Medicare Part B and FEHB Update (Feedback

Posted by:  :  Category: Medicare

The information provided may not cover all aspect of unique or special circumstances, federal regulations, and financial information is subject to change. To ensure the accuracy of this information, contact your benefits coordinator and ask them to review your official personnel file and circumstances concerning this issue. Retirees can contact the OPM retirement center. Our article is not intended nor should it be considered investment advice and our articles and replies are time sensitive. Over time, various dynamic economic factors relied upon as a basis for this article may change. The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.
Source: fedretire.net

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

The Medicare Part D Prescription Drug Benefit

The Medicare Modernization Act of 2003 (MMA) established a voluntary outpatient prescription drug benefit for people on Medicare known as Part D, which went into effect in 2006. All 55 million people on Medicare, including those ages 65 and older and those under age 65 with permanent disabilities, have access to the Medicare drug benefit through private plans approved by the federal government. During the Medicare Part D open enrollment period, which runs from October 15 to December 7 each year, beneficiaries can choose to enroll in either stand-alone prescription drug plans (PDPs) to supplement traditional Medicare or Medicare Advantage prescription drug (MA-PD) plans (mainly HMOs and PPOs) that cover all Medicare benefits including drugs. Beneficiaries with low incomes and modest assets are eligible for assistance with Part D plan premiums and cost sharing. This fact sheet provides an overview of the Medicare Part D program and information about 2016 plan offerings, based on data from the Centers for Medicare & Medicaid Services (CMS) and other sources.
Source: kff.org

National Correct Coding Initiative Edits

The CMS developed the National Correct Coding Initiative (NCCI) to promote national correct coding methodologies and to control improper coding leading to inappropriate payment in Part B claims. The CMS developed its coding policies based on coding conventions defined in the American Medical Association’s CPT Manual, national and local policies and edits, coding guidelines developed by national societies, analysis of standard medical and surgical practices, and a review of current coding practices. The CMS annually updates the National Correct Coding Initiative Coding Policy Manual for Medicare Services (Coding Policy Manual). The Coding Policy Manual should be utilized by carriers and FIs as a general reference tool that explains the rationale for NCCI edits.
Source: cms.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

Medicare Plans for Different Needs

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

Extra Help with Medicare Prescription Drug Plan Costs

Posted by:  :  Category: Medicare

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

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 Plans for Different Needs

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

California Health Advocates

We provide accurate, unbiased information about Medicare benefits and long-term care for Californians. Learn how Medicare works, ways to supplement your coverage, about low-income programs, prescription drugs and your long-term care options.
Source: cahealthadvocates.org

Medicare.gov Nursing Home Compare

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Source: medicare.gov

Australian Government Department of Human Services

This information was printed Wednesday 24 August 2016 from humanservices.gov.au/ It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.
Source: gov.au

Medicare Sustainable Growth Rate

Posted by:  :  Category: Medicare

Section 101 of the Tax Relief and Health Care Act of 2006 (MIEA-TRHCA) provided a 1-year update of 0% for the conversion factor for CY 2007 and specified that the conversion factor for CY 2008 must be computed as if the 1-year update had never applied. Section 101 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) provided a 6-month increase of 0.5% in the CY 2008 conversion factor, from January 1, 2008, through June 30, 2008, and specified that the conversion factor for the remaining portion of 2008 and the conversion factors for CY 2009 and subsequent years must be computed as if the 6-month increase had never applied. Section 131 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) extended the increase in the CY 2008 conversion factor that was applicable for the first half of the year to the entire year, provided for a 1.1% increase to the CY 2009 conversion factor, and specified that the conversion factors for CY 2010 and subsequent years must be computed as if the increases had never applied.
Source: wikipedia.org

