Medicare Advantage PPO Plans (Preferred Provider Organization)

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Generally, beneficiaries can receive their health care from any doctor or health care provider while enrolled in a PPO plan. These plans have network doctors and providers, but plan members are still given the flexibility to choose out-of-network doctors. Be aware that out-of-network care will cost more for the beneficiary as the PPO plan will cover less of the expenses. Some Medicare Advantage plans require beneficiaries to choose a primary care doctor to coordinate their health care, but PPO plans do not have this requirement. Additionally, referrals from a primary care doctor are not required for a beneficiary to see a specialist. Like with other aspects of care under a PPO plan, using an in-network plan specialist will usually cost less than using an out-of-network specialist.
Source: planprescriber.com

Medicare Advantage Plans in Michigan

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

Questions About Wellpoint Medicare Advantage Plans?

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One thing that separates WellPoint is the amount of information and educational tips that the company provides for members. Various workshops and programs are provided to help members maintain their health in-between doctor visits. WellPoint has been praised recently for some of its programs, including a health improvement program that targets diabetes. Insured individuals who enroll in this program are 27 percent less likely to go to the hospital than those who are not.
Source: medicare.net

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

About Medicare health plans

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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

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

Unique Physician Identification Number (UPIN) Directory

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The Unique Physician Identification Number (UPIN) Directory contains selected information on physicians, doctors of Osteopathy, limited licensed practitioners and some non-physician practitioners who are enrolled in the Medicare Program. The data elements in the file (UPIN, full name, specialty, Physician License State Code, zip code, Medicare provider billing number and State) are extracted from the UPIN Database and are approved for public release in the Centers for Medicare & Medicaid Services (CMS) System of Records. The file is updated quarterly with updates being available usually by April 15, July 15, October 15, and January 15. Each update file is considered as a replacement file.
Source: cms.gov

Medicare Plan Finder – Search by Plan Name and/or ID

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

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

Difference between the Medicare Provider Numbers

Applicable FARSDFARS Restrictions Apply to Government Use. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60654. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
Source: wpsmedicare.com

National Provider Identifier Standard (NPI)

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.
Source: cms.gov

Blue Medicare PPO and Blue Medicare HMO Providers

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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.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

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

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 Supplemental Insurance Plans

With a variety of standardized Medicare supplement insurance plans available, it’s important to know your options. Learn about the benefits and how a Medicare supplement insurance plan could be the right fit for you
Source: aarpmedicaresupplement.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

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