Medicare Plans & Coverage: Part A, Part B, Part C, Part D

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To be eligible for Medicare, one must be a legal permanent resident for the past five years or a U.S. citizen 65 years or older, or younger with a qualifying disability. If you are not a citizen of the United States, you can contact the Social Security Administration office to learn if you would be eligible.
Source: medicareconsumerguide.com

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.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

Frequently Asked Questions (FAQs)

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

Frequently Asked Questions

Will I have to identify the NPIs of ACO providers/suppliers billing under my ACO participants? You must include the National Provider Identifier (NPI) information for physicians who directly provide patient primary care services in an FQHC or RHC on the ACO Participant List submitted as part of your application. By including the NPI information for these physicians, you attest that the individual NPIs are physicians who directly provide patient primary care services in the FQHC or RHC as required under 42 CFR §425.404. We use this information to identify the pool of eligible beneficiaries for assignment, although all NPIs under the FQHC or RHC CMS Certification Number (CCN) are part of the ACO as ACO providers/suppliers. In the application, you will not have to identify any NPIs on the ACO Participant List for physicians who do not provide primary care services under an FQHC or RHC. However, if we accept your application to the Medicare Shared Savings Program we will identify all the Medicare enrolled providers and suppliers associated with your ACO participants using the Medicare Provider Enrollment, Chain, and Ownership System (PECOS). All ACO providers/suppliers billing under an ACO participant tax ID number (TIN) are a part of the ACO. Once we identify the providers and suppliers associated with your ACO participants, we will send you a list of those NPIs for your review. You should note any corrections to the list, certify the accuracy of the list (as corrected, if necessary), and return the certified list to CMS. It is important that all your ACO participants and ACO providers/suppliers verify that their PECOS enrollment is up to date. Your ACO participants, and the ACO providers/suppliers billing under those TINs must update their own enrollment information in PECOS. You can learn more about Medicare enrollment at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MedEnroll_PECOS_PhysNonPhys_FactSheet_ICN903764.pdf. Instructions are available through the CMS Web site at https://pecos.cms.hhs.gov/pecos/login.do. 
Source: cms.gov

Cigna Medicare Insurance Plans

Posted by:  :  Category: Medicare

The Medicare Supplement Insurance (Medigap) policies offered provide a way for you to supplement your Original Medicare benefits. While Medicare Part A and B pay for certain hospital stay and physician services provided, Medigap can help you cover your costs associated with Part A and B deductibles, coinsurance, and copayment requirements. It offers seven supplemental Medicare plans with basic to comprehensive coverage for everything from deductibles to copayments, excess charge coverage, and skilled nursing facility care coinsurance costs.
Source: medicaresolutions.com

Local Coverage Determinations (LCDs) for CGS Administrators, LLC

NOTE: You either have javascript disabled or have saved the page locally. Your experience may not be optimal due to these factors. Please consider enabling javascript or revisiting this page to get an optimal MCD experience. (Due to browser security settings, directly clicking the previous link may not work, so you may need to copy and paste the following link [http://www.cms.gov/medicare-coverage-database/indexes/lcd-list.aspx?Cntrctr=140&name=CIGNA+Government+Services+(18003,+DME+MAC)&ContrNum=18003&CntrctrType=DME] into your browser.)
Source: cms.gov

U.S. government suspends enrollment in Cigna Medicare Advantage, drug plans

n”>The U.S. government has suspended new enrollment in Cigna Corp’s Medicare Advantage health insurance and prescription drug plans, saying Cigna had “widespread and systemic failures” that prevented patients from accessing medical services. The government said Cigna did not handle complaints and grievances properly from patients who had been denied coverage for health benefits or drugs, according to a Jan. 21 letter from its regulator, the Centers for Medicare and Medicaid.
Source: reuters.com

Medicare Advantage Audit Costly For Cigna

Cigna has been under sanctions from federal regulators since late January. The Centers for Medicare and Medicaid Services said Cigna had widespread and systemic failures that prevented seniors from accessing medical services and prescription drugs. It said that the ways Cigna operated in restricting access to drugs and services created "a serious threat to enrollees’ health and safety."
Source: courant.com

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

Contact Information and Websites of Organizations for Medicare

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Source: medicare.gov

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. [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

Get a Free Medicare Advantage Kit

If you are turning 65 soon and/or are eligible for a Special Needs plan (including Medicaid eligibility), you may qualify for a WellCare Medicare Advantage Plan today! Now you can manage your health and enjoy life, just like Gloria.
Source: wellcarenow.com

Medicare Regulatory Specialist

Supports the Medicare Regulatory team in the management of our contracts with the Centers for Medicare and Medicaid Services and regulatory requirements associated with the Medicare lines of business. In addition, may also support the specialty products and expansion projects. Essential Functions:
Source: wellcare.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

Care N' Care Medicare Advantage Plan

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Whether you are new to Medicare or interested in improving your Medicare coverage, you deserve a Medicare Advantage plan that makes it easy to get the care you need, when you need it. Care N’ Care is a local, doctor-led heath insurance company offering PPO and HMO plans with many benefits; one of them is sure to be right for you.
Source: cnchealthplan.com

