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

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Source: medicare.gov

Find and compare Nursing Homes

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Source: medicare.gov

Medicare Plans for Different Needs

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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

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Source: medicare.gov

Medicare.gov Physician Compare Home Page

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Source: medicare.gov

SENIORS TO RECEIVE MEDICARE REBATE CHECKS

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“Seniors don’t fall victim to scams,” says Congresswoman Johnson. “Some people are calling seniors asking them for their social security numbers and other information in order to receive their rebate checks, this is simply untrue. Seniors have earned their benefits and Congress has a responsibility to deliver them.”                                                                                                                                    ### U.S. Representative Eddie Bernice Johnson is the highest-ranking Texan on the House Committee on Transportation & Infrastructure and a senior member of the Science Committee. She represents the 30th Congressional District of Texas, which, includes Downtown Dallas, Fair Park, Oak Lawn, Turtle Creek, Old East Dallas, Pleasant Grove, & South Oak Cliff; all of Balch Springs, DeSoto, Hutchins, Lancaster & Wilmer and parts of Cedar Hill, Duncanville, Ferris, Glenn Heights and Ovilla.  
Source: house.gov

Medicare “Donut Hole” Rebate Checks: PlanPrescriber Answers Consumer Questions

: EHTH) is the parent company of eHealthInsurance, the nation’s leading online source of health insurance for individuals, families and small businesses. Through the company’s website, http://www.eHealthInsurance.com, consumers can get quotes from leading health insurance carriers, compare plans side by side, and apply for and purchase health insurance. eHealthInsurance offers thousands of health plans underwritten by more than 180 of the nation’s leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia, making it the ideal model of a successful, high-functioning health insurance exchange. Through its eCommerce On-Demand solution (eOD), www.ehealth.com/eOD, eHealth is also a leading provider of on-demand e-commerce software services. eHealth’s eOD platform provides a suite of hosted solutions that enable health plan providers and resellers to market and distribute products online. eHealth’s eCommerce On-Demand solution is currently available to health plan providers in all 50 states and the District of Columbia. eHealthInsurance and eHealth are registered trademarks of eHealthInsurance Services, Inc. eHealth, Inc. also provides powerful online and pharmacy-based tools to help seniors navigate Medicare health insurance options and choose the right plan through its wholly-owned subsidiary, PlanPrescriber (http://www.planprescriber.com). PlanPrescriber’s decision support tools are licensed to and incorporated into the websites and pharmacy counters of a number of major pharmacy chains and retailers. These pharmacy partnerships also drive high quality Medicare traffic to www.planprescriber.com.
Source: marketwired.com

Medicare Donut Hole Rebate Checks

Washington, D.C. – Congressman G. K. Butterfield reminds seniors who fall into the Medicare Part D “donut hole” that the one-time, tax-free $250 rebate checks start going out to this week.   “This is an important first step toward closing the Medicare donut hole,” Butterfield said.   Under the Affordable Care Act passed by Congress and signed by President Obama, Medicare will automatically send a $250 check to seniors who reach the coverage gap in 2010. Checks will be mailed monthly staring June 10th throughout the year as beneficiaries enter the coverage gap.   Butterfield said that once a Medicare beneficiary reaches the donut hole, they should expect to automatically receive a check within 45 days. Individuals receiving Medicare Extra Help will not receive a rebate check.   Butterfield warned seniors to be aware of scams seeking personal information.   “Medicare sends check automatically and there are no forms to fill out,” Butterfield said. “Don’t give any personal information – Medicare, Social Security or bank account numbers – to anyone who calls about the rebate check.”   Anyone who does receive calls seeking personal information is encouraged to call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.   Butterfield explained that most Medicare prescription drug plans have a coverage gap, which means that once beneficiaries have spent a certain amount, all drug costs must be paid for out of pocket up to a limit. Medicare drug coverage resumes once the limit is exceeded.   Butterfield said that under the health insurance reforms, the donut hole will eventually be closed completely. Beginning in 2011, beneficiaries in the donut hole will receive a 50 percent discount on brand-name drugs. Additional discounts for brand-name and generic drugs will be phased in to close the donut hole completely by 2020.   A typical senior who hits the donut hole is expected to save over $700 in 2011, and over $3,000 annually by 2020.   Butterfield said that the health insurance reform provided a number of additional improvements to make health care more affordable for seniors. In addition to closing the donut hole, out-of-pocket expenses for preventive services in Medicare have been eliminated, and cost sharing for many individuals dually eligible for Medicare and Medicaid will also be eliminated.
Source: house.gov

