Medical Mutual of Ohio: Health Insurance Plans & Quotes

Posted by:  :  Category: Medicare

Medical Mutual is the oldest and largest health insurer in Ohio. Our headquarters are here and we have offices throughout the state. For 80 years, we’ve been serving our members and the Ohio communities where they live and work. We strive to be the health insurance choice of Ohioans and help make Ohio the best it can be.
Source: medmutual.com

Health Insurance, Medical Insurance, Free Online Insurance Quotes, Affordable Individual, Group, Family Plans

HealthInsurance.com offers a wide variety of health plans including individual and family health insurance, group health insurance, HMOs, PPOs, POS, Indemnity plans, short-term health insurance plans, dental health insurance, and international travel health insurance. Popular health insurance companies such as Blue Cross and Blue Shield, Anthem, Aetna, Humana, Golden Rule Insurance Company, HealthNet, Assurant, Celtic, Unicare, Kaiser and PacifiCare Life and Health Insurance Company offer the plans we feature.
Source: healthinsurance.com

What is Original Medicare?

Posted by:  :  Category: Medicare

Unless you choose otherwise, you will have Original Medicare. You can instead decide to get your Medicare benefits from a Medicare Advantage Plan, also called a Medicare private health plan. Remember, you still have Medicare if you enroll in a Medicare Advantage Plan. This means that you must still pay your monthly Part B premium (and your Part A premium, if you have one). Each Medicare Advantage Plan must provide all Part A and Part B services offered by Original Medicare, but can do so with different rules, costs, and restrictions that can affect how and when you receive care.
Source: medicareinteractive.org

Choosing Between Traditional Medicare and a Medicare Advantage Plan 

Costs in MA plans vary.  You must pay the same monthly premium as those enrolled in traditional Medicare Part B.  Additional out-of-pocket costs in an MA plan depend on what type of MA plan you choose and may include the following: whether the plan charges an extra monthly premium; whether the plan has a yearly deductible; how much you pay for each visit or service (copayments or coinsurance); the type of health care services needed and how often; and, whether network providers are used.  MA plans may charge cost-sharing for a service that is above or below the traditional Medicare cost-sharing for that service.  However, MA plans cannot impose cost-sharing for chemotherapy administration services, renal dialysis services, and skilled nursing care services that exceed the cost-sharing for those services under traditional Medicare.  All MA plans must have a maximum allowable out-of-pocket (MOOP) limit on the amount of cost-sharing they can charge for all Part A and Part B services, after which you will pay nothing for the rest of the year.  MA plans may also change benefits, premiums, and copays every year.
Source: medicareadvocacy.org

Does Medicare cover my care when I travel?

, you can travel anywhere in the U.S. and its territories and get the medical care you need from almost any doctor or hospital. This includes all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Medicare, in most cases, does not cover medical care you get outside the country.
Source: medicareinteractive.org

Traditional Medicare…Disadvantaged?

Craig’s experience raises important issues for consumers and policymakers.  Health insurance choices facing Boomers aging onto Medicare are complex, and may be hard to undo as medical needs and preferences change over time.  Craig’s story illustrates how current rules may disadvantage seniors who prefer traditional Medicare because they want greater control over their health care, but feel they need the financial protection of an out-of-pocket limit.  Under current rules, seniors are entitled to an out-of-pocket limit only if they sign up for a Medicare Advantage plan, but not if they choose traditional Medicare.  And, while seniors have the opportunity to switch from Medicare Advantage to traditional Medicare for any reason during an open enrollment season, they may be unable to protect themselves from unforeseeable costs by purchasing supplemental coverage if they have a medical problem.
Source: kff.org

10 Ways to Make the Most of Medicare

The premiums, covered medications, out-of-pocket costs and even the Medicare Part D plans offered change each year, so it’s important to compare plans during the annual open enrollment period. Check to see if your current medications will continue to be covered by your existing plan at reasonable rates or if you would be better served by an alternative Part D plan, especially if you expect your medication needs to change in the coming year.
Source: usnews.com

The Rising Cost of Living Longer: Analysis of Medicare Spending by Age for Beneficiaries in Traditional Medicare

Consistent with other studies documenting higher costs for patients at the end of life, this analysis shows that Medicare per capita spending was nearly 4-times greater among beneficiaries who died in 2011, on average, than among those who lived the entire year.  Yet the analysis also shows that Medicare per capita spending among decedents declines with age, suggesting that patients, families, and providers may be opting for less intensive and less costly end-of-life interventions for beneficiaries as they grow older.  This possibility is consistent with the finding that average per capita spending on hospice services among beneficiaries in traditional Medicare increases with age, due to both a larger share of beneficiaries electing hospice at older ages and higher per capita hospice costs for older than younger Medicare beneficiaries who elect hospice care.
Source: kff.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

