislation Specialty drugs specialty rx The Link Value Waste Fraud and Abuse women’s health
Source: ahipcoverage.com

Medicare Advantage Cuts in the Affordable Care Act: April 2014 Update

The overwhelming majority of Medicare Advantage enrollees will face significant benefit cuts in 2015, relative to benefit levels in 2014. This is primarily the result of ACA-mandated changes to the benchmark payment formula, and the elimination of the star rating bonus pilot program. The cuts are somewhat mitigated by changes in risk adjustment and other factors. Compared to the pre-ACA baseline, all beneficiaries are experiencing a substantial benefit reduction. The overwhelming majority of this reduction is due to ACA-mandated changes to the benchmark formulas in effect in 2010 and prior years. The effect of the star rating pilot program is absent, since star ratings were not used to determine payments at all prior to 2012. The effect of year-to-year (and even cumulative) adjustment factors is small compared to the cumulative effects of the benchmark changes mandated by the ACA.
Source: americanactionforum.org

Reductions in Medicare Advantage Payments: Impact on Seniors

[35]This is slightly different conceptually from the elasticities explained in elementary economics textbooks. Those elasticities are typically the “price elasticity of supply” and the “price elasticity of demand,” which measure the effect of a change in price on either supply or demand in isolation from the other. The price elasticity of demand is the ratio of the percent change in the quantity demanded to the percentage change in the price, assuming the supply function stays the same. Likewise, the elasticity of supply assumes the demand function remains unchanged. However, this study follows the example of the CMS actuary and calculates a “benchmark elasticity of enrollment,” a combined elasticity that is the ratio of the percent change in the MA benchmark to the percent change in MA enrollment. This elasticity captures both the supply effect and the demand effect. The supply effect results from lower revenue to MA plan providers, and the demand effect results from MA plans having to provide less generous benefits.
Source: heritage.org

America’s Health Insurance Plans

The Coalition for Medicare Choices is a rapidly growing organization of Medicare Advantage beneficiaries. More than 1.4 million Americans in 50 states have joined the Coalition to protect the benefits they receive through their Medicare Advantage plan. Together, we are working to show Congress that Medicare Advantage plans provide critical benefits and lower out-of-pocket costs to millions of beneficiaries. As Congress debates potential changes to Medicare Advantage, we will make certain that your voices are heard. The Coalition for Medicare Choices is administered by America’s Health Insurance Plans, the national association representing nearly 1,300 member companies providing health insurance coverage to more than 200 million Americans.
Source: ahip.org

Replace Medicare Advantage Cuts with Market

Use market-based bids for benchmark payments. Congress should delink benchmark payments from FFS and instead base payment solely on the bids that MA plans submit to the CMS to provide the traditional Medicare benefit (Parts A and B) to MA beneficiaries. There are a variety of ways to do this. For example, the new MA benchmark payment could be based on the weighted average bid of all plans in each county.[46] Under this method, each bid would be weighted by the proportion of beneficiaries enrolled in that plan in the preceding year. The benchmark payment could also be set at the levels proposed under various premium support proposals, such as the second-lowest cost plan[47] or the average of the three lowest-cost plan bids.[48] Bids would reflect the cost of providing benefits for a beneficiary in average health, and insurers would receive larger or smaller risk-adjusted payments from the government if an enrollee’s health was worse or better than average. If a plan were to bid higher than the benchmark payment, enrollees would pay the difference through increased premiums. If a plan were to bid below the benchmark payment, enrollees would receive the difference in a plan rebate.
Source: heritage.org

Highmark cuts Medicare Advantage premiums; looks to regain market share

He said monthly premiums for the company’s popular Freedom Blue PPO plans will range from $79.50 to $299.50, while Security Blue HMO plans will run from $49 to $269.50. Premiums for Community Blue HMO products will range from no cost to $193.50 a month, according to the company, which outlined some reduced co-pays and more generous coverage of chiropractic and podiatry care.
Source: post-gazette.com