CMS National Training Program

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Source: cms.gov

HealthCare Administrative Solution

NOTE: In the Final Rule published in the Federal Register on April 15, 2010, CMS clarified that providers “who have met the fraud, waste, and abuse certification requirements through enrollment into the Medicare program or accreditation as a Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) are deemed to have met the training and educational requirements for fraud, waste, and abuse.”
Source: hcasma.org

AHIP Medicare + Fraud, Waste & Abuse Training: Login to the site

Now there’s one single source for both Medicare and Fraud, Waste and Abuse (FWA) training. Our comprehensive online program gives you the background to make informed decisions on Medicare, including plan options, marketing, enrollment requirements, and FWA guidelines.
Source: ahipmedicaretraining.com

Medicare & Medicaid Cost Report l Owner Administrator Forum Seminar

Medicare Training & Consulting, Inc., was founded by Jim Plonsey in the Chicago area. After training Medicare auditors for Blue Cross Association, Jim established a business training Medicare auditors. This lead to doing cost reimbursement seminars for providers, most notably, home health agencies. Medicare Training & Consulting, Inc. has become a leader in providing Owners and Administrators with the reimbursement strategies.
Source: medicareconsulting.net

2016 Workshops and Seminars

This information-packed workshop is designed to educate and train your entire operation on a variety of important Medicare topics. Scott White from the CGS Jurisdiction C DME MAC Provider Outreach and Education team will be covering a variety of DME topics including Audits, Affordable Care Act requirements for written orders prior to delivery, face-to-face evaluations, and new features to the CGS website (MR Wizard and myCGS web portal). Sample case file documentation received by CGS will also be reviewed. Additional speakers include Andrea Stark with MiraVista and Kelly Grahovac of The Van Halem Group.
Source: cgsmedicare.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

Joining a health or drug plan

During the 7-month period that starts 3 months before your 25th month of getting Social Security or RRB disability benefits and ends 3 months after your 25th month of getting disability benefits. Your coverage will begin the first day of the month after you ask to join a plan. If you join during one of the 3 months before you first get Medicare, your coverage will begin the first day of your 25th month of entitlement to disability payments.
Source: medicare.gov

Six things to know about Fall Open Enrollment

Even if you are satisfied with your current Medicare coverage, take action and look at other Medicare options in your area that may better suit your individual needs in the upcoming year. For example, even if you are satisfied with your current Medicare Advantage or Part D plan, you should check to see if there is another plan in your area that will offer you better health and/or drug coverage at a more affordable price. Research shows that people with Medicare prescription drug coverage (Part D) could lower their costs by shopping among plans each year; there could be another Part D plan in your area that covers the drugs you take with fewer restrictions and/or lower prices.
Source: medicareinteractive.org

Medicare Open Enrollment: Be a smart shopper

There may be dozens of Medicare plans in your area, all with different costs and levels of coverage. How much are each plan’s premiums and deductibles? How much will you pay for the benefits and services you’re likely to use? Is there a limit on what you’ll have to pay out-of-pocket for the year? If you’re currently in a plan, how does that plan stack up to the other plans that are available? Thinking about these things will help you make a smart choice to get good value that meets your own health care needs.
Source: medicare.gov

How to spot, avoid Medicare open

Scammers and identity thieves view the open enrollment period as senior citizen hunting season. Myriads of Medicare scams are common during this time.  Among the most common scams are phone calls or emails purporting to be from the Centers for Medicare & Medicaid Services (CMS) informing you that Medicare is issuing new Medicare cards. and that In order for you to continue receiving benefits, the scam goes, you need to obtain a new card, And to do this, you must provide  your Medicare number, which is the same as your Social Security number.  This is a total scam and if you provide your Medicare/ Social Security number to the scammer, you will end up becoming a victim of identity theft.
Source: usatoday.com

Montana Medicare Supplements

Posted by:  :  Category: Medicare

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-montana.com

Medicare Coverage in Montana

If you’re enrolling in Original Medicare, the application process works the same in all states. To qualify for Medicare, you must be either a United States citizen or a legal permanent resident of at least five continuous years. Montana residents are automatically enrolled in Original Medicare, Part A and Part B at age 65 if they already receive benefits through the Social Security Administration (SSA) or the Railroad Retirement Board (RRB). You can also be enrolled automatically before age 65 if you receive disability benefits from Social Security or certain disability benefits from the RRB for 24 consecutive months. People with amyotrophic lateral sclerosis are automatically enrolled in Medicare in the first month of receiving disability benefits.
Source: medicare.com

Montana Healthcare Programs

The Department of Public Health and Human Services (DPHHS) administers healthcare services to help improve and protect the health and safety of some low-income Montanans. DPHHS reimburses private and public providers for a wide range of preventive, primary, and acute care services. Major service providers include: physicians, public health departments, clinics, hospitals, dentists, pharmacies, durable medical equipment, and mental health providers.
Source: mt.gov