Your Medicare Advisor Archives

Posted by:  :  Category: Medicare

2016 presidential campaign 2016 presidential election abortion act Affordable Care Act AMAC America Barack Obama Business Congress Conservative Dan Weber Democrats Economy freedom gimmeinfo Gold GOP government health healthcare health care Hillary Clinton Insurance IRS isis Jedediah Bila jobs marketing Medicare messaging Money New York City Obama ObamaCare obamacare experiences politics Republican Party Republicans Retirement Seniors Social Security Supreme Court Tax Travel
Source: amac.us

Medicare Supplemental Health Insurance Plans

"The shopping and purchase of my insurance policy went smooth.  Jim Corn had a lot of patience and thoroughly answered all my questions. I worked exclusively with him over the phone.  He set times for us to discuss my choices and he called at the designated time without fail.  He’s never late.  I didn’t find myself frustrated at the entire process simply because Jim walked me through the different plans and explained them in detail."
Source: medigapadvisors.com

Medicare Advisor—’Medicare Week,’ Incident

If you are trying to determine if you have followed a physician’s order, for example "five days per week", the week begins on the first day of assessment/treatment and ends after seven days. For example, if treatment is initiated on Thursday, the patient would have to be treated a total of five days between that Thursday and the following Wednesday. So counting the day of assessment/treatment (Thursday) as one day of treatment, you need to treat four more days before the next Wednesday. The days do not have to be consecutive, as long as you get a total of five days of treatment. So, if your facility does not treat patients on weekends, you can still get five days of treatment in using Thursday, Friday, Monday, Tuesday and Wednesday.
Source: advanceweb.com

Medicare Eligibility When Disability Benefits Stop Due to Work

Hello. My SSDI payment (should) will stop because I had earnings over the limit for October, November and now December. I reported the increased earnings in October and they finally sent me the paperwork acknowledging my increase. I believe my work will continue at higher than SGA. I am now filling out the “work review” paperwork but have not received anything about a medical review yet. I am well past my TWP (ended in 2008) and the 36 month extended entitlement period. How quickly do they terminate (shut off) my Medicare? They still sent me a check in November so I know I will have to return the funds. I have still been using my Medicare insurance. But, I feel that I am back to work now and would no longer meet the disability requirements in a medical review (which is a very good thing!) So if I have to re-apply for Medicare since I am with in the 93 months I wouldn’t get it since I work above SGA and would not pass the medical review. Do they turn off my Medicare instantly or will it be good at least until they notify me they have terminated it or will they back date the termination to October 1 and deny any claims out there? Or, will it still be active while I go thru the current work review paperwork or while I go thru a future medical review? Thanks!
Source: disabilityadvisor.com

Medicare Advisor—Addressing Billing for Iontophoresis

“We received questions from other commenters on how to handle cases in which the beneficiary is out of the facility at the time of census-taking, midnight. These activities are all interrelated and have generated many questions during the initial phase of PPS implementation. There are a number of reasons why a beneficiary may leave the SNF for a “leave of absence.” These include a temporary home visit, a temporary therapeutic leave, or a hospital observational stay of less than 24 hours in which the beneficiary is not formally admitted to the hospital and is not discharged from the SNF. In each of these situations, there is no requirement for the SNF to complete a Discharge or a Re-Entry Tracking form.
Source: advanceweb.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

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 Hospital Compare Quality of Care

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 Supplement and Advantage Health Plans

Posted by:  :  Category: Medicare

Medicare has neither reviewed nor endorsed this information. Blue Shield of California is an HMO and PDP plan with a Medicare contract. Enrollment in Blue Shield of California depends on contract renewal.
Source: blueshieldca.com

Blue Shield $0 Premium 65 Plus Medicare Advantage Plans

This is not a complete listing of plans available in your service area. For additional plan options contact us. This website may display a subset of available plans based on your preferences and the plans we are contracted with. This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE or consult www.medicare.gov.
Source: medicareoptions4u.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 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

Get Medicare Part D Quotes in Seconds

As could be expected, prices for Humana policies rocketed for the 2015 calendar year. Mean premiums for Humana Part D jumped from $21.80 to $38.70. Medicare Part D is priced at $41.55 and Part D Medicare comes in at the slightly lower price of $38.80. Humana’s standalone market share coverage has dropped to 18.6% whereas their Medicare Part D policies have increased to a market share of 12.8%.
Source: medicareaide.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

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 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