Choose Your Viva Medicare Plan

Posted by:  :  Category: Medicare

The Annual Enrollment Period is a great opportunity for you to review your current plan information, compare Medicare Advantage plans, and make the changes necessary to find a plan that best fits your budget.
Source: makingmedicareeasy.com

Coventry Medicare: First Health Part D

Posted by:  :  Category: Medicare

First Health Part D (Legal Disclaimers) Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location. ©2015 Aetna Inc. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. 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. Our dual-eligible Special Needs Plan is available to anyone who has both Medical Assistance from the state and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help that you receive. Please contact the plan for further details. You must continue to pay your Medicare Part B premium. The Part B premium is covered for full-dual members. This information is available for free in other languages. Please call our customer service number at 1-866-865-0662 (TTY: 711) OR Coventry Health Care at 1-877-988-3589 (TTY: 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. Esta información está disponible en otros idiomas de manera gratuita. Comuníquese con Servicios al Cliente al 1-866-865-0662 (TTY: 711), de 8 am a 8 pm, siete días a la semana, desde el 1º de octubre hasta el 14 de febrero, y de 8 am a 8 pm, de lunes a viernes, desde el 15 de febrero hasta el 30 de septiembre. Medicare beneficiaries may also enroll in Coventry plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 7 to 14 days. You can call First Health Part D at 1-866-865-0662 (TTY: 711), 8 a.m. to 8 p.m., local time, seven days, from October 1 – February 14; 8 a.m. to 8 p.m. Monday – Friday, from February 15 – September 30, if you do not receive your mail-order drugs within this timeframe. [Members may have the option to sign-up for automated mail-order delivery.] Cost sharing for members who get “Extra Help” is the same at preferred and network pharmacies. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to www.aetnamedicare.com
Source: coventryhealthcare.com

Medicare Part D Plans, Prescription Drug Plan (PDP)

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location. ©2015 Aetna Inc. This information is not a complete description of benefits. Contact the plan for more information. 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. 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. Our dual-eligible Special Needs Plan is available to anyone who has both Medical Assistance from the state and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help that you receive. Please contact the plan for further details. You must continue to pay your Medicare Part B premium. The Part B premium is covered for full-dual members. This information is available for free in other languages. Please call our customer service number at 1-866-865-0662 (TTY: 711) OR Coventry Health Care at 1-877-988-3589 (TTY: 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. Esta información está disponible en otros idiomas de manera gratuita. Comuníquese con Servicios al Cliente al 1-866-865-0662 (TTY: 711), de 8 am a 8 pm, siete días a la semana, desde el 1º de octubre hasta el 14 de febrero, y de 8 am a 8 pm, de lunes a viernes, desde el 15 de febrero hasta el 30 de septiembre. Medicare beneficiaries may also enroll in Coventry plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 7 to 14 days. You can call First Health Part D at 1-866-865-0662 (TTY: 711), 8 a.m. to 8 p.m., local time, seven days, from October 1 – February 14; 8 a.m. to 8 p.m. Monday – Friday, from February 15 – September 30, if you do not receive your mail-order drugs within this timeframe. Members may have the option to sign-up for automated mail-order delivery. Cost sharing for members who get “Extra Help” is the same at preferred and network pharmacies. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to www.aetnamedicare.com
Source: coventryhealthcare.com

Coventry Medicare: Formulary (Drug List)

A formulary is a list of prescription medications that are covered by your plan and are available in a booklet format and an online searchable tool.  A pharmacy directory is a listing of pharmacies in your plan’s network, including preferred retail pharmacies, mail-order, home infusion and long-term care pharmacies. 
Source: coventryhealthcare.com

First Health Network: Home

As a member of a group health plan using the First Health Network, we provide you with the most current, innovative provider search tools available through our online web tools, 24 hours a day, and 7 days per week. 
Source: coventryhealthcare.com

Who is Eligible for Medicare?