petition: STOP MEDICARE COLONOSCOPY CUTS

Medicare Patients: Voice your concerns against the finalized cuts that put access to colorectal screening and prevention at risk. Medicare bureaucrats have finalized plans to cut doctors’ reimbursement for colonoscopy starting January 2016. The stakes are high for Medicare patients and public health. Here’s why this matters to Medicare and what you can do: Medicare patients are at high risk for colorectal cancer because of age • Age is a major risk factor for colorectal cancer and Medicare beneficiaries are at higher risk based on age Colorectal cancer hits Medicare population harder • Medicare beneficiaries account for two-thirds of all new cases of colorectal cancer each year according to the U.S. Centers for Disease Control (CDC) Colorectal screening lags behind national targets for Medicare – cuts could make it worse • The Medicare-age population has screening rates far below national targets – only 64% according to the American Cancer Society* and far below the 80% target many public health groups have set for the year 2018 Colorectal cancer prevention by colonoscopy is a public health success story • This country is making progress against colorectal cancer in recent years – new cases are down, deaths are down overall. According to the American Cancer Society, colorectal cancer incidence rates in the United States have dropped over 30% over the past decade thanks to colonoscopy Medicare needs more colorectal cancer screening, not less • More needs to be done to increase the use of screening tests by Medicare beneficiaries to advance the fight against the second leading cause of cancer death in the United States TAKE ACTION: The American College of Gastroenterology is fighting on behalf of Medicare beneficiaries and physicians on the front lines of screening and prevention for colorectal cancer. Sign this petition to add your voice to demand that Congress not allow cuts to colonoscopy and help stop Medicare bureaucrats in their tracks.  *Source: American Cancer Society: “Colorectal Cancer Fact & Figures 2014-016” According to ACS, “the large declines over the past decade have largely been attributed to the detection and removal of precancerous polyps as a result of increased colorectal cancer screening.”*
Source: thepetitionsite.com

Healthcare – Just Facts

[Under Medicare Part C] Most beneficiaries have the option to enroll in private health insurance plans that contract with Medicare to provide Part A and Part B medical services. The share of Medicare beneficiaries in such plans has risen rapidly in recent years, reaching 25.0 percent in 2010 from 12.4 percent in 2004. Plan costs for the standard benefit package can be significantly lower or higher than the corresponding cost for beneficiaries in the “traditional” or “fee-for-service” Medicare program, but prior to the Affordable Care Act [ACA, a.k.a. Obamacare], private plans were generally paid a higher average amount, and the additional payments were used to reduce enrollee cost-sharing requirements, provide extra benefits, and/or reduce Part B and Part D premiums. These benefit enhancements were valuable to enrollees but also resulted in higher Medicare costs overall and higher premiums for all Part B beneficiaries, not just those who were enrolled in MA plans. Under the ACA, payments to plans will be based on “benchmarks” in a range of 95 to 115 percent of fee-for-service Medicare costs, with bonus amounts payable for plans meeting high quality-of-care standards. (Prior to the ACA, the benchmark range was generally 100 to 140 percent of fee-for-service costs.) As these changes phase in during 2012-2017, the overall participation rate for private health plans is expected to decline from 25 percent in 2010 to about 15 percent in 2020.
Source: justfacts.com

Fact Check: Obamacare’s Medicare Cuts

As for the cuts, they come from eliminating a massive subsidy to private insurers and gradually reducing the rate of growth in payments to some providers. These changes, while not catastrophic for Medicare, are important. Under the ACA, the federal government will substantially reduce the amount it spends funding Medicare Advantage, which is privately administered insurance offered to Medicare beneficiaries. About one-quarter of Medicare recipients are enrolled in private Medicare Advantage. In theory, these plans are supposed to manage health care spending better than fee-for-service Medicare. But they don’t actually save the federal government any money. They cost, per patient, 14% more than traditional Medicare. (See Figure 3 of this fact sheet from the Kaiser Family Foundation. And see here for more.) The ACA eliminates this subsidy and pegs Medicare Advantage payments to quality metrics.
Source: time.com

The 2016 Medicare Trustees Report: One year closer to IPAB cuts?

For most of the last five decades, the most-discussed finding by the Medicare trustees has been the insolvency date, when Medicare’s trust fund would no longer be able to pay all of the program’s costs. Last year’s report projected that the hospital insurance trust fund would be depleted by 2030 – just 14 years from now. The report also predicted a more immediate and controversial event: the Independent Payment Advisory Board (IPAB), famously nicknamed “death panels,” would be required to submit proposals to reduce Medicare spending in 2018, with the reductions taking place in 2019. Do we remain on this path to automatic Medicare cuts next year?
Source: brookings.edu

2016 Medicare Advantage Plans Available to Residents of Maryland

Posted by:  :  Category: Medicare

AK  AL  AR  AZ  CA  CO  CT  DC  DE  FL  GA  HI  IA  ID  IL  IN  KS  KY  LA  MA  MD  ME  MI  MN  MO  MS  MT  NC  ND  NE  NH  NJ  NM  NV  NY  OH  OK  OR  PA  RI  SC  SD  TN  TX  UT  VA  VT  WA  WI  WV  WY
Source: q1medicare.com

What’s Medicare Supplement Insurance (Medigap)?