Difference between the Medicare Provider Numbers

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Applicable FARSDFARS Restrictions Apply to Government Use. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60654. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
Source: wpsmedicare.com

Medicare Provider Utilization and Payment Data

As part of the Obama administration’s work to make our health care system more affordable and accountable, data are being released that summarize the utilization and payments for procedures, services, and prescription drugs provided to Medicare beneficiaries by specific inpatient and outpatient hospitals, physicians, and other suppliers. These data include information for common inpatient and outpatient services, all physician and other supplier procedures and services, and all Part D prescriptions. Providers determine what they will charge for items, services, and procedures provided to patients and these charges are the amount that providers bill for an item, service, or procedure.
Source: cms.gov

Health professionals forms

This information was printed Saturday 17 September 2016 from humanservices.gov.au/health-professionals/forms 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 Information, Help, and Plan Enrollment

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Humana is a Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan 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. Plan Formulary may change at any time. You will receive notice when necessary. Benefits, premiums, and/or co-payments and/ or co-insurance may change on January 1 of each year.
Source: medicare.com

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

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Source: medicare.gov

Medicare PPO Blue PlusRx (PPO)

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You do not currently have end-stage renal disease (ESRD). If you initiated dialysis treatments for ESRD but have recovered your normal kidney function and no longer require a regular course of dialysis to maintain life, or have had a successful kidney transplant, or are currently a member of Blue Cross Blue Shield of Massachusetts, you may still join the plan. In addition, if you were a member of a Medicare Advantage plan that terminated its services after December 31, 1998, and you currently have ESRD, you may still join the plan. There may be additional requirements. Please contact the plan for details.
Source: bluecrossma.com

Blue Medicare PPO and Blue Medicare HMO Providers

Blue Cross and Blue Shield of North Carolina is an HMO, PPO, and PDP plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal. Blue Cross and Blue Shield of North Carolina does not discriminate based on race, ethnicity, national origin, religion, gender, age, mental or physical disability, health status, claims experience, medical history, genetic information, evidence of insurability or geographic location within the service area. All Blue Cross and Blue Shield of North Carolina items and services are available to all eligible beneficiaries in the service area.
Source: bcbsnc.com

Blue Cross Medicare Advantage (PPO) Network Participation

If you are located in Bastrop, Bexar, Burnet, Caldwell, Chambers, Collin, Dallas, Denton, Fayette, Fort Bend, Hardin, Harris, Hays, Jefferson, Lee, Liberty, Montgomery, Tarrant, Travis, or Williamson counties, Blue Cross and Blue Shield of Texas (BCBSTX) would like to extend the opportunity to you for participation as a provider in the Blue Cross Medicare Advantage (PPO) plan.
Source: bcbstx.com

Medicare Plus Blue PPO and Prescription Blue PDP Formularies

To view a list of formularies available to our members, visit the drug list page on our Medicare site. You can learn more about what drugs we cover for individual and group PPO, HMO and PDP members. Information about prior authorization and step therapy is also available.
Source: bcbsm.com

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

Texas Department of Insurance

We’re looking for hard working people who want to help us protect Texans. Some of our services include fighting insurance fraud, reducing fire hazards, and helping those who have been injured on the job get the benefits they need. We have openings for people who have skills in engineering, accounting, administrative support, investigations, information technology, and more. Check out our job postings and see if one is a good fit for you.
Source: texas.gov

