How to compare Medigap policies

Posted by:  :  Category: Medicare

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Source: medicare.gov

Medicare Supplement Plan F

* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. ** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
Source: bcbsil.com

Medicare Supplement Plan F

* A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. **This high deductible plan pays the same or offers the same benefits as Plan F after you have paid a calendar year $2110 deductible. Benefits from the high deductible Plan F will not begin until out-of-pocket expenses are $2110. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the plan’s separate foreign travel emergency deductible.
Source: medigap360.com

Boomer Benefits Medicare Supplements

Our caring agents provide lifetime claims service for your policy. This means when claims occur, you are not alone. You will have our experts on hand to help you sort through your statements, and even assist with appeals if necessary.
Source: boomerbenefits.com

Sterling Life Insurance � Compare Medicare Supplement Insurance

Posted by:  :  Category: Medicare

To compare Sterling Life Medicare Supplemental Insurance Plans with those of multiple other companies, simply call (877) 812-7571 today. Qualified Medicare Supplemental Insurance Specialists are ready to help you. Or you can fill out the form at the top right of this page to compare rates of multiple companies and apply online.
Source: medicaresupplement360.com

Medicare Supplement, Life, Dental & Critical Condition Insurance

Sterling recognizes the vital role providers play as the critical link between patients and their health. Sterling treats providers with the respect they deserve with Medicare Supplement expertise, top-notch customer service, quick and accurate claims processing, and comprehensive tools to manage the administrative process.
Source: cigna.com

Medicare.gov Nursing Home Compare

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Source: medicare.gov

Compare Sterling Life Medicare Supplements

Medigap Companies: Admiral Life Insurance Aetna Life Insurance American Continental Insurance American National Life Insurance Anthem Life American Pioneer Life Insurance American Republic Insurance Bankers Fidelity Life Insurance Blue Cross and Blue Shield Central Reserve Life Insurance Christian Fidelity Life Insurance Combined Insurance Company Conseco Insurance Company Continental General Insurance Continental Life Insurance Company Equitable Life and Casualty Insurance Family Life Insurance Company Forethought Insurance Company Genworth Life Insurance Company Gerber Life Insurance Company Globe Life and Accident Insurance Golden Rule Insurance Company Great American Life Insurance Guarantee Trust Life Insurance Humana Insurance Company Lincoln Heritage Life Insurance Loyal American Life Insurance Marquette National Life Insurance Mutual of Omaha Insurance Company National States Insurance Company New Era Life Insurance Company Old Surety Life Insurance Company Pacificare Life Assurance Company Pennsylvania Life Insurance Company Philadelphia American Life Insurance Physician’s Life Insurance Company Provident American Life & Health Reserve National Insurance Company Royal Neighbors of America Sierra Health and Life Insurance Southwest Service Life Insurance Standard Life and Accident Insurance State Mutual Insurance Company Sterling Investors Life Insurance Sterling Life Insurance Company Unicare United American Insurance Company United Commercial Travelers (UCT) United National Life Insurance United of Omaha Life Insurance United Teacher Associates United World World Corp Insurance Company
Source: medigap360.com

Sterling Investors Life Insurance

Founded in 1978 and located in Indianapolis, Indiana, Sterling Investors Life Insurance Company proudly serves the insurance needs to middle class America by providing valuable insurance protection across a broad range of insurance plans. We’re not the biggest so we work very hard everyday to make sure that our policyholders and agents across the country receive a level of service from us that always exceeds their expectations. We believe our company reflects the same conservative values as that of our regional surroundings.
Source: sterlinglifeco.com

Medicare Information, Help, and Plan Enrollment

Posted by:  :  Category: Medicare

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

The comprehensive solution for Medicare Administration

RAM Technologies, Inc. is pleased to offer a comprehensive solution focused on your Medicare requirements.  This offering provides the performance you need at a fraction of the operating costs traditionally incurred for this population.  Switch to HEALTHsuite Mercato and stop worrying about administration and compliance and focus on the care of your members.
Source: ramtechnologiesinc.com

Access to CMS Data & Application

Medicare fiscal intermediaries and carriers shall use the Government furnished Medicare Data Communications Network (MDCN) to support all Medicare operational data connectivity requirements. Such uses include Common Working File communications, shared processing remote operations, remote printing, shared system maintenance support (testing, release/fix distribution, remote diagnostics) and functional subcontracting arrangements necessitating the transfer of data to remote sites.
Source: cms.gov