Posted by:  :  Category: Medicare

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

AARP Medicare Supplement Plans insured by United Healthcare

You are leaving AARP Member Advantages and going to the website of a trusted provider. The provider’s terms, conditions and policies apply. Please return to AARP Member Advantages to learn more about other products, services and discounts.
Source: aarp.org

Medicare Supplemental Insurance Plans

Medicare Supplement Insurance Plans, insured by UnitedHealthcare Insurance Company. If you’re considering a Medicare supplement plan, talking to an agent/producer may offer the direct assistance you’re looking for.
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

Supplements & other insurance

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Source: medicare.gov

Compare 2016 Medicare Supplement Plans

Posted by:  :  Category: Medicare

Each of these levels has somewhat different benefits. Of all of these choices, plans C and F are the most popular choices. They are the most robust and also the most expensive. This shows that people who purchase supplements are probably more concerned about having good benefits than they are about monthly premiums. Somewhat lower-priced are plans K through N since they require more cost-sharing. The right choice may depend upon your health needs, budget, and the way you prefer to access health services.
Source: 2016medicaresupplementplans.com

Get your FREE AUTO INSURANCE QUOTES from top providers RIGHT NOW!

Remember that your dog or your car back can be of some houses on the quality of coverage than the one meeting your budget. This type of car that is in excess of $30,000 per accident. Fortunately, short-term car insurance cost increase or even injury. One of the vehicle identification number are recorded and your credit score is used primarily for business purposes that were not defined in your determination to cut back on the business of making money, not giving it away, and they’re not what you haven’t done it right away.
Source: getyourquotesonline.com

Australian Government Department of Human Services

This information was printed Tuesday 23 August 2016 from humanservices.gov.au/ It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.
Source: gov.au

Dental Insurance for Seniors on Medicare

Posted by:  :  Category: Medicare

As with any insurance, it’s a good idea to purchase a dental plan before you’re facing a crisis. By buying dental insurance for seniors before problems arise, you’ll generally get a better rate. However, if you already suspect that you need serious dental work, it still makes sense to apply. That’s because once you’re approved, the plan may potentially save you some money by allowing you to purchase the dental services you need at the insurance company’s lower, negotiated rates. But be warned: you may pay much higher premiums or be rejected outright if dental problems have already manifest themselves.
Source: medicarewire.com

Exclusive Dental Coverage

You are leaving AARP Member Advantages and going to the website of a trusted provider. The provider’s terms, conditions and policies apply. Please return to AARP Member Advantages to learn more about other products, services and discounts.
Source: aarp.org

Dental Coverage Under Medicare

For complete dental coverage, you can shop online at www.ehealthinsurance.com to learn about and buy an individual dental insurance plan that fits your personal needs. You may also have group dental insurance available, if either you or your spouse is employed. Be sure to read the plans carefully. Some dental plans require you to stay within a network of dental care providers. The premiums may be a bit higher for this type of plan, but the costs are offset by lower out-of-pocket fees, like copayments, coinsurance, and deductibles, mainly because network dentists usually agree to charge discounted rates to members of the dental plan. Other plans let you go to any licensed dental professional, but you may have to pay more at the time of service.
Source: ehealthmedicare.com

When to Apply for Medicare

Posted by:  :  Category: Medicare

If you sign up for Medicare prescription drug coverage (whether through a stand-alone Medicare Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug plan), you can avoid late-enrollment penalties by enrolling in this coverage as soon as you’re eligible for Medicare. If you decide to stay with Original Medicare and add a Medicare Supplement (Medigap) plan, the Medigap plan must accept you if you sign up for Medigap during the 6-month period that begins as soon as you are 65 or older and enrolled in Part B. If you don’t buy a Medigap plan at this time, but decide to get one later, the plan may not have to accept you.
Source: ehealthmedicare.com

When to Apply for Medicare

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Source: mymedicarematters.org

