Centers for Medicare & Medicaid Services

Posted by:  :  Category: Medicare

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Source: cms.gov

Locating an Individual Provider Transaction Access Number (PTAN)

“The contractor shall not send an individual’s provider transaction access numbers (PTAN) to a group or organization (including the group’s authorized or delegated official). If a group/organization needs to know an individual provider’s PTAN, it must contact the provider directly for this information or have the individual provider request this information in writing from the contractor. If the individual provider requests his/her PTAN number, the contractor can mail it to the provider’s practice location. The contractor should never give this information over the phone.”
Source: custhelp.com

Applicationstatus lookup tool

First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.
Source: fcso.com

Mandatory Insurer Reporting (NGHP)

Posted by:  :  Category: Medicare

Reporting is accomplished by either the submission of an electronic file of liability, no-fault, and workers’ compensation claim information, where the injured party is a Medicare beneficiary, or by entry of this claim information directly into a secure Web portal, depending on the volume of data to be submitted. Upon receipt of this information, CMS checks whether the injured party associated with the claim report is a Medicare beneficiary, and determines if the other insurance is primary to Medicare. CMS then uses this information in the Medicare claims payment process and, if Medicare paid first when it should not have, uses it to seek repayment from the other insurer or the Medicare beneficiary.
Source: cms.gov

Medicare Eligibility: Who is Eligible for Medicare?

Posted by:  :  Category: Medicare

You are age 65 or older and you or your spouse has worked 0-29 quarters in Medicare-covered employment. You must enroll as a voluntary enrollee and pay the full Part A monthly premium. Note: Low-income programs can help you pay these premiums if you meet the income and asset levels.
Source: cahealthadvocates.org

Blue Medicare PPO and Blue Medicare HMO Providers

Posted by:  :  Category: Medicare

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

Direct Graduate Medical Education (DGME)

Posted by:  :  Category: Medicare

Prior to July 1, 2010, under section 1886(h)(4)(E) of the Act, a hospital could count residents training in nonprovider settings for direct GME purposes (and under section 1886(d)(5)(B)(iv) of the Act, for IME purposes), if the residents spent their time in patient care activities and if “. . . the hospital incurs all, or substantially all, of the costs for the training program in that setting.” The implementing regulations, first at §413.86(f)(3), effective July 1, 1987, and later at §413.86(f)(4) (redesignated as §413.78(d)) , effective January 1, 1999, required that, in addition to incurring all or substantially all of the costs of the program at the nonprovider setting, there must have been a written agreement between the hospital and the nonprovider site (in place prior to the time the hospital began to count the residents training in the non-provider site) stating that the hospital would incur all or substantially all of the costs of training in the nonprovider setting. The regulations further specified that the written agreement must have indicated the amount of compensation provided by the hospital to the nonprovider site for supervisory teaching activities. Effective October 1, 2004, the hospital must have either had a written agreement with the nonprovider setting, or, as described in the regulations at §413.78(e), paid for all or substantially all of the costs, concurrent with the training in the nonprovider setting. Effective for cost reporting periods beginning on or after July 1, 2007 and before July 1, 2010, “all or substantially all of the costs for the training program” in the nonprovider setting is defined as at least 90 percent of the total of the costs of the residents’ salaries and fringe benefits (including travel and lodging where applicable) and the portion of the cost of teaching physician’s salaries attributable to nonpatient care direct GME activities.
Source: cms.gov

Medicare Health Benefits MHB Insurance Services

Posted by:  :  Category: Medicare

We work as facilitators, listening to the voices of many, both prominent and under served. Ultimately our decisions are made possible by considering ideas brought to light by those voices. We provide the opportunity for people to prosper and connect within their communities.
Source: medicarehealthbenefits.com

Frequently Asked Questions

MHB can help you if your new health care benefits or if you are currently receiving. MHB can help you with Medicare Supplements, Medicare Advantage Plans, and Medicare Part D Prescription Drug Plan. Our agent’s highly skilled in that they can compare plans and offer you the best options for your specific situation. We understand that your time is valuable and we pride ourselves in tailoring our service around your needs. MHB agents will walk you through one step at a time to meet your needs and budget. Since 1996 MHB has thrived on assisting individuals on selecting the policy that is right for them. If you are interested please visit Our Products MHB agents offer.
Source: medicarehealthbenefits.com

How to compare Medigap policies

Posted by:  :  Category: Medicare

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Source: medicare.gov

Comparing Medicare Supplement Plans

If you need help finding a Medigap or other Medicare plan that fits your needs, I’m here to help. Take a look at my profile below to learn about my Medicare experience. To schedule a time to speak one-on-one or have me email you more information, use the links below. If you’re ready to find plans now, you can use the Compare Plans buttons on this page to browse plans now. To speak with someone more quickly, call us using the information below.
Source: medicare.com

Medicare Supplement Comparison Chart

Although there are several plans to choose from, comparing and contrasting Medicare Supplement Plans (also called Medigap) is relatively simple. The Centers for Medicare and Medicaid Services (CMS) has designed all Medicare Supplement Plans currently available. There are a total of 10 plans, and they are set up in a letter system ranging from “Plan A” to “Plan N”. All 10 Medigap plans are “Standardized”, meaning if you compared one particular letter plan, with another plan of the same letter offered by a different insurance company, the benefits would be identical. The only difference between companies is the price they charge.
Source: medicaresupplementsolutions.com

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

Posted by:  :  Category: 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

How to compare Medigap policies

Posted by:  :  Category: Medicare

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Source: medicare.gov

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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Source: medicare.gov

Compare Medicare Supplement Plans Side by Side

Last but not least is the coverage you desire from your Medigap plan.  There are ten plans to choose from that are labeled Plan A – Plan N (plans E, H, I, and J are no longer offered).  Plan F is the most popular Medicare Supplement, because it offers the most comprehensive coverage on the market.  Plan G is a great plan because it also has extensive coverage, with lower premiums and rate increases than Plan F.  Another popular plan is Plan N, which has more cost sharing but lower premiums than the other Medigap policies. 
Source: medicareinsurancefinders.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

Fidelis Care > Products > Medicare Advantage and Dual Advantage > Overview

Posted by:  :  Category: Medicare

A: Medicare Advantage, also referred to as “Part C” coverage, is a different way to get your Medicare coverage. You still have Medicare Part A (Hospital) and Part B (Medical) coverage, but most of your Medicare-covered services will be paid by Medicare Advantage. You or someone on your behalf must continue to pay your monthly Part B premium, as well as any Medicare Advantage premium.
Source: fideliscare.org

Fidelis Medicare $0 Premium Putnam County NY 2016 Medicare Advantage

Yes, Fidelis Medicare $0 Premium is considered an MAPD which stands for Medicare Advantage Prescription Drug Plan. It includes drug coverage along with your regular Medicare health coverage as well. Fidelis Care has included a deductible of $0.00 in the Fidelis Medicare $0 Premium for 2016. You will also want to view the formulary ID# 00015369 for Fidelis Medicare $0 Premium to make sure that your drugs are covered and what each drug will cost.
Source: medicare-plans.net