Medicare.gov Nursing Home Compare

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’s Future: Letting the Affordable Care Act Work, While Learning From the Past 

4 Id. at 5–6. We are fortunate, nonetheless, that the Medicare program continues to add to its array of preventive services, many of which are offered without copayments. See e.g. Balanced Budget Act of 1997 (hereinafter BBA), Pub. L. No. 105-33, §§ 4101(a)–(b), 4103(a), 4104(a), 4105(a), 4106(a), 111 Stat. 251 (1997); Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA), Pub. L. No. 106-554, § 4107, 114 Stat. 2764 (2000), amending §§ 1834, 1861, of the Social Security Act; Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), Pub. L. No. 108-173, § 612, 117 Stat. 2066 (2003), amending §§ 1861(s)(2), 1862(a)(1), and adding § 1861(xx)(1) to the Social Security Act, 42 U.S.C. §§ 1395x(s)(2), 1395l(a)(1), 1395w-4(j); Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), Pub. L. No. 110-275, § 101, 122 Stat. 2494 (2008). The Secretary has the authority to add preventive services that he or she determines are reasonable and necessary for the prevention or early detection of an illness or a disability, where such preventive services are recommended with a grade of A or B by the U.S. Preventive Services Task Force and appropriate for individuals entitled to benefits under Medicare Part A or enrolled under Part B. In the case of additional preventive services, the Medicare agency will pay 80 percent of the lesser of the actual charge for the service or the amount determined under a fee schedule established by the Secretary; see Patient Protection and Affordable Care Act (hereinafter ACA), Pub. L. No. 111-148, § 4103, 124 Stat. 119 (2010), amending 42 U.S.C. § 1395x(s)(2) of the Social Security Act. The constitutionality of the ACA was upheld by the United States Supreme Court in the case, National Federation of Independent Businesses, et al. v. Sebelius, No. 11-393, 567 U.S. __ (2012), 132 S. Ct. 2566, (decided June 28, 2012).
Source: medicareadvocacy.org

Consumer Information and Insurance Oversight

The page could not be loaded. The CMS.gov Web site currently does not fully support browsers with “JavaScript” disabled. Please enable “JavaScript” and revisit this page or proceed with browsing CMS.gov with “JavaScript” disabled. Instructions for enabling “JavaScript” can be found here. Please note that if you choose to continue without enabling “JavaScript” certain functionalities on this website may not be available.
Source: cms.gov

AARP Press Center – News, Media Center, Press Releases

Cover Interview: Pop Icon Cyndi Lauper Shares Her Secrets for Reinvention and Why Rules, Especially About Aging, Just Don’t Apply Entertainment: Bob Costas, William Shatner, and the Monkees Discuss Their Careers, Legacies and Life Adventures Not–So-Smartphones: How Your Cell May Be Hurting You World War ZZZ: America’s Sleep Crisis All That Glitters: Older Americans Lose Millions Through Coin Scams Great 48-Hour Summer Getaways Checkup for Your Medicine Cabinet: Purging Your Meds Safely
Source: aarp.org

Health and Human Services Commission

Posted by:  :  Category: Medicare

Eligible Texas women on Medicaid can go straight to their pharmacist to pick up mosquito repellent, Health and Human Services Executive Commissioner Charles Smith announced today. Texas Medicaid has issued a standing order for mosquito repellent prescriptions for women who are between the ages of 10 and 45 or pregnant. Ver comunicado de prensa en español
Source: tx.us