How to Apply for Medicare Part B Online

Review the Medicare rules before registering for Part B. Register for Part A within three months of your 65th birthday. Consider whether you should apply for Part B. You may not want to apply for Part B if you are still working and have health insurance coverage for outpatient services, unless your employer has less than 20 employees. Most literature recommends Part B if your employer has less than 20 employees, since the Part B coverage is your primary insurance under that circumstance. You have eight months after you quit working or after your employee insurance coverage ends to apply for Part B coverage without additional penalties.
Source: ehow.com

Apply For Medicare VA Health Insurance Program

Medicaid and coverage for children under FAMIS Plus are programs that help pay for medical care. To be eligible for Medicaid or FAMIS Plus, you must have limited income and resources and you must be in one of the groups of people covered by Medicaid. Some groups covered by Medicaid are: pregnant women, children, people with disablilities, and people age 65 and older.
Source: vhi.org

Glasses After Cataract Surgery: What Can I Get With Medicare Plan B?

Posted by:  :  Category: Medicare

Medicare Part B can pay for one pair of eyeglasses following your cataract surgery, if you had a new lens implanted in your eye. If you have two separate cataract operations, one on each eye, Medicare will cover new glasses after each surgery. Medicare Part B will pay for the lenses and the frames, but only for a basic, low-cost frame. If you buy more expensive frames than the basic ones approved by Medicare, you’ll have to pay out of pocket for the difference between the standard amount Medicare pays and the amount your frames actually cost. Also, you have to pay a coinsurance amount, which is 20 percent of the amount Medicare approves for the lenses and frames. To read more about these rules, you can go online to the Medicare pamphlet Medicare Coverage of Durable Medical Equipment and Other Devices.
Source: caring.com

Providers for Medicare Glasses

only pays for eyeglasses following cataract surgery in which a new lens is implanted in the eye. If you have any other kind of eye problem, or simply have poor vision, Medicare does not pay for glasses. If you are treated by an eye specialist physician — as opposed to just getting glasses from an optometrist — for medical condition related to the eyes, Medicare Part B can pay its share (80 percent of the Medicare-approved amount) for that doctor’s services, but not for the glasses themselves.
Source: caring.com

Eyeglasses/contact lenses

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.
Source: medicare.gov

How Medicare Covers Your Eyes

Advantage Option Another way you can get extra vision coverage when you join Medicare is to choose a Medicare Advantage plan instead of original Medicare. Many of these plans — which are sold through private insurance companies (see medicare.gov/find-a-plan) — cover routine eye care and eyeglasses along with dental, hearing and prescription drugs, in addition to all of your hospital and medical insurance. Or, if you choose original Medicare, consider purchasing an individual vision insurance policy (see ehealthinsurance.com). These policies cover routine eye care and eyeglasses and typically run between $12 and $15 per month.
Source: huffingtonpost.com

Medicare Guide :: Guide to Medicare Coverage :: Bexar Care Home M

Competitive Bidding areas are designated based on the zip code of your permanent residence on file with Social Security. To find out if your zip code is affected by Competitive Bidding, call 1-800-MEDICARE (1-800-4227). You may also visit Medicare.gov and lookup suppliers in your area by zip code (a notice will appear if your area is subject to Competitive Bidding). If medical equipment is marked with a yellow/orange star, it will need to be provided by a contracted supplier (also marked with an orange star).  Throughout this guide, products that are potentially impacted by the competitive bidding program will be designated with a double asterisk **.  Your provider can assist you with answering your questions about competitive bidding and can address whether or not they have been contracted to provide the services you need if subject to competitive bid.
Source: bexarcare.com

General Medicare Frequently Asked Questions (FAQs)

A non-participating provider is a health care provider who does not agree to accept assignment on all Medicare claims. If a non-participating provider does not accept assignment on a claim, he or she may charge more than Medicare’s approved amount, but not more than the limiting charge. The limiting charge is 115 % of the Medicare approved amount. A non-participating provider may also collect full payment directly from the patient at the time of service. When a provider does not accept assignment on a claim, Medicare sends its payment directly to the beneficiary, not to the provider.
Source: wpsmedicare.com

Medicare Eligibility Requirements

Posted by:  :  Category: Medicare

If you’re turning 65, you have an opportunity to enroll in Medicare. You can enroll three months before the month you turn 65, the month of your birthday or three months after your birth month. Eligibility requirements include:
Source: aarpmedicaresupplement.com