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

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Source: medicare.gov

Medicare Information, Help, and Plan Enrollment

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

Questions and Answers on the Net Investment Income Tax

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Yes. For taxable years beginning before Jan. 1, 2014 (e.g., calendar year 2013), taxpayers may rely on the 2012 proposed regulations (published on Dec. 5, 2012), the 2013 proposed regulations (published on Dec. 2, 2013), or the 2013 final regulations (published on Dec. 2, 2013) for purposes of completing Form 8960. However, to the extent that taxpayers take a position in a taxable year beginning before Jan. 1, 2014 that is inconsistent with the final regulations, and such position affects the treatment of one or more items in a taxable year beginning after Dec. 31, 2013, then such taxpayer must make reasonable adjustments to ensure that their Net Investment Income Tax liability in the taxable years beginning after Dec. 31, 2013 is not inappropriately distorted. For example, reasonable adjustments may be required to ensure that no item of income or deduction is taken into account in computing net investment income more than once, and that carryforwards, basis adjustments and other similar items are adjusted appropriately.
Source: irs.gov

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

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Source: medicare.gov

Additional Medicare Tax Rate

As an employee, you are responsible for 1.45% of the tax. Your employer pays the other 1.45%. Some taxpayers considered “high wage earners,” are liable for an additional 0.9% of Additional Medicare Tax, if their income exceeds certain thresholds. Income thresholds are based on the IRS filing status as shown below. If filing as “Married filing jointly, remember that the threshold applies to the combined wages, self employment and/or RRTA compensation of both joint taxpayers.
Source: silverscript.com

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

Medicare Summary Notice (MSN)

MSNs are usually mailed four times a year and contain information about submitted charges, the amount that Medicare paid, and the amount you are responsible for. Note that you may receive an MSN more often if you are being reimbursed for a bill you paid. You can also access your MSN online at www.mymedicare.gov. This site allows you to look at electronic versions of your MSNs and print copies from your own computer whenever you would like (but it does not replace the paper MSN).
Source: medicareinteractive.org

How to Read Your Part B Medicare Statement

Medical procedures and services are assigned billing codes. You have the right to receive an itemized billing statement that lists each medical service you received. If you need an itemized statement, contact your doctor. Compare the billing code on your MSN with the code that appears on the billing statement you received from your doctor. If the codes are different, or if you didn’t receive the medical service indicated, contact the doctor who is making the claim. It may be a simple mistake that the doctor’s office can easily correct. If the office does not resolve your concerns, call Medicare at 1-800-MEDICARE (1-800-633-4227).
Source: aarp.org

Medicare Part D Coverage & Enrollment

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Coverage gap, or “donut hole”: After you and your plan have spent a certain amount on covered medications (including the deductible), you may enter the coverage gap, which is a temporary increase in your out-of-pocket prescription drug costs. In the past, beneficiaries paid for all prescription costs once they entered the coverage gap; however, recent health-care legislation created discounts on your costs for covered brand name and generic drugs in the coverage gap. Once you have paid up to a certain amount out of pocket, you’re out of the coverage gap and your Medicare plan begins catastrophic coverage, during which you pay only a small copayment or coinsurance for covered prescription drugs for the rest of the year, while your plan covers the rest of the costs. Health-care reform lowers your costs in the “donut hole” every year until 2020, when the coverage gap is closed.
Source: ehealthinsurance.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

Medicare Part D Costs & Coverage

After you reach your yearly deductible, you may still be responsible for certain out-of-pocket costs, even after your Medicare plan has covered its share. This may include coinsurance and copayments. If you have to pay a coinsurance, you will be responsible for a percentage of the cost of the drug. For example, you may owe a 15% coinsurance each time you fill a particular prescription. If you have to pay a copayment, you will be responsible for paying a set amount for medications on a certain tier as determined by your Medicare plan. As mentioned, Medicare plans that cover prescription drugs place covered drugs into cost tiers, and medications on higher tiers may have higher copayments and coinsurance costs. Your cost sharing may also vary depending on whether you’re taking brand-name or generic medications; generics tend to have lower costs than brand-name prescription drugs.
Source: ehealthinsurance.com

Prescription Drug Coverage

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Source: cms.gov

United American Medicare Part D

As a proud member of the CVS Health family of companies, SilverScript (PDP) shares that commitment by offering affordable, high quality coverage to people with Medicare. Unlike other Medicare insurers, Part D prescription drug coverage is our only business and has been since the Part D program began. We have the experience, expertise and focus to deliver high quality, affordable coverage that millions
Source: uamedicarepartd.com

