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

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.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

Medicare PPO Blue SaverRx (PPO)

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 more information.
Source: bluecrossma.com

Medicare Advantage PPO Plans

The Medicare Part B premium. If you enrolled in Part B before 2016, you’ll pay $104.90. You’ll pay the standard premium of $121.80 in 2016 if any of the following situations applies: You enrolled in Part B for the first time in 2016; you get billed directly for your Part B premiums; you aren’t currently getting Social Security or Railroad Retirement benefits; and/or you have both Medicare and Medicaid, and Medicaid pays for your premiums. You may also pay a higher monthly premium if your adjusted modified gross income from your tax return two years ago is above a certain amount, or if you owe a late-enrollment penalty for Part B.
Source: ehealthmedicare.com

Medicare Plans for Different Needs

When it comes to Medicare, one size definitely does not fit all. What works for your neighbor may not be the best bet for you. Which is why it’s great to have choices. To find plans that may be a good fit for you, enter your ZIP code in the field below and click the "Find plans" button.
Source: uhcmedicaresolutions.com

Health Insurance, Medicare Insurance and Dental Insurance

At Humana, we go beyond insurance. We help provide a roadmap to a healthier you. By taking a personalized look at your life and your health, we can help you find the perfect plan and achieve your goals. Start becoming your best you. Start with healthy.
Source: humana.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

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

Oklahoma Insurance Department

The Senior Health Insurance Counseling Program (SHIP) is a non-profit organization helping to inform the public about Medicare and other senior health insurance issues. This division provides accurate and objective counseling, assistance, and advocacy relating to Medicare, Medicaid, Medicare supplements, Medicare Advantage, long-term care, and other related health coverage plans for Medicare beneficiaries, their representatives, or persons soon to be eligible for Medicare.
Source: ok.gov

Oklahoma Insurance Department

Medicare is made up of Parts A, B, C & D. Most people over age 65 get Medicare Part A premium free but most must pay a monthly premium for Medicare Part B ($121.80 in 2016). A choice of how you take your Medicare is given with Medicare Part C (Medicare Advantage), and Part D gives the opportunity to purchase a prescription drug plan.
Source: ok.gov

Welcome To The Oklahoma Health Care Authority

Due to inclement weather, the Governor has authorized state agencies to reduce non-essential services as of 3:00PM CST on Tuesday, April 26th. As a result, OHCA will be closing at that time. Thank you for your patience and be safe.
Source: okhca.org

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

Find a Medicare Insurance Plan

  Notice: Because of the lingering effects of Hurricane Matthew, the Medicare Annual Enrollment Period deadline has been extended to 12/31/16 – plans will go into effect on 1/1/17. If you have yet to make your election you may still have time. For information on Blue Medicare, call us at 1-800-665-8037, 7 days a week, 8 a.m. to 8 p.m.
Source: bcbsnc.com

Medicare in North Carolina

Medicare Advantage, or Medicare Part C, is an option that provides your Original Medicare benefits through insurance companies that contract with Medicare. Many of them include prescription drug coverage; these are called Medicare Advantage Prescription Drug plans. Not every Medicare Part C plan may be available in every county in North Carolina. You continue paying your Medicare Part B premium when you have any Medicare Advantage plan. Medicare Part D is optional prescription drug coverage available from insurers that contract with Medicare. You can enroll in a stand-alone Part D Prescription Drug Plan to add to your Part A and Part B coverage, or you can enroll in one Medicare Advantage Prescription Drug plan to provide all of this coverage. Medicare Supplement plans, also called Medigap plans, are optional insurance policies that may cover certain out-of-pocket costs not covered by Original Medicare. There’s a range of Medigap policies; some may cover deductibles, copayments, and limited foreign travel emergency health care. You must be enrolled in Original Medicare (Part A and Part B) to qualify for a Medigap plan.
Source: medicare.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

Medicare Supplement Plan J for AL, AR, AZ, CO, DC, FL, GA,
KS, KY, LA, MD, MO, MS, NC, OH, OK, SC, TN, TX, VA & WV.