Posted by:  :  Category: Medicare

Your eligibility for Medicare is based on your age and your medical condition. If you’re eligible, you can usually sign up for Medicare Part A — hospital care and similar expenses — without paying a premium, based on the years you or your spouse have been working and paying Medicare taxes. If you haven’t put in enough work, the premium, at time of writing, was $407 a year. Part B, which covers doctor visits and other services, costs $104.90 a month, though some high-income individuals pay more.
Source: ehow.com

Original Medicare (Part A and B) Eligibility and Enrollment

To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child. To receive premium-free Part A, the worker must have a specified number of quarters of coverage (QCs) and file an application for Social Security or Railroad Retirement Board (RRB) benefits. The exact number of QCs required is dependent on whether the person is filing for Part A on the basis of age, disability, or End Stage Renal Disease (ESRD). QCs are earned through payment of payroll taxes under the Federal Insurance Contributions Act (FICA) during the person’s working years. Most individuals pay the full FICA tax so the QCs they earn can be used to meet the requirements for both monthly Social Security benefits and premium-free Part A.
Source: cms.gov

Medicare Eligibility Rules

If you are age 65 and currently receiving Social Security or Railroad Retirement Benefits, you are eligible for Medicare and you will be automatically enrolled in Medicare Part A and Part B. However, because Part B has a premium, you have the option of declining Part B coverage. In addition, Part B does require payment of a monthly premium of $104.90, barring certain exceptions, for individuals enrolling in Part B January 1, 2015 or later. These premiums can change on an annual basis.
Source: planprescriber.com

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

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

Medicare Open Enrollment 2016

In accordance with section 1853(b)(1) of the Social Security Act (the Act), we are notifying you of the annual Medicare Advantage (MA) capitation rate for each MA payment area for CY 2014 and the risk and other factors to be used in adjusting such rates. The capitation rate tables for 2013 are posted on the Centers for Medicare & Medicaid Services (CMS) web site at http://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/index.html under Ratebooks and Supporting Data. The statutory component of the regional benchmarks, transitional phase-in periods for the Affordable Care Act rates, qualifying counties, and each county’s applicable percentage are also posted at this website.
Source: medicarehealthinsurancefacts.com

Medicare Supplemental Health Insurance Plans

"My experience with MediGap Advisors has been excellent primarily due to the efforts of my agent, Jim Kinert. Jim spends considerable time with me in order to provide the single best coverage I could have ever hoped for. He is an exceptional representative of your organization, far surpassing my expectations by making the entire process easy to understand and easy to actuate. Rarely have I dealt with a salesperson that has made me feel that he had my best interests at heart. I have never particularly enjoyed the prospect of obtaining insurance of any kind, but Jim’s approach gave me a great sense of confidence that I was doing business with the right man and the right company. Jim’s winning personality, in-depth knowledge, and lack of high pressure sales tactics convinced me to do business with you."
Source: medigapadvisors.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 Supplemental Insurance by 1

 A Medicare Supplement Plan, or Medigap, is a type of medicare health insurance that is sold by private insurance companies and is specifically designed to help you by filling in the “gaps” of Original Medicare. In order to purchase a Medigap plan you must be enrolled in Medicare Part A and B, and you will continue to pay your monthly Part B premium. You would then pay your Medigap premium and as long as your premium gets paid you will have the benefit of guaranteed renewable coverage. What this means is that the insurance company cannot cancel your policy.   There are several different plan types available to consider, but it is important to note that Medigap policies are “standardized.” This means that they are required to abide by the Federal and State laws that are put in place to protect you. The standardized policies must provide you with the same benefits no matter what company sells them and generally the only difference from company to company, if it is the same plan type, is the cost. Many couples would like to be covered under the same policy, but you and your spouse must each purchase your own individual policies. In some instances you might be allowed to purchase a Medicare Supplement plan that is guaranteed issue without any medical underwriting! This means that you cannot be denied coverage. 
Source: youandmedicare.com

Medicare Supplemental Insurance compare rates and view plans

We provide Medigap / Medicare Supplemental Insurance to all seniors throughout the United States of America. Use our website to view and compare rates of multiple plans without entering any personal information. Our Medicare Supplemental Insurance comparison chart is a great tool to aid you in identifying the best Medigap Supplemental Insurance carrier to meet your needs. Once you have identified a Medicare Supplemental Insurance plan, you can either print out a Medicare Supplemental Insurance application, or call one of our professional agents to help guide you through your Medigap Insurance application.
Source: seniorhealthdirect.com

