What is Medicare? What is Medicaid?

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Medicare Part A, or Hospital Insurance (HI), helps pay for hospital stays, which includes meals, supplies, testing, and a semi-private room. This part also pays for home health care such as physical, occupational, and speech therapy that is provided on a part-time basis and deemed medically necessary. Care in a skilled nursing facility as well as certain medical equipment for the aged and disabled such as walkers and wheelchairs are also covered by Part A. Part A is generally available without having to pay a monthly premium since payroll taxes are used to cover these costs.
Source: medicalnewstoday.com

Medicare and Medicaid: What's the Difference?

Costs to Consumer: You must pay a yearly deductible for both Medicare Part A and Part B, and make hefty copayments for extended hospital stays. Under Part B, you must pay the 20% of doctors’ bills Medicare does not pay, and sometimes up to 15% more. Part B also charges a monthly premium. Under Part D, you must pay a monthly premium, a deductible, copayments, and all of your prescription drug costs over a certain yearly amount and up to a ceiling amount, unless you qualify for a low-income subsidy.
Source: nolo.com

What is the difference between Medicare and Medicaid?

. They were part of President Lyndon Johnson’s “Great Society” vision of a general social commitment to meeting individual health care needs. Medicare and Medicaid are social insurance programs that allow the financial burdens of illness to be shared among healthy and sick individuals, and affluent and low-income families.
Source: medicareinteractive.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

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

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

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Source: medicare.gov

When to Enroll in Medicare

If you retire or your employer coverage ends after age 65, you have an eight month Special Election Period to enroll in a Medicare plan. If you’re not planning to retire and you will continue to have employer coverage, you may not need to consider a Medicare plan. Check with your benefits administrator to see how your employer coverage works with Original Medicare Parts A and B.
Source: uhc.com

Medicare Eligibility and Enrollment

re already getting Social Security checks, you will be automatically enrolled in traditional Medicare. You’ll get your Medicare card three months before your 65th birthday. The benefits kick in on the first day of the month of your 65th birthday. Traditional Medicare, which is also called original Medicare, includes Medicare Parts A and B. Part A is hospital coverage. Part B covers doctor visits, lab tests, and other outpatient services.
Source: webmd.com

Turning 65? When To Enroll In Medicare

How do you enroll in Medicare? You will be automatically enrolled in Medicare Part A (hospital and other inpatient coverage) and Part B (doctor, medical and other outpatient coverage) if you are signed up for Social Security. You will not need to pay a Medicare Part A premium if you or your spouse has worked and paid into Medicare for at least 10 years. You will need to pay a Part B premium unless you are eligible for extra help because your income is low. Otherwise, what you pay for Part B will vary based upon your income. And, this premium is projected to rise significantly in 2017. Be aware that some commercial insurers, such as Aetna, Humana and UnitedHealthcare, in some areas are automatically enrolling members who become eligible for Medicare into their Medicare Advantage health plans, without people knowing it. And, these Medicare Advantage plans generally have very different provider networks, benefits and out-of-pocket costs from what you get through your employer health plans. You should understand the differences between traditional Medicare and Medicare Advantage plans and call Medicare at 800-633-4227 to make sure Medicare knows which plan you are choosing. If you’d like prescription drug coverage, you can enroll in a Medicare Part D prescription drug plan. There are many to choose from. And, if your income is low, you may be eligible for help paying the cost of this coverage. Keep in mind that you will have health care costs even with Medicare. Medicare does not cover dental or vision care, nor does it cover hearing aids. It also does not cover custodial nursing home care or other long term services and supports, which can cost a lot as you age. Traditional Medicare has deductibles and coinsurance that you can budget for if you buy Medicare supplemental insurance (“Medigap”), which fills all these gaps. Medicare Advantage plans, health plans offered by commercial insurers that offer Medicare benefits, also have copays and deductibles and generally limit coverage to a network of doctors and hospitals. Your out-of-pocket costs for in-network care is capped at $6,700, but your costs are unlimited if you go out of network. Most people opt for traditional Medicare.
Source: huffingtonpost.com