* A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. ** We do not recommend The High Deductible plan J. Plan J without the high deductible is very recommended. This high deductible plan pays the same or offers the same benefits as Plan J after you have paid a calendar year $2000 deductible. Benefits from the high deductible Plan J will not begin until out-of-pocket expenses are $2000. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the plan’s separate foreign travel emergency and prescription drug deductibles.
Source: themedicarechannel.com

Plan J vs Plan F: Should I switch?

There are many people out there that still have their Plan J, and most of them are seeing their rates climb steadily. Each plan letter has a collection of policy holders, or a “risk pool.” Since Plan J has not been sold since May of 2010, there are no new clients entering the Plan J “risk pool.” This fact, combined with the fact of life that we have more health conditions as we get older, combine to conspire against our pocketbooks. Since the insurance companies are in the business to make money, they must keep revenue higher than the claims they pay out. Since they can’t sell new policies, the only way for them to offset the increasing number of claims for Plan J policy holders is to increase the monthly premium of those already in the risk pool. The end result is that those in Plan J will continue to see their rates rise by hundreds, and even thousands of dollars in the near future.
Source: gomedigap.com

How to compare Medigap policies

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

South Carolina Medicare Part D Plans

Posted by:  :  Category: Medicare

In Original Medicare, if you don’t already have creditable prescription drug coverage (for example, from a current or former employer or union) and you would like Medicare prescription drug coverage, you must join a Medicare Prescription Drug Plan. These plans are available through private companies under contract with Medicare. If you don’t currently have creditable prescription drug coverage, you should think about joining a Medicare Prescription Drug Plan as soon as you’re eligible. If you don’t join a Medicare Prescription Drug Plan when you’re first eligible and you decide to join later, you may have to pay a late enrollment penalty.
Source: medicare-providers.net

State of Oregon: Medicare Help

Posted by:  :  Category: Medicare

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Source: oregon.gov

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

Oregon Medicare Advantage Plans

Ask the business office of your doctors and hospital if they are in the network for a plan you are considering. Even though a plan may be offered in your area, providers do not have to participate. In some plans, if your doctor is not part of the preferred network, you will have to pay more to see that doctor. It is very important to know if the plan you’re considering includes your doctors and hospital of choice. And get this information for yourself—Internet web sites and printed materials can be incorrect and an agent wanting to sell you a plan may be misinformed.
Source: medicare-providers.net

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

Health Insurance, Medicare Insurance and Dental Insurance

At Humana, we go beyond insurance. We help provide a roadmap to a healthier you. By taking a personalized look at your life and your health, we can help you find the perfect plan and achieve your goals. Start becoming your best you. Start with healthy.
Source: humana.com

Dental Coverage Under Medicare

For complete dental coverage, you can shop online at www.ehealthinsurance.com to learn about and buy an individual dental insurance plan that fits your personal needs. You may also have group dental insurance available, if either you or your spouse is employed. Be sure to read the plans carefully. Some dental plans require you to stay within a network of dental care providers. The premiums may be a bit higher for this type of plan, but the costs are offset by lower out-of-pocket fees, like copayments, coinsurance, and deductibles, mainly because network dentists usually agree to charge discounted rates to members of the dental plan. Other plans let you go to any licensed dental professional, but you may have to pay more at the time of service.
Source: ehealthmedicare.com

Does Medicare Cover Dental Care?

For example, Medicare might pay for a tooth extraction if it is required before heart surgery. Or, a person with oral cancer might get a procedure covered prior to radiation treatment. Even if Medicare does pay for some services as preparation for a medical procedure, it will not cover the cost of implants or dentures.
Source: ncoa.org

Costs in the coverage gap

Posted by:  :  Category: Medicare

Mr. Evans reaches the coverage gap in his Medicare drug plan. He goes to his pharmacy to fill a prescription for a covered generic drug. The price for the drug is $20, and there’s a $2 dispensing fee that gets added to the cost. Mr. Evans will pay 58% of the plan’s cost for the drug (51% in 2017) and dispensing fee ($22 x .58 = $12.76 in 2016; $22 x .51 = $11.22 in 2017). The $12.76 amount ($11.22 in 2017) he pays will be counted as out-of-pocket spending to help him get out of the coverage gap.
Source: medicare.gov

What’s Medicare Supplement Insurance (Medigap)?