Medicare Part D coverage gap

The Medicare Part D coverage gap (informally known as the Medicare donut hole) is a period of consumer payment for prescription medication costs which lies between the initial coverage limit and the catastrophic-coverage threshold, when the consumer is a member of a Medicare Part D prescription-drug program administered by the United States federal government. The gap is reached after shared insurer payment – consumer payment for all covered prescription drugs reaches a government-set amount, and is left only after the consumer has paid full, unshared costs of an additional amount for the same prescriptions. Upon entering the gap, the prescription payments to date are re-set to $0 and continue until the maximum amount of the gap is reached: copayments made by the consumer up to the point of entering the gap are specifically not counted toward payment of the costs accruing while in the gap.
Source: wikipedia.org

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

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Source: medicare.gov

Remittance Advice Remark Codes

The law permits exceptions to the refund requirement in two cases: – If you did not know, and could not have reasonably been expected to know, that we would not pay for this service; or – If you notified the patient in writing before providing the service that you believed that we were likely to deny the service, and the patient signed a statement agreeing to pay for the service. If you come within either exception, or if you believe the carrier was wrong in its determination that we do not pay for this service, you should request appeal of this determination within 30 days of the date of this notice. Your request for review should include any additional information necessary to support your position. If you request an appeal within 30 days of receiving this notice, you may delay refunding the amount to the patient until you receive the results of the review. If the review decision is favorable to you, you do not need to make any refund. If, however, the review is unfavorable, the law specifies that you must make the refund within 15 days of receiving the unfavorable review decision. The law also permits you to request an appeal at any time within 120 days of the date you receive this notice. However, an appeal request that is received more than 30 days after the date of this notice, does not permit you to delay making the refund. Regardless of when a review is requested, the patient will be notified that you have requested one, and will receive a copy of the determination. The patient has received a separate notice of this denial decision. The notice advises that he/she may be entitled to a refund of any amounts paid, if you should have known that we would not pay and did not tell him/her. It also instructs the patient to contact our office if he/she does not hear anything about a refund within 30 days
Source: wpc-edi.com

Centers for Medicare & Medicaid Services

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Source: cms.gov

Utah Health Insurance: Individual and Family Plans, Short

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Special Enrollment Period Typically, you may only enroll in an individual or family health plan during open enrollment. If you are eligible, you may be granted a period of time during which you may enroll outside of Open enrollment. This is known as a Special Enrollment Period (SEP). Events that may qualify you for an SEP include getting married, having a baby, losing health insurance, or moving.
Source: selecthealth.org

International Health Insurance & Medical Insurance

Bupa Global is a trade name of Bupa, an independent licensee of Blue Cross and Blue Shield Association, an association of independent BlueCross and BlueShield Plans. Restrictions and limitations apply in some areas. For more information, visit bupaglobalaccess.com. The Blue Cross Blue Shield Association is an association of 36 independent, locally operated Blue Cross and Blue Shield companies. Blue Cross Blue Shield Global is a brand owned by the Blue Cross and Blue Shield Association
Source: bupaglobal.com

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

Cost of Medicare Part B & Part A

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There is a monthly premium for Part B coverage. How much you pay in 2016 is based on how you paid it in 2015 because there was no cost-of-living increase for 2016 Social Security benefits. If you had your premium withheld from your Social Security check in 2015, then you continue to pay $104.90 in 2016. If you didn’t have your premium withheld in 2015 or are new to Medicare in 2016, then your monthly premium is $121.80. It could also be higher than $121.80 depending on how much money you earn. If you’re single with an income of $85,000 or more OR married with an income of $170,000 or more, you will pay a higher premium. Medicare beneficiaries who meet certain income and resource guidelines can get their Part B premium paid for by their state’s Medicare Savings Program.
Source: mymedicarematters.org

Medicare Part B: Doctor Costs and Lab Tests

Preventive services. Medicare Part B helps pay for a number of tests, screenings, vaccinations, and a one-time physical exam to help you stay healthy. Many of these services are available at no cost at the time of the visit. Part B also covers screening and counseling for alcohol use (for people who are not considered alcoholic), obesity screening and counseling, screening for depression, sexually transmitted infections screening and counseling, and cardiovascular behavioral counseling.
Source: webmd.com

When & how to sign up for Part A & Part B

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Source: medicare.gov

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

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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

Enroll for Medicare Part B: Step By Step Guide

If you are automatically enrolled in Part B, you will receive your card in the mail three months before your benefits are scheduled to begin (except for those with ALS). You do not have to accept Part B. Your card comes with instructions for rejecting coverage. Simply follow them and send the card back if you do not wish to receive Part B coverage. You will pay Part B premiums as long as you keep the card.
Source: mymedicaremedicaid.com

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

Rules for Medicare health plans

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Source: medicare.gov