Decision Memo for Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) (CAG

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The NLST demonstrated benefit by enrolling a large number of high exposure patients (smoking history) to be followed for several years to detect a significant decrease (247 deaths from lung cancer per 100,000 person-years in the low-dose CT group and 309 deaths per 100,000 person-years in the radiography group; number needed to screen (NNS) to prevent one lung cancer death = 320).  The trial was ended early after an interim analysis.  The decision to compare to screening with chest radiology (Church, 1990) was made before the PLCO trial was completed that showed chest radiology did not reduce lung cancer mortality (Oken, 2011); however, the radiology group was exposed to harms that may not have occurred in a no screening control, potentially enhancing the relative benefits and the likelihood of a positive trial result.  The harms of LDCT relate to the CT scan itself and the follow-up diagnostic tests or interventions (adverse events from bronchoscopies and biopsies), and patient psychosocial consequences, and have been recognized for many years as noted in past USPSTF reviews.  For example, death within 60 days after most invasive diagnostic procedures was twice as high in the radiology group compared to the LDCT group (2.1 % versus 1.0 %; NLST, 2011), which with a large sample size may result in a meaningful difference.  NLST investigators wrote:  “one of the most important factors determining the success of screening will be the mortality associated with surgical resection, which was much lower in the NLST than has been reported previously in the general U.S. population (1 % vs. 4 %).”  If this is not maintained with broad implementation of screening, the screening benefits may not be realized.  A better understanding of why patients screened with LDCT had lower mortality from invasive procedures is needed.  Questions such as whether the state of disease, patient, physician, or bias of either the physician/practitioner or patient may need to be considered.   
Source: cms.gov

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

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Source: medicare.gov

Medicare Hospital Compare Quality of Care

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Source: medicare.gov

Physicians for a National Health Program

The moderators for the next presidential debate have agreed to consider the most popular questions on the Open Debate website. PNHP has submitted the following question: “Do you support a single payer health program, aka improved Medicare for all?” Our question is within striking distance of being considered. If you’d like for single payer to be part of our national debate, please vote today and share the link with your friends!
Source: pnhp.org

GeorgiaCares > Medicare > Original Medicare (Part A and B)

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Special Enrollment Period for International Volunteers – If you wait to enroll in Part B because you have health insurance while volunteering in a foreign country, you have a 6-month period to sign up when you are no longer volunteering outside of the United States, or the sponsoring organization is no longer tax exempt, or you no longer have health coverage outside the United States, whichever comes first.
Source: mygeorgiacares.org

Part B Medicare Fee schedules

If you are unable to locate a specific item or topic, we will be happy to provide assistance navigating our website. Fill out this short form and we will make every effort to reply within 24 to 48 hours!
Source: cahabagba.com

Georgia Medicare Advantage Plans with Part D (Prescription Drug) Coverage

The plans below offer Medicare Advantage and Part D coverage to Georgia residents. Medicare Advantage plans, also known as Medicare Part C, are alternatives to original Medicare. These plans help cover the costs of services provided by hospitals, doctors, lab tests and some preventive screenings. These plans’ Part D component helps cover prescription drugs. Even if a plan’s monthly premium is $0, you would still pay the equivalent of the original Medicare premium. Not all plans shown here will be available to you; enter your zip code to see plans in your area. You can read about whether Medicare Advantage is right for you. If you only want plans with drug coverage, browse Prescription Drug (Part D) Plans.
Source: usnews.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

What is Medicare? What is Medicaid?

Medicare Part A, or Hospital Insurance (HI), helps pay for hospital stays, which includes meals, supplies, testing, and a semi-private room. This part also pays for home health care such as physical, occupational, and speech therapy that is provided on a part-time basis and deemed medically necessary. Care in a skilled nursing facility as well as certain medical equipment for the aged and disabled such as walkers and wheelchairs are also covered by Part A. Part A is generally available without having to pay a monthly premium since payroll taxes are used to cover these costs.
Source: medicalnewstoday.com

Medicare and Medicaid: What's the Difference?

Costs to Consumer: You must pay a yearly deductible for both Medicare Part A and Part B, and make hefty copayments for extended hospital stays. Under Part B, you must pay the 20% of doctors’ bills Medicare does not pay, and sometimes up to 15% more. Part B also charges a monthly premium. Under Part D, you must pay a monthly premium, a deductible, copayments, and all of your prescription drug costs over a certain yearly amount and up to a ceiling amount, unless you qualify for a low-income subsidy.
Source: nolo.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

Supplements & other insurance

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Source: medicare.gov

Get Medicare Supplemental Insurance Plan Quotes

As long as you enroll during this six-month Medigap Open Enrollment Period, the insurance company cannot refuse to sell you a Medigap policy, charge you more because you have health problems, or make you wait for coverage to begin. However, you may have to wait up to six months for coverage of a pre-existing condition. Original Medicare will still cover that health problem even if your Medicare Supplement plan doesn’t cover your out-of-pocket costs.
Source: ehealthmedicare.com

Medigap (Medicare Supplement Health Insurance)

