Medicare Appeals – Health Care Professionals

Posted by:  :  Category: Medicare

All Medicare patients can appeal an inpatient hospital discharge decision. This includes members in our Medicare Advantage plans. This process is called a Quality Improvement Organization (QIO) review. The QIO in the state in which services are provided reviews the hospital discharge decision. The result is binding (final).
Source: aetna.com

Compare Medicare Advantage & Supplemental Plans

Medicare Advantage insurance is offered by private insurance companies with a Medicare contract, and replaces Original Medicare Part A and Part B. You must continue to pay your Part B premiums. Medicare Advantage plans typically offer additional benefit options and have less cost-sharing than Original Medicare, and you may have to pay a monthly premium in return for the extra benefits. Medicare Advantage plans come in a variety of formats, such as HMO, PPO and PFFS plans, as well as special needs plans. Medicare beneficiaries can enroll in Medicare Advantage plans if they have Medicare Part A and Part B, but only during designated enrollment periods. These enrollment periods change from time-to-time, so please call us to get the most-up-to-date information.
Source: medicaresolutions.com

Compare Medicare Advantage & Supplemental Plans

Posted by:  :  Category: Medicare

Medicare Advantage insurance is offered by private insurance companies with a Medicare contract, and replaces Original Medicare Part A and Part B. You must continue to pay your Part B premiums. Medicare Advantage plans typically offer additional benefit options and have less cost-sharing than Original Medicare, and you may have to pay a monthly premium in return for the extra benefits. Medicare Advantage plans come in a variety of formats, such as HMO, PPO and PFFS plans, as well as special needs plans. Medicare beneficiaries can enroll in Medicare Advantage plans if they have Medicare Part A and Part B, but only during designated enrollment periods. These enrollment periods change from time-to-time, so please call us to get the most-up-to-date information.
Source: medicaresolutions.com

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.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 Physician Compare Home Page

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

Free Medigap Quote & Compare Medigap Plans!

We are committed to helping Americans, such as yourself, confidently choose the best Medigap plan. Our licensed insurance agents are paid a flat commission rate on all insurance carriers so that we can deliver 100% unbiased recommendations on the best insurance solution based on your unique health needs.
Source: gomedigap.com

Compare Banker’s Fidelity Medicare Supplements

Medigap Companies: Admiral Life Insurance Aetna Life Insurance American Continental Insurance American National Life Insurance Anthem Life American Pioneer Life Insurance American Republic Insurance Bankers Fidelity Life Insurance Blue Cross and Blue Shield Central Reserve Life Insurance Christian Fidelity Life Insurance Combined Insurance Company Conseco Insurance Company Continental General Insurance Continental Life Insurance Company Equitable Life and Casualty Insurance Family Life Insurance Company Forethought Insurance Company Genworth Life Insurance Company Gerber Life Insurance Company Globe Life and Accident Insurance Golden Rule Insurance Company Great American Life Insurance Guarantee Trust Life Insurance Humana Insurance Company Lincoln Heritage Life Insurance Loyal American Life Insurance Marquette National Life Insurance Mutual of Omaha Insurance Company National States Insurance Company New Era Life Insurance Company Old Surety Life Insurance Company Pacificare Life Assurance Company Pennsylvania Life Insurance Company Philadelphia American Life Insurance Physician’s Life Insurance Company Provident American Life & Health Reserve National Insurance Company Royal Neighbors of America Sierra Health and Life Insurance Southwest Service Life Insurance Standard Life and Accident Insurance State Mutual Insurance Company Sterling Investors Life Insurance Sterling Life Insurance Company Unicare United American Insurance Company United Commercial Travelers (UCT) United National Life Insurance United of Omaha Life Insurance United Teacher Associates United World World Corp Insurance Company
Source: medigap360.com

Compare 2017 Medicare Supplement Plans

Each of these levels has somewhat different benefits. Of all of these choices, plans C and F are the most popular choices. They are the most robust and also the most expensive. This shows that people who purchase supplements are probably more concerned about having good benefits than they are about monthly premiums. Somewhat lower-priced are plans K through N since they require more cost-sharing. The right choice may depend upon your health needs, budget, and the way you prefer to access health services.
Source: 2016medicaresupplementplans.com

Compare Medicare Advantage Plans for 2016

Because the more expensive supplements can almost completely eliminate out-of-pocket health expenses, they may help some beneficiaries save money in the long run. The interesting thing to note is that the two supplements that are the most expensive, Plan F and C, are also the most commonly purchased. This might be surprising, but for some beneficiaries, the price of the premium is low when compared to the cost of the deductibles and copays that the supplement might cover for them.
Source: medicareadvantageplans2016.net

Individuals & Families

Posted by:  :  Category: Medicare

Distinctive Heathcare for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Our Blue Distinction® program recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Learn more about Blue Distinction and find a doctor or hospital to meet your needs.
Source: bcbs.com

