Medicare Advantage Plans in Michigan

Posted by:  :  Category: Medicare

Medicare Advantage plans are a lot like the health insurance you may have had before becoming eligible for Medicare. You can choose a complete insurance package with the convenience of one ID card for all services.
Source: bcbsm.com

Blue Medicare PPO and Blue Medicare HMO Providers

Blue Cross and Blue Shield of North Carolina is an HMO, PPO, and PDP plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal. Blue Cross and Blue Shield of North Carolina does not discriminate based on race, ethnicity, national origin, religion, gender, age, mental or physical disability, health status, claims experience, medical history, genetic information, evidence of insurability or geographic location within the service area. All Blue Cross and Blue Shield of North Carolina items and services are available to all eligible beneficiaries in the service area.
Source: bcbsnc.com

Medicare PPO Blue ValueRx (PPO)

You do not currently have end-stage renal disease (ESRD). If you initiated dialysis treatments for ESRD but have recovered your normal kidney function and no longer require a regular course of dialysis to maintain life, or have had a successful kidney transplant, or are currently a member of Blue Cross Blue Shield of Massachusetts, you may still join the plan. In addition, if you were a member of a Medicare Advantage plan that terminated its services after December 31, 1998, and you currently have ESRD, you may still join the plan. There may be additional requirements, please contact the plan for more information.
Source: bluecrossma.com

What’s Medicare Supplement Insurance (Medigap)?

Posted by:  :  Category: Medicare

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 Supplement Options

* Network restrictions apply. ** Policy forms UWMSP(A)-2010, UWMSP(F)-2010, UWMSP(F-HD)-2010, UWMSP(G)-2010, UWMSP(K)-2010, UWMSP(L)-2010, UWMSP(N)-2010, UWMSP-SEL(F)-2010, UWMSP-SEL(G)-2010, UWMSP-SEL(K)-2010, UWMSP-SEL(L)-2010, UWMSP-SEL(N)-2010.
Source: bcbstx.com

Medicare Supplement Insurance

Original Medicare can be difficult to understand at best and Medicare Supplement insurance plans can be a daunting task! We are here to help! You may be asking yourself, when is the best time to buy a Medicare Supplement insurance policy? The best time to purchase a policy is during “open enrollment”, open enrollment is six months prior to your 65th birthday and lasts 6 months from the first day of the month in which you turned 65. This enrollment is extended for those who enrolled in Medicare Part B after the age of 65. During this open enrollment period insurance companies cannot use medical underwriting to turn you down for insurance, make you wait for coverage, or charge you a higher premium. An insurance company also cannot use a pre-existing condition waiting period if you have a guaranteed issue right (also called Medigap protection). For people that are past their open enrollment period you can enroll or change Medicare Supplements any time of the year.
Source: medicaresupplementtexas.com

Health Plan Medicare Advantage Risk Adjustment

Posted by:  :  Category: Medicare

Optum provides end-to-end support to help plans deliver high-quality care, manage increasing health care costs, and achieve payment accuracy. Our risk adjustment services help Medicare Advantage, Managed Medicaid, and Commercial/Exchange plans support accurate reimbursement while streamlining risk management processes and assisting in improving quality of care. Through our integrated solutions, Optum helps:
Source: optum.com

What is a “Medicare Risk Adjustment Factor (RAF)?”

The purpose for the Centers for Medicare and Medicaid Services (CMS) to conduct Risk Adjustment Factors is to pay plans for the risk of the beneficiaries they enroll, instead of calculating an average amount of Medicare/Medicare Advantage beneficiaries.  By doing so, CMS is able to make appropriate and accurate payments for enrollees with differences in expected costs. Lastly, the risk adjustment allows CMS to use standardized bids as base payments to plans.
Source: clinicservice.com

Home Health Risk Adjustment of Outcome of Care Measures

For OASIS-based quality measures, prediction models use patient case mix information taken from OASIS-C SOC/ROC assessments to establish a relationship between these characteristics and the likelihood of a quality outcome. Each improvement and utilization outcome has its own unique prediction model. Virtually every item on OASIS-C, with the exception of a few demographic/patient tracking items and clinical record items, are potential risk factors that can be used to create this prediction equation.
Source: medicare.gov

Medicare Risk Adjustment for the Health Insurance Industry

As an invaluable resource to both health plans and the providers included in the MRA chart review, provider education materials are a tool to help providers identify areas for improvement in their record documentation and also provide general coding guidelines. MediConnect has standard provider education materials but can also develop additional customized materials. (Sample report.)
Source: mediconnect.net

What Is Medicare Risk Adjustment?

Medicare managed care providers track and report patient diagnoses to Medicare. There is a specific diagnostic code for each illness and the severity of each illness. Medicare has developed four payment models to increase accuracy: new enrollee, end stage renal disease, long-term care institutional and a community model.
Source: ehow.com

Medicare HCC Chart Review, RAPS Submission

HDVI provides a solution that answers this challenge: unrivalled accuracy in collection and coding, backed by performance guarantees. In addition, HDVI offers a whole set of coding and analytics options, which ensure that the results are exactly what our clients have been looking for. This may include coding diagnoses other than the ones supporting HCCs (anticipating chases in the model, using information for care management, etc.), smart and logic-driven member suspect identification data comparisons or the use of identified diagnoses as a baseline.
Source: healthdatavision.com

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

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

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

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

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

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Find a Medigap Policy in Your Area

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 Eligibility and Medicare Supplements

While you don’t have to pay a premium for Part A if you meet one of those conditions, you must pay for Part B if you want it. The Part B monthly premium in 2011 is $115.40. (Note: Most beneficiaries will continue to pay the same premium amount they pay today. For additional details, see our FAQ titled: Will my Medicare Part B premium increase in 2011 ?) It is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you don’t get any of the above payments, Medicare sends you a bill for your Part B premium every 3 months.
Source: mymedicaresupplementinsurance.com

