Medicare Plan Finder for Health, Prescription Drug and Medigap plans

Posted by:  :  Category: Medicare

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Source: medicare.gov

About Medicare health plans

Generally, a plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits to people with Medicare who enroll in the plan. Medicare health plans include all Medicare Advantage Plans, Medicare Cost Plans, and Demonstration/Pilot Programs. Programs of All-inclusive Care for the Elderly (PACE) organizations are special types of Medicare health plans that can be offered by public or private entities and provide Part D and other benefits in addition to Part A and Part B benefits.
Source: medicare.gov

Pick the Best Medicare Advantage Plan for You

The Plan Finder tool includes each plan’s overall rating based on 36 topics within five categories: staying healthy (screening, tests and vaccines), managing chronic conditions, health plan responsiveness and care, and health plan member complaints and appeal (those last two categories are particularly important). For plans that also cover drug services, the tool includes an additional 17 topics in four categories — drug plan customer service, drug plan member complaints and Medicare audit findings, member experience with the drug plan, and drug pricing and patient safety. There’s also a red caution sign for plans that have received a low rating from the Medicare program for three years in a row.
Source: kiplinger.com

Medical Billing and Coding Guidelines and tips to improve billing.: Medicare claim submission address

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Medical Billing Solution, Medical Billing Training Program, About Outsourcing Services, Medical Billing Process and Concept, Tips to Medical Biller, Specialist. Medical Insurance Billing Denial Guidelines. Medical Billing Training Articles and Software Review. Medicare Billing CPT code ,ICD-9 DX Code Update.
Source: whatismedicalinsurancebilling.org

Medical Billing and Coding Guidelines and tips to improve billing.: Medicare billing address

Medical Billing Solution, Medical Billing Training Program, About Outsourcing Services, Medical Billing Process and Concept, Tips to Medical Biller, Specialist. Medical Insurance Billing Denial Guidelines. Medical Billing Training Articles and Software Review. Medicare Billing CPT code ,ICD-9 DX Code Update.
Source: whatismedicalinsurancebilling.org

How to compare Medigap policies

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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

What is Medicare Supplement (Medigap) Insurance?

Some states may offer Medigap plan options to beneficiaries under 65 who qualify for Medicare because of disability or certain conditions (such as end-stage renal disease). Federal law doesn’t require states to sell Medicare Supplement insurance to beneficiaries under 65. However, depending on where you live, some states may offer Medigap coverage to beneficiaries under 65; eligibility and the specific available options may vary by state. If you’re a Medicare beneficiary under 65 and interested in purchasing Medicare Supplement insurance, contact your state insurance department to learn if you’re eligible for Medigap coverage in your state.
Source: ehealthinsurance.com

The Top Medicare Supplemental Insurance Companies Compared

At first blush, the care provided through this federal program appears to be all encompassing, but the truth is, many programs are not covered. For example, if a patient needs to be seen by a specialist or undergo an expensive surgery or an uncovered series of rehabilitation, that patient will very likely have to pay for their treatment out of pocket. In extreme cases (which unfortunately are common), many senior citizens will instead choose to forgo the treatment lest they drain their bank account in the process. This is where supplemental insurance comes into play. It covers the difference between what your insurance is willing to pay and what is actually not covered under your plan.
Source: medicaresupplementalinsurancecomparison.net

What’s Medicare Supplement Insurance (Medigap)?

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 Insurance Plan Benefit Comparison

*After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year. Plan K Out-of-Pocket Limit is $4,800.00. Plan L Out-of-Pocket Limit is $2,400.00. Out-of-pocket limit is the maximum amount you would pay for Co-insurance and Co-payments in a calendar year. The out-of-pocket annual limit will increase each year for inflation.
Source: medicaresupplementplans.com

Costs in the coverage gap

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Mrs. Anderson reaches the coverage gap in her Medicare drug plan. She goes to her pharmacy to fill a prescription for a covered brand-name drug. The price for the drug is $60, and there’s a $2 dispensing fee that gets added to the cost. Mrs. Anderson will pay 45% of the plan’s cost for the drug ($60 x .45 = $27) plus 45% of the cost of the dispensing fee ($2 x .45 = $0.90), or a total of $27.90, for her prescription. $57.90 will be counted as out-of-pocket spending and will help Mrs. Anderson get out of the coverage gap because both the amount that Mrs. Anderson pays ($27.90) plus the manufacturer discount payment ($30.00) count as out-of-pocket spending. The remaining $4.10, which is 5% of the drug cost and 55% of the dispensing fee paid by the drug plan, isn’t counted toward Mrs. Anderson’s out-of-pocket spending.
Source: medicare.gov

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

How does this Donut Hole really work?

