Healthcare – Just Facts

Posted by:  :  Category: Medicare

[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

Policy Basics: Where Do Our Federal Tax Dollars Go?

Medicare, Medicaid, CHIP, and marketplace subsidies: Four health insurance programs — Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and Affordable Care Act (ACA) marketplace subsidies — together accounted for 25 percent of the budget in 2015, or $938 billion.  Nearly two-thirds of this amount, or $546 billion, went to Medicare, which provides health coverage to around 55 million people who are over age 65 or have disabilities. The rest of this category funds Medicaid, CHIP, and ACA subsidy and exchange costs.  In a typical month, Medicaid and CHIP provide health care or long-term care to about 72 million low-income children, parents, elderly people, and people with disabilities. (Both Medicaid and CHIP require matching payments from the states.)  In 2015, 8 million of the 11 million people enrolled in health insurance exchanges received ACA subsidies, at an estimated cost of about $28 billion.
Source: cbpp.org

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

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 Supplement Plans

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

Medicare Supplement Plans in Utah

In Utah, as in the rest of the country, you must be enrolled in Medicare Part A and Part B to be eligible for Medicare Supplement insurance. In general, the best time to enroll in a Medicare Supplement plan is during your Medigap Open Enrollment Period, which is the six-month period that starts automatically once you’re 65 or older and enrolled in Medicare Part B. During this period, you can enroll in any Medicare Supplement plan offered in your Utah service area with guaranteed issue. This means that insurance companies cannot turn you down for coverage, regardless of pre-existing conditions or health problems you may have. In addition, you can’t be charged higher premiums due to health.
Source: ehealthmedicare.com

Utah Medicare Supplements

Most existing beneficiaries will be "held harmless" and will pay $104.90 in 2016. Beneficiaries not subject to the “hold harmless” provision will pay $121.80, as calculated reflecting the provisions of the Bipartisan Budget Act signed into law by President Obama last week. Medicare Part B beneficiaries not subject to the “hold-harmless” provision are those not collecting Social Security benefits, those who will enroll in Part B for the first time in 2016, dual eligible beneficiaries who have their premiums paid by Medicaid, and beneficiaries who pay an additional income-related premium. These groups account for about 30 percent of the 52 million Americans expected to be enrolled in Medicare Part B in 2016. 
Source: medicare-utah.net

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

Florida Department of Children and Families

This may result in fines of up to $250,000, a prison term or both, if you are convicted of public assistance fraud. In addition you will not be able to get benefits for 12 months the first time, 24 months the second time, and permanently the third time that you provide false or inaccurate information.
Source: myflorida.com

Wps Medicare Fee Schedule 2016 Missouri

Posted by:  :  Category: Medicare

The Centers for Medicare & Medicaid Services (CMS) provides a comprehensive overview regarding No fee schedules, basic unit, relative values or related listings are included in CPT.. WPS Medicare Iowa, Kansas, Missouri, Nebraska & National Providers 2016 Wisconsin Physicians Service Insurance Corporation. Source: www.wpsmedicare.com
Source: quinarie.com

Coventry Medicare: Coventry Health Care of Missouri (MO, IL)

Whether you are an employer, health care provider, interested in enrolling, or already a member, our goal is to provide you with valuable and convenient online resources and information. Come explore the ways in which we can help you take charge of your Medicare Advantage coverage.
Source: coventryhealthcare.com

Missouri HIT Assistance Center

We are excited to share the Health IT Buzz Blog announcing the release of the Million Hearts® EHR Optimization Guides. These vendor-specific guides offer step by step instructions for providers to leverage their EHR systems to find, use, and improve data on cardiovascular measures. We anticipate these guides will facilitate the identification of at-risk patients, and hope that they will help providers and clinical teams protect their patients from heart attacks, strokes, and other cardiovascular events. So far, we have completed guides for Allscripts, Cerner, and NextGen, though we are working with other EHR vendors to develop additional guides to be posted on the Million Hearts® Resource Center of HealthIT.gov.
Source: missouri.edu

Medigap (Medicare Supplement) Insurance

Plans are assigned letters A through N, and are not to be confused with the “parts” of Medicare, such as Parts A & B. Each Medigap policy plan must offer the same basic benefits, no matter which insurance company sells it. For example Plan K from insurance company ABC must offer the same benefits as Plan K from insurance company XYZ.
Source: mo.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 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

CMS medical claim FORM HCFA

THIS PRODUCT IS “AS IS”. WE DO NOT PROVIDE ANY SUPPORT FOR IT. Tips: 1. Make sure your Page Scaling is set to None. You can change this setting from File/Print menu. 2. If the text is still not aligning to the paper form try different settings of your printer – Top/Left margins, scaling, etc. There are several things that can vary from computer to computer – operating system, browser, PDF reader, printer and printer driver, various settings. Try aligning your top left field on the PDF to the paper form by adjusting the margins of your print area from the settings. Then adjust your scaling if the rest of the fields are still off. 3. Click on “Highlight Fileds” to display all fields that allow input.
Source: mdcodewizard.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.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