2011 Premiums for Medicare Part B

Those who do not qualify under those conditions will be required to pay the new 2011 Part B premium of $115.40, which represents a 4.4 percent increase in premiums over 2010. This new rate is brought about by anticipated increases in what it costs to administer Part B benefits. Beneficiaries who make more than $85,000 individually or $170,000 jointly could face even higher premiums.
Source: emedicaresupplements.com

Annual Statistical Supplement, 2011

Certain other Medicare beneficiaries may receive help with Medicare premium and cost-sharing payments through their state Medicaid program. Qualified Medicare Beneficiaries (QMBs) and Specified Low-Income Medicare Beneficiaries (SLMBs) are the best-known categories and the largest in numbers. QMBs are those Medicare beneficiaries who have financial resources at or below twice the standard allowed under the SSI program and incomes at or below 100 percent of the FPL. For QMBs, Medicaid pays the Hospital Insurance (HI, or Part A) and Supplementary Medical Insurance (SMI) Part B premiums and the Medicare coinsurance and deductibles, subject to limits that states may impose on payment rates. SLMBs are Medicare beneficiaries with resources like the QMBs but with incomes that are higher, though still less than 120 percent of the FPL. For SLMBs, the Medicaid program pays only the Part B premiums. A third category of Medicare beneficiaries who may receive help consists of disabled-and-working individuals. According to Medicare law, disabled-and-working individuals who previously qualified for Medicare because of disability, but who lost entitlement because of their return to work (despite the disability), are allowed to purchase Medicare Part A and Part B coverage. If these persons have incomes below 200 percent of the FPL but do not meet any other Medicaid assistance category, they may qualify to have Medicaid pay their Part A premiums as Qualified Disabled and Working Individuals (QDWIs).
Source: ssa.gov

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

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

2016 Medicare Advantage Plans Available to Residents of Florida

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AK  AL  AR  AZ  CA  CO  CT  DC  DE  FL  GA  HI  IA  ID  IL  IN  KS  KY  LA  MA  MD  ME  MI  MN  MO  MS  MT  NC  ND  NE  NH  NJ  NM  NV  NY  OH  OK  OR  PA  RI  SC  SD  TN  TX  UT  VA  VT  WA  WI  WV  WY
Source: q1medicare.com

Medicare Advantage in Florida

Florida residents wishing to enroll in Medicare Advantage must already be enrolled or be eligible to enroll in Original Medicare, Part A and Part B. You are first able to join Original Medicare during your Initial Enrollment Period, which begins three months before you turn 65, includes your birthday month, and ends three months after that month. If you don’t sign up for Medicare during your Initial Enrollment Period, you may subject to a late-enrollment penalty for as long as you remain enrolled in Medicare. You may enroll in Original Medicare at a later date, during the annual General Enrollment Period, which runs from from January 1 to March 31, but be aware that you would still have to pay the late-enrollment penalty fee.
Source: planprescriber.com

Florida Blue Medicare Advantage Plans for 2016

Are you a Florida senior citizen who is trying to maximize your Medicare benefits? Just as each senior citizen has her own unique needs and preferences, insurers offer a variety of different ways to enjoy these hard-earned health benefits and even help you plan for medical expenses that original Medicare does not completely cover. At Secure Health Options, we want to help all Floridians find the right plan that assures them of convenient and affordable access to the best medical providers. You can request information on Medicare Advantage plans and Florida Medicare supplemental insurance in your own local area by entering your home ZIP code in the box at the top of this page. If you have questions or would like help signing up, be sure to give us a call.
Source: floridamedicareadvantageplans.com

How Medicare Advantage Plans work

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. You’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare.
Source: medicare.gov

EmblemHealth: Medicare Coverage

Posted by:  :  Category: Medicare

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 copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare part B premium. This information is available for free in other languages. Please call our customer service number at 1-877-344-7364 (HMO Customer Service) or 1-866-557-7300 (PPO Customer Service), TTY/TDD users call 711, Monday through Sunday, from 8 am to 8 pm. Esta información está disponible gratis en otros idiomas. Por favor llame a nuestro número de servicios de atención al cliente al 1-877-344-7364 (HMO Servicios de atención al cliente) o 1-866-557-7300 (PPO Servicios de atención al cliente) (TTY/TDD: 711) de 8 am a 8 pm, los siete días de la semana.
Source: emblemhealth.com

Does Medicare Cover Hip Replacements?

To qualify for this surgery, your doctor will have to provide detailed information and medical records showing that joint replacement is medically needed in your case. Even if your surgery is approved, you may have to pay the Part A and/or the Part B deductibles before Medicare will pay, plus you may have copayments due. Before scheduling any surgical procedure, it’s a good idea to get an estimate of costs and find out what your coverage options are.
Source: medicare.com

Medicare proposes payment changes to hospitals for hip, knee replacement

The proposal announced Thursday by the Centers for Medicare and Medicaid Services is part of the Obama administration’s efforts to overhaul the health-care system, in part by using the payment system to reward quality of care rather than volume of services. Under the current system, doctors and hospitals typically get paid set fees for every procedure they perform, regardless of how patients fare.
Source: washingtonpost.com

Department of Human Services

Posted by:  :  Category: Medicare

For questions about New Jersey Medicaid, call 1-800-356-1561 or your County Welfare Agency For questions about NJ FamilyCare call 1-800-701-0710 You can also get information by visiting NJHelps.org, where you can self-screen for eligibility for NJ FamilyCare/Medicaid, as well as for many other social service programs.
Source: nj.us

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