I use medications not covered by my Medicare Part D plan or sometimes I buy my medications from outside of the country (for instance, in Canada or Mexico). Are these prescription drug expenses included in the $3310 or any other Part D calculation? No. Any medications not included on your Medicare Part D plan’s formulary or drug list (also known as: out of formulary drugs) or drugs that you purchased outside of the United States fall outside of your Medicare Part D coverage and are not included in the $3310 or any other Part D calculation. If you use a medication that is not included on your formulary, you can ask your Medicare Part D plan for a formulary exception or coverage determination, whereby your non-formulary drug would be included on your own personal formulary. If your Medicare Part D plan denies your request for a coverage determination, you can appeal the denial – several times. Be sure to ask your Medicare Part D plan for details on the formulary exception and appeals process.
Source: q1medicare.com

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

Health Insurance Information Center

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Health insurance can be a complicated subject. What’s a premium? What’s a deductible? How should you choose a plan? You’ll find the answers to these questions and more in our Health Insurance Info Center for seniors.
Source: gohealthinsurance.com

Utah Department of Health

The mission of the Division of Family Health and Preparedness is to assure care for many of Utah’s most vulnerable citizens. The division accomplishes this through programs designed to provide direct services, and to be prepared to serve all populations that may suffer the adverse health impacts of a disaster, be it man-made or natural.
Source: utah.gov

New Medicare Benefits and Changes for 2011

Posted by:  :  Category: Medicare

Once your total drug costs reach $4,550 (see the Ms. Medicare column "Paying Less for Drugs in the Doughnut Hole" for details about how this is calculated), you are eligible for "catastrophic coverage" and your prescription costs drop to a lower copay for the remainder of the year. Last year, when there were no doughnut-hole discounts, $250 rebate checks were sent to all affected Part D subscribers. Because of the discounts now in place, there will be no rebate checks for 2011 expenses. Another 2011 change for Part D subscribers is that if you have a high annual income (more than $85,000 for individuals and $170,000 for couples) and pay higher-income premiums for Part B, you’ll also pay a higher premium for Part D drug coverage.
Source: aarp.org

Changes to Medicare in 2011

Amir Mostafaie plays a lead role in training and educating new and existing agents in our customer care center, and over the past 9 years has enjoyed helping numerous people find health coverage that fits their needs. His background in the medical field and expertise in the health insurance marketplace allows him to provide unbiased assistance and insight on a broad range of health insurance topics.
Source: ehealthinsurance.com

Learn What to do If you Already Have Medicare Health Coverage

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Yes. Coverage from an employer through the SHOP Marketplace is treated the same as coverage from any job-based health plan. If you’re getting health coverage from an employer through the SHOP Marketplace based on your or your spouse’s current job, Medicare Secondary Payer rules apply.
Source: healthcare.gov

Medicare Coverage of Home Health Care

If you are interested in home health care after a stay in the hospital, or as an alternative to a stay in a hospital or nursing facility, contact a home health care agency recommended by your doctor or the hospital discharge planner. The discharge planner can even contact an agency for you. You may also get help in locating home health care agencies from a community health organization, visiting nurses association, United Way, Red Cross, or neighborhood senior center. Medicare.gov lists home health care agencies in your area and allows you to compare the quality of their service depending on past performance.
Source: nolo.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 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

Geeks On Finance: FICA & Medicare Tax Rates

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In 2013, there will be an additional Medicare tax of .9 percent on earned income for single persons earning $200,000, married filing jointly returns earning over $250,000 and married filing separate returns over $125,000. This rate is in addition to the 1.45 percent paid by employees on all wages. There is no employer matching percentage on the additional .9 percent Medicare tax.
Source: geeksonfinance.com

Medicare Summary Notice Download

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This website is privately owned and all information and advertisements are independent and are not associated with any state exchange or the federal marketplace. Additionally, this website is not associated with, sanctioned by or managed by the federal government, the Centers for Medicare & Medicaid or the Department of Health and Human Services.
Source: medicareenrollment.com

Medicare Summary Notice (MSN)

MSNs are usually mailed four times a year and contain information about submitted charges, the amount that Medicare paid, and the amount you are responsible for. Note that you may receive an MSN more often if you are being reimbursed for a bill you paid. You can also access your MSN online at www.mymedicare.gov. This site allows you to look at electronic versions of your MSNs and print copies from your own computer whenever you would like (but it does not replace the paper MSN).
Source: medicareinteractive.org