Coventry Medicare: Grievances & Appeals

Posted by:  :  Category: Medicare

How do I submit a Part C Organization Determination to request coverage for medical services? You, your doctor, or representative can call, fax or mail your request to us. Phone and Fax: Our contact information (phone number, address, and fax number) is available to you on the contact us page of this website and in the plan’s Evidence of Coverage (EOC). You can also call us using the number on the back of your ID card. Fax: 855-788-3994 Mail: Part C Appeal & Grievance P.O. Box 7776 London, KY 40742-7776 What can I do if my Part C Organization Determination request is denied? If we don’t cover or pay for your benefits or services, you, your doctor, or representative can appeal our decision. You need to submit your name, address, member number and reason for appealing. Any evidence you want us to review, such as medical records, doctor’s letter or other information that explains why you need the item or services, can be submitted. Call your doctor if you need this information . For a standard appeal, mail or fax deliver your appeal to: Part C Appeal & Grievance P.O. Box 7776 London, KY 40742-7776 Fax: 855-788-3994 For an expedited appeal: Phone: 866-613-4977 Fax: 855-788-3994 How do I submit a Coverage Determination for my prescription drug? If you’re a member, you can request an exception if a drug has a prior authorization, quantity limit or step therapy. Not an Aetna member yet? You can call 1-877-988-3589 (TTY: 711) to get answers to your questions. You, your doctor, or representative can submit the online form, or download the form for your type of plan, and fax or mail deliver your request to us. You may also call us. Submit online form If we don’t currently cover your medication or you need prior authorization before we cover your medication, you can ask for this coverage by completing one of the forms below: First Health Part D Prescription Drug Plans Medicare Advantage Plans Fax: 1-800-639-9158 Mail: Part D – Medicare Appeals & Grievances P.O. Box 7773 London, KY 40742 Phone: Our phone numbers (standard and expedited) are on the contact us page of this website, in the plan’s Evidence of Coverage (EOC), and on your ID card. What can I do if my Coverage Determination is denied? If we deny your Prescription Drug request, you can appeal our decision. You, your doctor, or representative can submit the online form, or download the form below and mail or fax deliver it to us. Submit online form Download: Request for Redetermination of Medicare Prescription Drug Denial Fax: 1-800-535-4047 Mail: Part D Medicare Appeals & Grievances – Redeterminations P.O. Box 7773 London, KY 40742 If your request needs to be “Expedited” you can call or fax us. Expedited Phone Line: 1-800-536-6167 Expedited Fax Number: 1-800-535-4047 What can I do if I have a complaint (also called a “grievance”)? If you have a complaint about your medical or pharmacy coverage, you, your representative , or your doctor can call, fax, or write to us. For Part C Appeal and Grievance: Phone : Our phone numbers are on the contact us page of the website, in the plan’s Evidence of Coverage (EOC), and on the back of your Member ID card. Mail: Part C Appeal & Grievance P.O. Box 7776 London, KY 40742-7776 Fax #: 855-788-3994 For Part D Appeal & Grievance: Phone : Our phone numbers are on the contact us page of the website, in the plan’s Evidence of Coverage (EOC), and on the back of your Member ID card. Fax #: 1-800-535-4047 Mail: Part D Appeal & Grievance P.O. Box 7773 London, KY 40742 You can contact the Office of the Medicare Ombudsman for help with a complaint, grievance, or information request. To learn more, visit https://www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html. How long does it take to get a decision? You can request either a “Standard” or “Expedited” (fast) decision process. If your health requires it, you can ask us to give you a "fast coverage decision". A "fast coverage decision" is called an "expedited coverage determination" or an “expedited organization determination”. When we give you our decision, we will use the "standard" deadlines unless we have agreed to use the "fast" deadlines. We will respond to your request no later than the below timeframes. Request for an Coventry Medicare Advantage Plan (Part C) Organization Determination  Standard Process = Pre-service: 14 days     Claims: 60 days Expedited Process = Pre-service: 72 hours     Claims: n/a Request for a Coventry Medicare Advantage Plan (Part C) Organization Determination Denial Standard Process = Pre-service: 30 days Claims: 60 days Expedited Process = Pre-service: 72 hours Claims: n/a Request for Prescription Drug Coverage Determination Standard Process= 72 hours Expedited Process= 24 hours Request for Redetermination for a Coventry Medicare Prescription Drug Denial Standard Process= 7 days Expedited Process= 72 hours Coventry Medicare Advantage Plan Grievance Standard Process= 30 days Expedited Process= 24 hours Prescription Drug Plan Grievance Standard Process= 30 days Expedited Process= 24 hours
Source: coventryhealthcare.com

Part D late enrollment penalty

Since Mrs. Martinez was without creditable prescription drug coverage from June 2012–December 2014, her penalty in 2015 was 31% (1% for each of the 31 months) of $33.13 (the national base beneficiary premium for 2015) or $10.27. Since the monthly penalty is always rounded to the nearest $0.10, she paid $10.30 each month in addition to her plan’s monthly premium in 2015.
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

2016 Medicare Part D Prescription Drug Plans: Overview by State

Choose your State from the list below for an overview of the Medicare Part D Prescription Drug Plans available in 2016. Please note – Medicare Part D Plans vary in cost and coverage by State – this means that if you move to a new State during the enrollment year, you may pay a different premium and/or possibly may not have access to the same selection of Medicare Part D plans. Select your state below or choose from one of these links to other tools available to review 2016 Medicare Part D Plans:
Source: q1medicare.com

Medicare Part D Plans and Guide, Prescription Drug Plans

En español l Medicare has an optional program — called Medicare Part D — that provides insurance to help you pay for prescription drugs. If you select to have the coverage, you pay a monthly premium. This guide explains how the program works and helps you make decisions in choosing a plan that’s right for you.
Source: aarp.org