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

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 Part D Coverage Gap (“Donut Hole”)

Coverage gap, also known as the “donut hole”: While in the coverage gap, you’ll pay 45% of the plan’s cost for brand-name drugs and 58% of the plan’s cost for generic drugs in 2016. You’re out of the coverage gap once your yearly out-of-pocket drug costs reach $4,850 in 2016. Once you have spent this amount, you’ve entered the catastrophic coverage phase. The costs paid by you or someone on your behalf (such as a spouse or loved one) for Part D medications on your plan’s formulary, or list of covered drugs, will count toward your out-of-pocket costs and help you get out of the coverage gap* Additionally, manufacturer discounts for brand-name drugs count towards reaching the spending limit that begins catastrophic coverage. If your plan requires you to get your prescription drugs from a participating pharmacy, make sure you do so, or else the costs may not apply towards getting out of the coverage gap. Keep in mind that costs that are paid for you by other insurance you may have, such as prescription drug coverage through an employer, won’t count towards your out-of-pocket spending.
Source: medicare.com

About the Medicare Coverage Gap

The Medicare coverage gap is the phase of your Medicare Part D benefit when there is a gap in prescription drug coverage. During this phase, you will have to pay more for your drugs, until you reach the catastrophic coverage phase. Most Medicare Advantage Prescription Drug plans and Medicare Prescription Drug Plans have a coverage gap, or “donut hole.” The coverage gap is reached when your total drug costs (what you and your plan pay) reach a certain amount. You then pay for your prescriptions out of pocket until entering the plan’s catastrophic coverage phase. This is when your total out-of-pocket costs, including the annual deductible and copayments/coinsurance, reach $4,850 in 2016.
Source: medicare.com

Medicare Part D Donut Hole – Prescription Drug Coverage Gap

Most Medicare Part D Prescription Drug Plans have a coverage gap, sometimes called the Medicare “donut hole.” This means that after you and your Medicare drug plan have spent a certain amount of money for covered prescription drugs, you then have to pay all costs out-of-pocket for the drugs, up to a certain out-of-pocket limit. The yearly deductible, coinsurance, or copayments, and what you pay while in the coverage gap, all count toward this out-of-pocket limit. The limit doesn’t include the drug plan’s premium.
Source: ehealthmedicare.com

Part D Information for Pharmaceutical Manufacturers

The Medicare Coverage Gap Discount Program (Discount Program) makes manufacturer discounts available to eligible Medicare beneficiaries receiving applicable, covered Part D drugs, while in the coverage gap. In order to participate in the Discount Program, manufacturers must sign an agreement with CMS to provide the discount on all of its applicable drugs (i.e. prescription drugs approved or licensed under new drug applications or biologic license applications). Beginning in 2011, only those applicable drugs that are covered under a signed manufacturer agreement with CMS can be covered under Part D.
Source: cms.gov

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

The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid

State decisions about Medicaid expansion have implications for the potential scope of Medicaid under the ACA. If all states expanded their Medicaid programs, eligibility for Medicaid in non-expansion states would grow from less than half a million to 4.5 million. Though some of these people can currently purchase subsidized coverage through the Marketplace, there are advantages and disadvantages to Medicaid and private coverage in different states. For example, enrollees may face higher out-of-pocket costs and limited networks for Marketplace coverage than they would for Medicaid, whereas access to specialist care may be problematic in some state Medicaid programs. In addition, while people can enroll in Medicaid throughout the year, Marketplace enrollment is only available during a limited open enrollment period. Medicaid is designed to provide a safety net of coverage for low-income people, with benefits and provider networks targeted to this population and coverage available throughout the year as people’s circumstances change. There is no deadline for states to opt to expand Medicaid under the ACA, and debate continues in some states about whether to expand. If more states adopt the expansion, the coverage gap will shrink and more low-income adults will gain access to Medicaid eligibility.
Source: kff.org

Medicare: What Are Medigap Plans?

If you are going to buy a Medigap plan, the open enrollment period is six months from the first day of the month of your 65th birthday — as long as you are also signed up for Medicare Part B — or within six months of signing up for Medicare Part B. During this time, you can buy any Medigap policy at the same price a person in good health pays. If you try to buy a Medigap policy outside this window, there is no guarantee that you’ll be able to get coverage. If you do get covered, your rates might be higher.
Source: webmd.com