Health Financial Systems Medicare Cost Report Software (MCR)

History: Since 1981, Health Financial Systems (HFS) has been developing and marketing CMS approved Medicare cost reporting software to assist health care facilities meet their governmental reporting requirements. HFS Medicare Cost Report software is used to prepare more cost reports than any other cost report system, making HFS the largest automated cost report vendor in the United States. [more…]
Source: hfssoft.com

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

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Source: medicare.gov

Medicare Remit Easy Print

Providers/suppliers who use the MREP software package have the ability to print paper documentation that can be used to reconcile accounts receivable, as well as create document(s) that can be included with claim submission to secondary/tertiary payers. The output of MREP is similar to the current Standard Paper Remittance (SPR) format. The availability to print out an ERA in the Standard Paper Remittance (SPR) advice format is cost effective. EDI Support Services (EDISS) encourages providers to use MREP or other software to read, view, and print an ERA to eliminate any need for the SPR.
Source: edissweb.com

Coventry Medicare: Advantra Plans

Posted by:  :  Category: Medicare

Our Medicare Advantage plans are open to all Medicare beneficiaries eligible by age or disability and living in the plan’s service area. You must be entitled to Medicare benefits under Part A and be enrolled in Part B. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. If you switch to premium withhold or move from premium withhold to direct bill, it can take up to three months for the switch to take effect. You will be held responsible for those premiums.  You may enroll during specific times of the year. You cannot enroll in this plan if your current or former employer helps pay for your drugs.  For information on enrollment periods and for full information on Coventry benefits, please click here to contact our Customer Service Department.
Source: coventryhealthcare.com

Medicare Advantage Plans By State, Plan Comparison

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location. ©2015 Aetna Inc. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or copayments/coinsurance may change on January 1 of each year. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. Our dual-eligible Special Needs Plan is available to anyone who has both Medical Assistance from the state and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help that you receive. Please contact the plan for further details. You must continue to pay your Medicare Part B premium. The Part B premium is covered for full-dual members. This information is available for free in other languages. Please call our customer service number at 1-866-865-0662 (TTY: 711) OR Coventry Health Care at 1-877-988-3589 (TTY: 711), 8 a.m. to 8 p.m., seven days, from October 1 – February 14; 8 a.m. to 8 p.m. Monday – Friday, from February 15 – September 30. Esta información está disponible en otros idiomas de manera gratuita. Comuníquese con Servicios al Cliente al 1-866-865-0662 (TTY: 711), de 8 am a 8 pm, siete días a la semana, desde el 1º de octubre hasta el 14 de febrero, y de 8 am a 8 pm, de lunes a viernes, desde el 15 de febrero hasta el 30 de septiembre. Medicare beneficiaries may also enroll in Coventry plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 7 to 14 days. You can call First Health Part D at 1-866-865-0662 (TTY: 711), 8 a.m. to 8 p.m., local time, seven days, from October 1 – February 14; 8 a.m. to 8 p.m. Monday – Friday, from February 15 – September 30, if you do not receive your mail-order drugs within this timeframe. Members may have the option to sign-up for automated mail-order delivery. Cost sharing for members who get “Extra Help” is the same at preferred and network pharmacies. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to www.aetnamedicare.com
Source: coventryhealthcare.com

Advantra Medicare Insurance Plans

Advantra Medicare Advantage plans offer the same coverage as the federal Medicare insurance plan but with additional benefits, such as vision, dental, hearing, preventive health screenings, fitness club memberships, and more. There are two types of Medicare Advantage Plans available through Advantra: the Advantra Preferred Provider Organization (PPO) and Advantra Health Maintenance Organization (HMO). Beneficiaries enrolled in either of these plans benefit from the Coventry Health Care network of contracted physicians and hospitals. They also have the option of going outside of their plans network to receive coverage. Advantra Medicare Advantage Plans combine Part A (hospital), Part B (medical), and Part D (prescription drug) coverage into one.
Source: medicaresolutions.com

HealthAmerica/HealthAssurance: Home

For existing members, to obtain the terms of your policy or a copy of your plan document, please contact us at the number located on the back of your member ID card. If you are not an existing member, for additional information on the terms of the policy or a copy of the plan document, please contact us using the phone number under the Contact Us tab.
Source: coventryhealthcare.com

