Medicare Plans for Different Needs

Posted by:  :  Category: Medicare

UnitedHealthcare is dedicated to helping people nationwide live healthier lives. Our goal is to simplify the health care experience, help you meet your health and wellness needs and carry on trusted relationships with care providers. We offer a wide range of Medicare Advantage, Medicare prescription drug and Medicare Special Needs Plans that might be a good fit for you.
Source: uhcmedicaresolutions.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

Workers’ compensation and payments

Posted by:  :  Category: Medicare

If you settle your workers’ compensation claim, you must use the settlement money to pay for related medical care before Medicare will begin again to pay for related care. In many cases, the workers’ compensation agency contacts Medicare before a settlement is reached, to ask Medicare to approve an amount to be set aside to pay for future medical care. Medicare will look at certain medical documentation and approve an amount of money from the settlement that must be used up first before Medicare starts to pay for related care that’s otherwise covered and reimbursable by Medicare.
Source: medicare.gov

Future Medical Allocation Services

GRG’s evaluation in workers’ compensation and third party liability cases includes satisfying Medicare’s past interests – reimbursement for conditional payments – and evaluating / satisfying Medicare’s future interests – identifying Future Medical Allocations and providing compliant spend-down options to ensure Medicare is not billed prematurely.
Source: garretsongroup.com

Enterprise Risk Management & Claim Settlement Solutions for Insurance & Financial Industries.

What is a Medicare Set Aside? Under Section 1862 42 U.S.C. §1395y(b)(2) and § 1862(b)(2)(A)(ii) of the Social Security Act, Medicare is not responsible for paying a qualified injured person’s medical expenses when payment “has been made or can reasonably be expected to be made under a workers’ compensation plan, an automobile or liability insurance policy or plan (including a self-insured plan), or under no-fault insurance.” If the medical expenses are disputed in a personal injury situation, the provider, physician, or other supplier may bill Medicare as the primary payer. If the product or service is normally reimbursable under Medicare rules, Medicare may pay the expenses conditionally. Then if there is a subsequent settlement, judgment, award, or other payment, Medicare requires reimbursement of the expenses. For more information about your unique situation, ask our experts!
Source: msariskpro.com

MSA Frequently Asked Questions

A WCMSA meets CMS’ criteria for review when: A.The Claimant is currently a Medicare beneficiary and the total settlement value is greater than $25,000. -or- B. The Claimant has a “reasonable expectation“ of Medicare enrollment within thirty (30) months of the settlement date and the anticipated total settlement amount for future medical expenses and disability/lost wages over the life or duration of the settlement agreement is expected to be greater than $250,000. Claimants have a “reasonable expectation” of enrollment where: (1) The claimant has applied for Social Security Disability Benefits. (2) The claimant has been denied Social Security Disability Benefits but anticipates appealing that decision. (3) The claimant is in the process of appealing a denial of or re-filing for Social Security Disability benefits. (4) The claimant is 62 years and 6 months old. (5) The claimant has an End-Stage Renal Disease (ESRD) condition but does not yet qualify for Medicare based upon ESRD. CMS has noted that while they do not wish to review WCMSAs if the thresholds are not met, these thresholds reflect a CMS operational workload standard only. They do not constitute a substantive dollar or “safe harbor” threshold. Medicare beneficiaries must still consider Medicare’s interests in all WC cases and ensure that Medicare is secondary payer to workers’ compensation. 5/11/11 Memorandum, Charlotte Benson, Acting Director, Financial Services Group. See also, WCMSA Reference Guide, cms.gov
Source: atlassettlements.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

Supplements & other insurance

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

2010 Medicare Part D Program Compared to 2009, 2008 and 2007

Reference-Based Pricing – Under these programs, sponsors may require enrollees to pay a defined cost-sharing amount plus supplemental cost-sharing based on the differential in cost between the drug being dispensed and a lower-cost preferred alternative such as a generic equivalent. In contract year 2009, fewer than 10% of Part D contracts used reference-based pricing. Given the complexity of reference-based pricing formulas, it is very difficult to accurately convey the extent of expected out-of-pocket spending for formulary drugs subject to reference-based pricing. For this reason, CMS has been unable to have the Medicare Prescription Drug Plan Finder (MPDPF) calculate correct pricing for drugs subject to reference-based pricing, which may distort projections of out-of-pocket expenditures for some beneficiaries and significantly affect their ability to compare cost-sharing obligations under different plans and choose the plan that best meets their needs. Based on CMS’ experience and the increased complexity, CMS has observed with these programs, CMS will eliminate the option of reference-based pricing in the Part D Prescription Benefit Program (PBP) beginning in CY 2010. The basis for this decision is CMS’ belief that reference-based pricing may be inherently misleading to beneficiaries and inconsistent with their goal of improving transparency with regard to expected beneficiary cost-sharing under the Part D program.
Source: q1medicare.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

What is Medicare? What is Medicaid?

Medicare Part A, or Hospital Insurance (HI), helps pay for hospital stays, which includes meals, supplies, testing, and a semi-private room. This part also pays for home health care such as physical, occupational, and speech therapy that is provided on a part-time basis and deemed medically necessary. Care in a skilled nursing facility as well as certain medical equipment for the aged and disabled such as walkers and wheelchairs are also covered by Part A. Part A is generally available without having to pay a monthly premium since payroll taxes are used to cover these costs.
Source: medicalnewstoday.com

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

What Does Medicare Cover?

Posted by:  :  Category: Medicare

Also called medical insurance, Part B covers outpatient care. For instance, it pays for your visits to a doctor’s office, tests, and preventive health care like cancer screenings and vaccines. Part B also covers some medical supplies, like blood sugar test strips, therapeutic shoes, and more. It’s common for people to be automatically enrolled in Part B, too.
Source: webmd.com

Kansas Insurance Department

Posted by:  :  Category: Medicare

Insurance consumers and the general public should find everything they need by following "The Department", "Auto/Home", "Health/Life", "Insurance Fraud & Education" and "Other Services " links on the left.
Source: ksinsurance.org

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

Medicare and Medicaid: What's the Difference?

Posted by:  :  Category: Medicare

Costs to Consumer: You must pay a yearly deductible for both Medicare Part A and Part B, and make hefty copayments for extended hospital stays. Under Part B, you must pay the 20% of doctors’ bills Medicare does not pay, and sometimes up to 15% more. Part B also charges a monthly premium. Under Part D, you must pay a monthly premium, a deductible, copayments, and all of your prescription drug costs over a certain yearly amount and up to a ceiling amount, unless you qualify for a low-income subsidy.
Source: nolo.com