Healthcare business news, research, data and events from Modern Healthcare

Amsurg CEO Chris Holden told analysts Thursday that Envision Healthcare had always been Amsurg’s first choice as a major merger partner. He and Envision CEO Bill Sanger had preliminary talks more than a year ago, long before Amsurg made an unsuccessful attempt to merge with rival TeamHealth.
Source: modernhealthcare.com

Medicare Insurance Plan Providers Search

Posted by:  :  Category: Medicare

Advantra Aetna American Continental AmeriChoice Amerigroup AmeriHealth Admiral Life Anthem AvMed Bankers Life and Casualty Blue Cross Blue Shield Bravo Health Insurance CareMore Cigna Clarian Clear One CommUnityCare ConnectiCare VIP Continental Life Coventry Elderplan Empire Excellus Family Life Foresters Forethought Freedom Health Geisinger Genworth Gerber Life GHI Government Personnel Mutual Life Guarantee Trust Life HAP Health Alliance Harvard Pilgrim Health Alliance Health Plus HealthPartners HealthSpring Highmark HIP Health Plan Humana Independence Blue Cross Kaiser Permanente Keystone Loyal American Supplement Mercy Mutual of Omaha New Era Oxford Optimum HealthCare PacifiCare Physicians United Plan Premera Blue Cross Presbyterian Health Plan Priority Health Scott and White Secure Horizons Complete Sentinel Standard Life Sterling SummaCare Summit Health TexanPlus Touchstone Unicare UnitedHealthCare Universal UPMC USAA Viva Health WellCare WellPoint Windsor
Source: medicaresolutions.com

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

Clearview Library District

Mango is an online language learning system teaching practical conversation skills for a wide variety of popular languages. With everyday dialog from native speakers, engaging interactive lessons, and a unique intuitive teaching style, Mango increases your ability to use, adapt and build on what you learn.
Source: clearviewlibrary.org

Find and compare Nursing Homes

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

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

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

The Facts on Medicare Spending and Financing

A number of changes to Medicare have been proposed that could help to address the health care spending challenges posed by the aging of the population, including: restructuring Medicare benefits and cost sharing; eliminating “first-dollar” Medigap coverage; further increasing Medicare premiums for beneficiaries with relatively high incomes; raising the Medicare eligibility age; shifting Medicare from a defined benefit structure to a “premium support” system; and accelerating the ACA’s delivery system reforms. At the same time, changes have been proposed to improve coverage under Medicare in order to limit the financial burden of health care costs on older Americans and younger beneficiaries with disabilities, though such changes would likely require additional spending. In addition to these potential changes, which would affect future spending levels, revenue options could also be considered to help finance care for Medicare’s growing and aging population.
Source: kff.org

Healthcare business news, research, data and events from Modern Healthcare

Amsurg CEO Chris Holden told analysts Thursday that Envision Healthcare had always been Amsurg’s first choice as a major merger partner. He and Envision CEO Bill Sanger had preliminary talks more than a year ago, long before Amsurg made an unsuccessful attempt to merge with rival TeamHealth.
Source: modernhealthcare.com

Medicare Payment Reform: Hospitals Cannot Succeed Without Medicare Data

Posted by:  :  Category: Medicare

Both programs define populations based on Medicare diagnosis-related groups (DRG), a system Medicare currently employs to classify inpatients by type of condition or surgical procedure and to determine hospital reimbursement. In many ways, episode-based reimbursement can be viewed as an extension of the DRG-based method, which put hospitals at financial risk for the costs of inpatient hospital care. Episode payments will put hospitals at financial risk for not only for the index hospitalization but also for physician and post-discharge services. Currently, high payments to outside providers for post-discharge care do not affect the hospital bottom line, but under episode-based reimbursement, high payments to outside organizations will become a drag on a hospital’s financial performance.
Source: healthaffairs.org

Summary of Key Changes to Medicare in 2010 Health Reform Law   

This brief provides a detailed look at the improvements in Medicare benefits, changes to payments for providers and Medicare Advantage plans, various demonstration projects and other Medicare provisions in the law. It includes a timeline of key dates for implementing the Medicare-related provisions in the law.
Source: kff.org

Medicare Payment Reform: Aligning Incentives for Better Care

In 1982, Congress established the Medicare risk contracting program, which provided an alternative option for enrollees who chose to obtain their Medicare benefits from private managed care plans. In 1997 and again in 2003, Congress expanded the number and scope of private plans available through this program, now called Medicare Advantage. Medicare Advantage plans receive a monthly payment for each Medicare beneficiary enrolled in the plan, based on the location, age, and health status of the beneficiary. The fixed per-member per-month payment should give the plan a financial incentive to provide more coordinated, effective, and efficient care—but payments to Medicare Advantage plans historically have exceeded what their enrollees were expected to cost in traditional Medicare, diluting the incentive for efficiency; moreover, although Medicare Advantage plans receive a fixed payment per enrollee, it is not clear how those incentives influence the way the plans actually pay their providers.
Source: commonwealthfund.org