Medicare Advantage Risk Adjustment Fraud

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In 2010, the owners of a Medicare Advantage plan in Florida (Dr. Walter Janke and his wife, Lalita Janke) paid the federal government $22.6 million to resolve allegations they caused Medicare to pay inflated capitation payments by submitting false diagnosis codes in connection with risk adjustment claims. The government alleged the Jankes’ Medicare Advantage plan had hired "chart auditors" to look through medical records for additional or upcoded diagnoses that it could submit to CMS for increased payment — whether or not those diagnoses were actually eligible for risk adjustment under CMS rules. The government also alleged the Jankes’ Medicare Advantage plan used a software program to submit diagnosis codes to CMS that was incapable of submitting delete codes to delete false data from CMS’s database and thereby correct mistakes, i.e., diagnosis codes the Medicare Advantage plan knew had been submitted improperly.
Source: phillipsandcohen.com

Director Medicare Risk Adjustment Jobs, Employment

Nurse Case Manager review: "Managers will break laws to advance. Worked as a case manager in the Indianapolis office. The managers were not advanced to managerial positions because of their abilities…"
Source: indeed.com

What is a “Medicare Risk Adjustment Factor (RAF)?”

The purpose for the Centers for Medicare and Medicaid Services (CMS) to conduct Risk Adjustment Factors is to pay plans for the risk of the beneficiaries they enroll, instead of calculating an average amount of Medicare/Medicare Advantage beneficiaries.  By doing so, CMS is able to make appropriate and accurate payments for enrollees with differences in expected costs. Lastly, the risk adjustment allows CMS to use standardized bids as base payments to plans.
Source: clinicservice.com

Florida Department of Children and Families

Posted by:  :  Category: Medicare

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

Medicare Plans in Florida

While signing up for Original Medicare (Part A and Part B), you may also be interested in buying a Medicare Supplement (Medigap) policy to cover the gaps in your coverage. The best time to buy a Supplement policy in The Sunshine State is during your Medigap Open Enrollment Period, which ends 6 months after the month you turn 65 years old and are enrolled in Part B (Medical Insurance). If you’re worried about running into a gap in coverage when your benefits begin, you can always apply for a Medigap policy before your Part B becomes effective.
Source: medicarehealthplans.com

Medicare Nursing Home Compare Results

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Source: medicare.gov

FLORIDA MEDICAID APPLICATION

Medicaid serves primarily low-income families, children, related caretakers of dependent children, pregnant women, people age 65 and older, and adults and children with disabilities. Initially, the program was only available to people receiving cash assist ance Temporary Assistance for Needy Families (TANF) or Supplemental Security Income (SSI). During the late 1980s and early 1990s, Congress expanded the Medicaid program to include a broader range of people, including older adults, people with disabilities and pregnant women. While individuals receiving TANF and SSI cash assistance continue to be automatically eligible for Medicaid, these and other federal changes declines Medicaid eligibility from receipt of cash assistance.
Source: floridamedicaidapplications.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

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 Advantage Plan Pharmacies

Certain medications known as “compound medications” will only be covered if dispensed by pharmacies that have met the National Compound Credentialing Program (NCCP) criteria to dispense compound medications. This rigorous additional credentialing is only for pharmacies to dispense compound medications. All other medications (non-compounded medications) may continue to be filled at any network pharmacy. For more information about what pharmacies can dispense these compound medications, please call OptumRx Customer Service toll-free at 1-866-589-5222 (TTY/TDD users should call 1-888-206-8041).
Source: kelseycareadvantage.com

List Of Medicare Supplement Companies

This website and all the information contained herein is for general informational purposes only. Nothing contained herein is representative of any specific insurance company or policy. Requests made on this site are for the services of a licensed agent to assist in locating appropriate coverage only and are not for details on a specific insurance company or policy.
Source: medigap360.com