Michigan Medicare Health Insurance Plans

Medicare is a health insurance program run by the government for people age 65 and older, and for people under 65 with certain disabilities. Understanding more about Medicare will make it easier to choose the right plan. Our Medicare 101 section has resources to help you do that.
Source: bcbsm.com

Medicare Information Office

Posted by:  :  Category: Medicare

10/19/16 The annual sign-up window for Medicare Part D is open, running Oct. 15-Dec. 7. Plans change and people’s needs change, so it’s a good idea to review plan options each year. To get more information, visit www.medicare.gov/part-d/ and click the button at left “Find health & drug plans”, or click here for a chart of Alaska plans. For help, call your fabulous local Medicare counselors:
Source: alaska.gov

The Role of Medicare and the Indian Health Service for American Indians and Alaska Natives: Health, Access and Coverage

Elderly American Indians and Alaska Natives report having health problems at higher rates than the overall U.S. population age 65 and older.  Turning to other surveys that focus on health issues, 39 percent of American Indians and Alaska Natives age 65 and over describe their overall health status as “fair” or “poor,” compared with a little more than 26 percent in the overall population age 65 and older (Figure 2).  Further, elderly American Indians and Alaska Natives are hospitalized during the year at twice the rate of the overall population age 65 and older (33% vs. 16%), consistent with having higher rates of certain health problems (Figure 3).  For example, nearly a third of American Indians and Alaska Natives age 65 and over report having diabetes, compared with 22 percent in the overall 65+ population.  While the prevalence of coronary heart disease is comparable between these groups, the share of elderly American Indians and Alaska Natives with a previously diagnosed stroke or heart attack is higher compared with the overall population age 65 and older.  Elderly American Indians and Alaska Natives also report more frequently that they suffered depression at some point in their lives, consistent with other research showing higher rates of mental illness among non-elderly American Indians and Alaska Natives.
Source: kff.org

The Role of Medicare and the Indian Health Service for American Indians and Alaska Natives: Health, Access and Coverage

This report, divided into four sections, examines these disparities and describes the roles of both the Indian Health Service (IHS) and Medicare in providing access to health care for American Indians and Alaska Natives.  The first section draws from recent surveys and other data sources to compare health and other socioeconomic indicators among elderly American Indians and Alaska Natives to the overall population age 65 and older.  The second section of this report describes the ways that IHS and other sources of coverage (including Medicare, Medicaid, and private insurance) may and may not provide access to health care services for elderly and disabled American Indians and Alaska Natives.  The third section explores the intersection of Medicare and the IHS in health service reimbursement, patient cost sharing, and access to care, and then discusses the implications of potential barriers to enrollment in federal or state programs that could assist American Indians and Alaska Natives with out-of-pocket expenses for health care.  The report concludes with a discussion of some of the future challenges and opportunities for improving access to care for American Indians and Alaska Natives through Medicare and the IHS.
Source: kff.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

Michigan Medicare Health Insurance Plans

Posted by:  :  Category: Medicare

Medicare is a health insurance program run by the government for people age 65 and older, and for people under 65 with certain disabilities. Understanding more about Medicare will make it easier to choose the right plan. Our Medicare 101 section has resources to help you do that.
Source: bcbsm.com

Individuals & Families

Distinctive Heathcare for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Our Blue Distinction® program recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Learn more about Blue Distinction and find a doctor or hospital to meet your needs.
Source: bcbs.com

Medicare Prescription Drug Coverage (Medicare Part D)

Posted by:  :  Category: Medicare

Medicare sets standard costs for the prescription drug benefit each year. Private companies approved by Medicare offer plans with different costs and selections of prescription drugs. You can select a plan based on the prescriptions you take and select a company that is most effective for you. To reduce your costs, enter your medications on Medicare’s secure online Find health and drug plans website. You will pay more if your prescriptions are not in the plan formulary or the plan restricts or limits their use.
Source: texas.gov

Texas Medicare Supplement

Texas Senior Benefits specializes in medicare supplement insurance, medigap insurance, life insurance, long term care insurance and also retirement, wealth and income protection. Texas Senior Benefits is a full-service, independent insurance agency specializing in quality insurance products designed to protect and insure the health, life, long term care and retirement needs of today’s Texas senior.
Source: texasseniorbenefits.com

Affordable Medicare Plans

Medicare can be quite overwhelming as you sort through your options and try to figure out what healthcare you need. For many of us, it’s the first time we really have to read the fine print, compare plans and understand the different options. But don’t worry, we’ve done the hard work for you and summarized Medicare in simple terms to help you find your best options. Once you have a level of comprehension under your belt, shop and compare Medicare plans to make sure you’re getting the best prices and coverage.
Source: medicare-plans.org

Texas Medicare Advantage Plans with Prescription Drug Coverage

Medicare Advantage plans are also available with or without prescription drug coverage. If you want to combine your health and prescription drug coverage into one plan, you can join any type of MA health plan (like a Health Maintenance Organization Plan or a Special Needs Plan) that includes this coverage. These plans are also known as Medicare Advantage Prescription Drug plans or MAPDs. Like other Medicare Advantage plans, MAPDs are required to offer the same coverage as Original Medicare; however, these plans also include the added benefit of prescription drug coverage.
Source: mytexasmedicare.net

