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

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Source: medicare.gov

More Medicare Information

If you live in Puerto Rico you will not receive Medicare Medical Insurance (Medicare Part B) automatically. You will need to sign up for it during your initial enrollment period or you will pay a penalty. To sign up, please call our toll-free number at 1-800-772-1213 (TTY 1-800-325-0778). You also may contact your local Social Security office. You can find your local Social Security office by using our Office Locator.
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

How to Apply for Medicaid

If you choose a managed care plan, you and your family receive their basic health care through a primary care doctor associated with a managed care plan. Medical care will be arranged through the managed care plan that you chose, and you must receive medical care with the doctors, hospitals, pharmacies associated with that managed care plan.
Source: illinois.gov

Claim Status Request and Response

Posted by:  :  Category: Medicare

Providers have a number of options to obtain claim status information from Medicare contractors: •Providers can call the provider help lines for their local Part A and Part B Medicare Administrative Contractor (MAC) and ask to speak to a customer service representative. •Providers can enter data via Interactive Voice Response (IVR) telephone systems operated by Medicare contractors. •Providers can enter claim status queries via direct data entry screens maintained by Medicare contractors. •Providers can send a Health Care Claim Status Request (276 transaction) electronically and receive a Health Care Claim Status Response (277 transaction) back from Medicare. The electronic 276/277 process is recommended since many providers are able to automatically generate and submit 276 queries as needed, eliminating the need for manual entry of individual queries or calls to a contractor to obtain this information. Submission of 276 queries and issuance of 276 responses should be less expensive for both providers and for Medicare. In addition, the 277 response is designed to enable automatic posting of the status information to patient accounts, again eliminating the need for manual data entry by provider staff members. If unsure whether your software is able to automatically generate 276 queries or to automatically post 277 responses, you should contact your software vendor or billing service.
Source: cms.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

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 Requirements

In purchasing a Medigap Supplemental Insurance Policy, getting enrolled by the initial enrollment period is very crucial. If you apply during the IEP, by law, you are guaranteed that all insurers selling Medigap coverage in your state must offer you all the Medigap Supplemental Policy coverage plans that they sell. In addition, this guarantees, by law, that the insurance rate premiums offered to you will be the same as a person considered to be in good health. This applies, regardless of the fact that your current or past health history may not have been good or you have ongoing health issues.
Source: medicare.net

Medicare Eligibility and Enrollment

re already getting Social Security checks, you will be automatically enrolled in traditional Medicare. You’ll get your Medicare card three months before your 65th birthday. The benefits kick in on the first day of the month of your 65th birthday. Traditional Medicare, which is also called original Medicare, includes Medicare Parts A and B. Part A is hospital coverage. Part B covers doctor visits, lab tests, and other outpatient services.
Source: webmd.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

Pharmaceutical Assistance Program

Posted by:  :  Category: Medicare

Some pharmaceutical companies offer assistance programs for the drugs they manufacture. Click on the first letter of your drug name to see if any programs are available for the drugs you are taking. If your drug is on the list, click on “details” for detailed information about the program.
Source: medicare.gov

Extra Help with Medicare Prescription Drug Plan Costs

Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.
Source: ssa.gov

Prescription Drug Assistance Programs

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and subsequent regulations require coordination between CMS, State programs, insurers, employers, and all other payers of prescription drug benefits to ensure that the prescription drug benefits provided to Medicare beneficiaries enrolled in Medicare Part D are maximized and the integrity of the Medicare program is assured. CMS has implemented data exchanges with Prescription Drug Assistance Programs including State Pharmaceutical Assistance Programs (SPAPs), AIDS Drug Assistance Programs (ADAPs), and Patient Assistance Programs (PAPs) to coordinate Medicare Part D prescription drug benefits with other coverage a Medicare beneficiary may have. This allows CMS to facilitate accurate claims payment and the calculation of the Medicare Part D True Out of Pocket (TrOOP) expenses incurred by Medicare beneficiaries.
Source: cms.gov

Department of Human Services

SHIP produces and regularly updates charts detailing the various Medigap, Medicare Advantage and Part D drug plans offered in New Jersey. These charts have been posted here to help you compare plans and make an informed decision about which plan best fits your needs and budget. Please note, however, that since Medigap options and pricing can change at anytime during the year, it is recommended you call the company you are interested in to confirm the information/premiums provided on these charts prior to enrolling or making a coverage change. If you are receiving your Medicare coverage through
Source: nj.us

Medicare Insurance Careers

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Before an agent starts a Medicare insurance career they must understand the differences between Original Medicare and additional Medicare plans provided by private insurance companies. Medicare is our socialized health care system that provides health coverage for individuals aged 65 or older and/or the disabled. Original Medicare is comprised of two parts: Part A which covers hospital bills and Part B that covers doctor bills. Original Medicare is less comprehensive than other health care plans; therefore the majority of seniors sign up for or purchase Medicare insurance policies from private companies to fill the gaps in coverage or provide additional coverage above traditional Medicare.  Agents sell policies such as Medicare supplements, Prescription Drug and Medicare Advantage plans to clients to help them lessen the costs associated with hospitalizations, emergency room visits, doctor visits, prescription drugs, etc.
Source: insurancecareer.com

Medicare & Medicaid Cost Report l Owner Administrator Forum Seminar

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Medicare Training & Consulting, Inc., was founded by Jim Plonsey in the Chicago area. After training Medicare auditors for Blue Cross Association, Jim established a business training Medicare auditors. This lead to doing cost reimbursement seminars for providers, most notably, home health agencies. Medicare Training & Consulting, Inc. has become a leader in providing Owners and Administrators with the reimbursement strategies.
Source: medicareconsulting.net

Expert Help Signing Up for Medicare

“Ample time was taken to answer all my questions. My research on my own was not giving me the confidence that I would be making the right decision. 65 Incorporated was able to not only answer my questions fully, but gave me confidence in my decisions.” - Bob J., WI
Source: 65incorporated.com

Understanding Employment Taxes

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Beginning January 1, 2013, employers are responsible for withholding the 0.9% Additional Medicare Tax on an employee’s wages and compensation that exceeds a threshold amount based on the employee’s filing status. You are required to begin withholding Additional Medicare Tax in the pay period in which it pays wages and compensation in excess of the threshold amount to an employee. There is no employer match for the Additional Medicare Tax.
Source: irs.gov

Social Security Tax / Medicare Tax and Self

The United States has entered into social security agreements with foreign countries to coordinate social security coverage and taxation of workers employed for part or all of their working careers in one of the countries. These agreements are commonly referred to as Totalization Agreements. Under these agreements, dual coverage and dual contributions (taxes) for the same work are eliminated. The agreements generally make sure that social security taxes (including self-employment tax) are paid only to one country. You can get more information on the Social Security Administration’s Web site.
Source: irs.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

DSS Medical Assistance Services: Medicaid

Medicaid furnishes medical assistance to eligible low-income families and to eligible aged, blind and/or disabled people whose income is insufficient to meet the cost of necessary medical services. Medicaid pays for: doctor visits, hospital care, labs, prescription drugs, transportation, routine shots for children, mental health and substance abuse services.
Source: delaware.gov