Medicare Advantage Plans cover all Medicare services

to make sure a service is medically necessary and will be covered. If the plan won’t pay for a service you think you need, you’ll have to pay all of the costs if you didn’t ask for an advance coverage decision. Get your plan’s contact information from a Personalized Search (under General Search), or search by plan name.
Source: medicare.gov

Coventry Advantra HMO for State of Illinois Medicare retirees: Home

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans 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, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. See Evidence of Coverage for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Cost sharing for members who get "Extra Help" is the same at preferred and network pharmacies. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. You may have the option to use mail-order. For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 7 to 14 days. Please call us if you do not receive your mail-order drugs within this timeframe. Aetna members, please call if you do not receive your mail-order drugs within this timeframe. Members may have the option to sign-up for automated mail-order delivery. For Customer Service call the number on the back of your ID card. Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. This information is available for free in other languages. Please call our customer service number at 1-855-223-4807 (TTY: 711), Monday through Sunday, 8 a.m. to 8 p.m. Esta información está disponible en otros idiomas de manera gratuita. Comuníquese con Servicios al Cliente al 1-855-223-4807 (TTY: 711). Horario de atención: de 8 a.m. a 8 p.m., los siete días de la semana. *By providing my email address or telephone number, I give permission to Coventry Health Care sales and service representatives to contact me in the manner indicated above regarding Coventry Health Care Medicare Advantage (HMO/PPO/HMO-POS) plans, products, services and/or educational initiatives related to health care. This information is not a complete description of benefits. Contact the plan for more information. SilverSneakers® is a registered mark of Healthways, Inc.
Source: aetna-coventryretiree.com

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

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

Posted by:  :  Category: 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 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

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

Posted by:  :  Category: Medicare

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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

Check the status of a claim

Posted by:  :  Category: Medicare

Check your Medicare Summary Notice (MSN). The MSN is a notice that people with Original Medicare get in the mail every 3 months. It shows all your Part A and Part B-covered services or supplies that providers and suppliers billed to Medicare during a 3-month period, what Medicare paid, and the maximum amount you may owe the provider. Learn more about the MSN, and view a sample.
Source: medicare.gov

Claim Status Request and Response

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

Filing a Medicare Claim and Checking the Status

If you have Original Medicare, the amount you pay at the time you receive a health service will depend on whether your doctor is a Medicare-participating provider and accepts assignment. Medicare-participating providers are on contract with Medicare to accept and treat patients for all Medicare-covered services and supplies. A provider that accepts assignment agrees to accept the Medicare-approved amount as full payment for a covered service or supply. In this instance, the provider is required to file Medicare claims for any services you received, and Medicare will pay the provider directly for those services. The provider is not allowed to charge you to submit the claim.
Source: planprescriber.com

Electronic Billing & EDI Transactions

The information in this section is intended for the use of health care providers, clearinghouses and billing services that submit transactions to or receive transactions from Medicare fee-for-service contractors. EDI is the automated transfer of data in a specific format following specific data content rules between a health care provider and Medicare, or between Medicare and another health care plan. In some cases, that transfer may take place with the assistance of a clearinghouse or billing service that represents a provider of health care or another payer. EDI transactions are transferred via computer either to or from Medicare. Through use of EDI, both Medicare and health care providers can process transactions faster and at a lower cost. Please see pages on specific types of EDI conducted by Medicare for related links and downloads as applicable.
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 Eligibility Rules

If you are age 65 and currently receiving Social Security or Railroad Retirement Benefits, you are eligible for Medicare and you will be automatically enrolled in Medicare Part A and Part B. However, because Part B has a premium, you have the option of declining Part B coverage. In addition, Part B does require payment of a monthly premium of $104.90, barring certain exceptions, for individuals enrolling in Part B January 1, 2016 or later. These premiums can change on an annual basis.
Source: planprescriber.com

Consumer Guide to Health Care

Posted by:  :  Category: Medicare

Medicare is the main insurance for people 65 and older and also provides coverage for some people with disabilities. It is the nation’s largest health insurance program – covering 49 million Americans in 2012. The federal Centers for Medicare and Medicaid Services (CMS), which runs the program, provides lots of information on its  Medicare website. Here is additional information about the program.
Source: wisconsin.gov