A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will each pay its share of covered health care costs. Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium ($96.40 in 2011 for most beneficiaries). In addition, you will have to pay a premium to the Medigap insurance company. As long as you pay your premium, your Medigap policy is guaranteed renewable. This means it is automatically renewed each year. Your coverage will continue year after year as long as you pay your premium. In some states, insurance companies may refuse to renew a Medigap policy bought before 1992. Insurance companies can only sell you a “standardized” Medigap policy. Medigap policies must follow Federal and state laws. These laws protect you. The front of a Medigap policy must clearly identify it as “Medicare Supplement Insurance.” It’s important to compare Medigap policies, because costs can vary. The standardized Medigap policies that insurance companies offer must provide the same benefits. Generally, the only difference between Medigap policies sold by different insurance companies is the cost. You and your spouse must buy separate Medigap policies.Your Medigap policy won’t cover any health care costs for your spouse. Some Medigap policies also cover other extra benefits that aren’t covered by Medicare. You are guaranteed the right to buy a Medigap policy under certain circumstances. For more information on Medigap policies, you may call 1-800-633-4227 and ask for a free copy of the publication “Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare.” You may also call your State Health Insurance Assistance Program (SHIP) and your State Insurance Department. Phone numbers for these Departments and Programs in each State can be found in that publication.
Source: cms.gov

Compare Medicare Supplement (Medigap) Plans and Rates in Your Area

"Times have changed since my mother had an AARP J plan and I was totally confused by the options available. Stan walked me through the process in a very educational, methodical, friendly way, and I feel secure now that we’re making the correct decision to provide the best possible coverage for my husband." – Pat K.
Source: medigap360.com

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

AARP® Medicare Supplemental Insurance by United Healthcare

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

Oxford Medicare Insurance Plans

Posted by:  :  Category: Medicare

The Medicare Supplemental Insurance (Medigap) Plans it provides supplement your Original Medicare benefits. These are the benefits you receive at age 65 from the federal government. Medigap insurance plans help you pay certain expenses, such as Part A and B deductibles that are payable, any coinsurance, and copayment amounts. Its plans fill the gaps in your Medicare coverage, allowing you the freedom to select your doctor, your hospital, or your preferred specialist. It has 10 Medigap plan options to choose from (Plan A-D, F-G, and K-N). Each of the plans provide basic benefits for hospitalization under Medicare Part A. Your Plan A option provides you with support for basic additional costs, and Plan F is the most comprehensive coverage offered. The benefits from Oxford even provide an option to pay for medical expenses incurred while traveling in a foreign country.
Source: medicaresolutions.com

Oxford Insurance Medicare Plans

Oxford Life has been around since 1965, and was founded in Arizona. In that short amount of time, their successful business practices and skillful acquisitions of other major insurance providers (such as Encore Financial and North American Insurance) have helped them skyrocket into becoming one of the largest US providers of Medicare supplement insurance, as well as other essential financial products.
Source: medigap.com

Oxford Life Medicare Supplement Insurance

Oxford Life is a member of AMERCO, a publicly traded financial holding network. The success of Oxford Life and its subsidiaries, Christian Fidelity Life Insurance Company, Dallas General Life Insurance Company and North American Insurance Company, lies in their long-term commitment to stability, growth, and outstanding customer service.
Source: medicaresupplementspecialists.com

Annual Statistical Supplement, 2011

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d. Standard premium rate for voluntary enrollment by certain aged and disabled individuals not otherwise entitled to Hospital Insurance (HI). (Most individuals aged 65 and older and many disabled individuals under age 65 are insured for HI benefits without payment of any premium.) Beginning in 1994, a reduced premium is available to premium-paying HI enrollees with at least 30 quarters of Medicare-covered employment (either their own or through a current or former spouse if the marriage meets certain duration criteria). In most cases, a surcharge applies for beneficiaries who enroll after their initial enrollment period.
Source: ssa.gov

MEDICARE Part A, B, C, & D PREMIUMS, DEDUCTIBLES FOR 2011

Part A premiums are decreasing because spending in 2010 was lower than expected and the Affordable Care Act implemented policies that lower Part A spending due to payment efficiencies and efforts related to waste, fraud and abuse.  Part B premiums are increasing because of growth in the use of services like outpatient hospital care, home health and physician-administered drugs.  In addition, the premium accounts for a likely Congressional action to avert a precipitous decrease in physician payments, which the Administration supports, and has occurred every year since 2003.  The Administration is committed to permanent reform of the physician payment formula. By law, the standard premium is set to cover one-fourth of the average cost of Part B services incurred by beneficiaries aged 65 and over, plus a contingency margin. The contingency margin is an amount appropriate to (i) cover incurred-but-unpaid claims costs, (ii) provide for possible variation between actual and projected costs, and (iii) amortize any surplus assets or unfunded liabilities.  The remaining Part B costs are financed by Federal general revenues.  (In 2011, $2.5 billion in Part B expenditures will be financed by the new fees on manufacturers and importers of brand-name prescription drugs under the Affordable Care Act.  The revenue from these fees reduces the standard Part B premium by $0.90.)
Source: q1medicare.com

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

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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 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. [Benefits, premiums and/or member cost-share] may change on January 1 of each year. The [Formulary, pharmacy network, and/or provider network] may change at any time. You will receive notice when necessary.
Source: medicare.com