Compare Medicare Advantage & Supplemental Plans

Posted by:  :  Category: Medicare

Medicare Advantage insurance is offered by private insurance companies with a Medicare contract, and replaces Original Medicare Part A and Part B. You must continue to pay your Part B premiums. Medicare Advantage plans typically offer additional benefit options and have less cost-sharing than Original Medicare, and you may have to pay a monthly premium in return for the extra benefits. Medicare Advantage plans come in a variety of formats, such as HMO, PPO and PFFS plans, as well as special needs plans. Medicare beneficiaries can enroll in Medicare Advantage plans if they have Medicare Part A and Part B, but only during designated enrollment periods. These enrollment periods change from time-to-time, so please call us to get the most-up-to-date information.
Source: medicaresolutions.com

Centers for Medicare and Medicaid Services (CMS)

Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Wisconsin Physicians Service Insurance Corporation But Transitioned to Palmetto Government Benefits Administrator in Jurisdiction 1 for the Period January 1, 2006, Through June 30, 2009 
Source: hhs.gov

Publications & Multimedia

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

Medicare Advantage 2015 Data Spotlight: Overview of Plan Changes

Posted by:  :  Category: Medicare

When SNPs were authorized, there were few requirements beyond those otherwise required of other Medicare Advantage plans. The Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 established additional requirements for SNPs, including requiring all SNPs to provide a care management plan to document how care would be provided for enrollees and requiring C-SNPs to limit enrollment to beneficiaries with specific diagnoses or conditions. As a result of the new MIPPA requirements, the number of SNPs declined in 2010. The ACA required D-SNPs to have a contract with the Medicaid agency for every state in which the plan operates, beginning in 2013. Additionally, in 2013, joint federal-state financial alignment demonstrations to improve the coordination of Medicare and Medicaid for dually eligible beneficiaries began to enroll beneficiaries. Today, financial alignment demonstrations are underway in 12 states: California, Colorado, Illinois, Massachusetts, Michigan, Minnesota, New York, Ohio, South Carolina, Texas, Virginia, and Washington. The financial alignment demonstrations could influence the availability of D-SNPs in these states, either increasing or decreasing the availability of SNPs, depending on the design of the demonstration.
Source: kff.org

Changes to Medicare insurance 2013

Seniors with Medicare do not have to purchase any other type of health insurance. Medicare is a recognized health insurance under the Affordable Care Act. If you have Medicare then you are in compliance. This groundless story came about from the Mandate. However, time the Exchanges open overlaps with Medicare open enrollment. Medicare policy owners may switch from traditional Medicare-to-Medicare Advantage and have the right to change their prescription coverage plans. However, the Exchanges do not deal with any Medicare changes. And there is no requirement for Medicare insured to make any changes.
Source: obamacarefacts.com

Social Security, Medicare changes are coming with new budget law

• File and suspend. Currently, a married person — typically the higher wage earner in a couple — who’s at least full retirement age could file for his or her own Social Security benefits and then immediately suspend those benefits while the spouse could file for spousal benefits. By doing this, the higher wage earner’s benefits would grow 8% per year. In the meantime, the couple still get a Social Security check, and down the road the surviving spouse could get a higher benefit.
Source: usatoday.com

How Medicare Advantage Plans work

Posted by:  :  Category: Medicare

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. You’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare.
Source: medicare.gov

What is a Medicare Advantage Plan?

If you have health coverage from your union or current or former employer when you become eligible for Medicare, you may automatically be enrolled in a Medicare Advantage Plan that they sponsor. You have the choice to stay with this plan, switch to Original Medicare, or enroll in a different Medicare Advantage Plan. Be aware that if you switch to Original Medicare or enroll in a different Medicare Advantage Plan, your employer or union could terminate or reduce your health benefits, the health benefits of your dependents, and any other benefits you get from your company. Talk to your employer/union and your plan before making changes to find out how your health benefits and other benefits may be affected.
Source: medicareinteractive.org

Things to know about Medicare Advantage Plans

Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you’ll pay nothing for covered services. This limit may be different between Medicare Advantage Plans and can change each year. You should consider this when choosing a plan.
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

The United States Social Security Administration

Thanksgiving is a time to reflect and be grateful for the blessings we’ve had through the year. Here are six of the services we, at Social Security, are most thankful for: 1. Our Social Security Disability Insurance program — for sixty years…
Source: ssa.gov

Welcome to Palmetto GBA eServices

You are accessing a U.S. Government information system, which includes: (1) this computer, (2) this computer network, (3) all computers connected to this network, and (4) all devices and storage media attached to this network or to a computer on this network. This information system is provided for U.S. Government-authorized use only. Unauthorized or improper use of this system may result in disciplinary action, as well as civil and criminal penalties. By using this information system, you understand and consent to the following:
Source: onlineproviderservices.com