Shopping For Medicare Supplemental Insurance

Health insurance from an employer, professional organization, government or military retiree plans. If you remain employed after your 65th birthday, you may be able to continue your group health insurance with your employer and may not need a Medicare Supplement insurance policy. Likewise, if you become eligible for Medicare but are covered by your working spouse’s health insurance, you may not need a Medicare Supplement Insurance policy. Retirees with group health plans from their employers may consider switching to individual Medicare Supplement insurance policies. If you are in this situation, it is important to review each option before making a decision.  Group retiree plans may not cost anything, or the cost may be lower than buying an individual Medicare Supplement insurance policy.
Source: vermont.gov

The Medicare Part D Prescription Drug Benefit

Posted by:  :  Category: Medicare

The Medicare Modernization Act of 2003 (MMA) established a voluntary outpatient prescription drug benefit for people on Medicare known as Part D, which went into effect in 2006. All 55 million people on Medicare, including those ages 65 and older and those under age 65 with permanent disabilities, have access to the Medicare drug benefit through private plans approved by the federal government. During the Medicare Part D open enrollment period, which runs from October 15 to December 7 each year, beneficiaries can choose to enroll in either stand-alone prescription drug plans (PDPs) to supplement traditional Medicare or Medicare Advantage prescription drug (MA-PD) plans (mainly HMOs and PPOs) that cover all Medicare benefits including drugs. Beneficiaries with low incomes and modest assets are eligible for assistance with Part D plan premiums and cost sharing. This fact sheet provides an overview of the Medicare Part D program and information about 2016 plan offerings, based on data from the Centers for Medicare & Medicaid Services (CMS) and other sources.
Source: kff.org

Understanding the Medicare Part D Donut Hole

Once you and your Part D drug plan have spent $2,840 for covered drugs, you will be in the donut hole. Previously, you had to pay the full cost of your prescription drugs while in the donut hole. However, in 2011, you get a 50% discount on covered brand-name prescription medications. The donut hole continues until your total out-of-pocket cost reaches $4,550. This annual out-of-pocket spending amount includes your yearly deductible, copayment, and coinsurance amounts.
Source: about.com

www.Q1Medicare.com Your Source for Medicare Part D Plan Information

Looking for a place to get started? Here is an overview of the Medicare Part D prescription drug and Medicare Advantage programs: Medicare Part D prescription drug plans (or PDPs) provide insurance coverage for your prescription drugs. Medicare Advantage plans (MAs or MA-PDs) provide your Medicare Part A coverage (In-patient and Hospitalization) and your Medicare Part B coverage (Doctors visits and Out-Patient care) – and maybe even Medicare prescription drug coverage. Medicare Part D plans and Medicare Advantage plans are both voluntary programs and you are not required to join a plan. But you may be subject to a late-enrollment penalty if you decide to join a prescription drug plan sometime after your initial enrollment period has ended. Medicare Part D plans and Medicare Advantage plans are regulated by the Centers for Medicare and Medicaid Services (CMS or Medicare) and implemented by private insurance companies (such as Aetna, Humana, and United HealthCare). If you decide to enroll in a Medicare Part D plan or Medicare Advantage plan, you will find that, like any insurance, you pay a monthly premium. The monthly premiums for a Medicare Part D PDP can range from under $20 to over $130 dollars. The monthly premiums for a Medicare Advantage plan with (MA-PD) or without (MA) prescription coverage can range from $0 (no kidding) to well over $100. Medicare Part D and Medicare Advantage plans may have an initial deductible, co-payments or co-insurance, and some Donut Hole (Doughnut Hole) or Gap coverage (you can find more on these topics in our Glossary). When you enroll in a Medicare Part D prescription drug plan or a Medicare Advantage plan that offers prescription coverage, you should find that your prescription medication costs are reduced. The amount of savings depends on the Medicare plan you select. If you wish to learn more, you can click on this link to view all of the Medicare Part D plans in your State
Source: q1medicare.com