Check the status of a claim

Posted by:  :  Category: Medicare

Check your Medicare Summary Notice (MSN). The MSN is a notice that people with Original Medicare get in the mail every 3 months. It shows all your Part A and Part B-covered services or supplies that providers and suppliers billed to Medicare during a 3-month period, what Medicare paid, and the maximum amount you may owe the provider. Learn more about the MSN, and view a sample.
Source: medicare.gov

Claim Status Request and Response

The electronic 276/277 process is recommended since many providers are able to automatically generate and submit 276 queries as needed, eliminating the need for manual entry of individual queries or calls to a contractor to obtain this information. Submission of 276 queries and issuance of 276 responses should be less expensive for both providers and for Medicare. In addition, the 277 response is designed to enable automatic posting of the status information to patient accounts, again eliminating the need for manual data entry by provider staff members. If unsure whether your software is able to automatically generate 276 queries or to automatically post 277 responses, you should contact your software vendor or billing service.
Source: cms.gov

MyMedicare.gov: Customer Service

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: mymedicare.gov

Electronic Billing & EDI Transactions

The information in this section is intended for the use of health care providers, clearinghouses and billing services that submit transactions to or receive transactions from Medicare fee-for-service contractors. EDI is the automated transfer of data in a specific format following specific data content rules between a health care provider and Medicare, or between Medicare and another health care plan. In some cases, that transfer may take place with the assistance of a clearinghouse or billing service that represents a provider of health care or another payer. EDI transactions are transferred via computer either to or from Medicare. Through use of EDI, both Medicare and health care providers can process transactions faster and at a lower cost. Please see pages on specific types of EDI conducted by Medicare for related links and downloads as applicable.
Source: cms.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

Medicare Eligibility Requirements

By law, you’re allowed to sign up for any Medigap policy in your state as long as you enroll during the initial window, even if you have medical issues that would otherwise prevent you from getting covered. An insurer has to charge you the same premium rate as a healthy person, too, so enrolling during this initial period is essential if you need the extra coverage. Your guarantees under the initial enrollment window expire once that 6-month eligibility period ends. Outside of the initial eligibility window, you may not find Medigap coverage at all. And if you do, it will probably cost a lot more.
Source: medicare.net

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

Medicare Eligibility Requirements

Part C: Medicare Part C is the Medical Advantage Plan whose services are performed by private companies also approved by Medicare. Part C combines Part A and Part B and may include coverage for other necessary medical services (drug prescription, hearing, and vision services). You must have Medicare Part A and Part B to be eligible for a Part C plan.  Many people will opt for this plan because it offers the ability to add a wide range of service coverage to their medical insurance plan.  However, most Medicare Advantage Plans consist of particular doctors and hospitals in an area that a person must use in order to receive coverage for the medical treatment they receive. In addition to the premium paid for Part B Medicare coverage, a person receiving Part C coverage will have to pay a monthly premium.  Benefits, premiums, and/or member cost-share may change on January 1 of each year. You must continue to pay your Medicare Part B premium.  There are several Medicare Advantage Plans available to you.  These plans include Medicare Health Maintenance Organizations (HMO), Medicare Preferred Provider Organization plans (PPO), Medicare Private Fee-for-Service plans (PPFS), Medicare Special Needs, and Medicare Medical Savings Account (MSA).  You must have Parts A and B to be eligible for a Medicare Advantage Plan.
Source: medicaresolutions.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

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

Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) provides health coverage to eligible children, through both Medicaid and separate CHIP programs. CHIP is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.
Source: medicaid.gov

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

Extra Help with Medicare Prescription Drug Plan Costs

Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.
Source: ssa.gov

Extra Help: Assistance paying for the Medicare drug benefit

*If you have Medicaid and have certain kinds of employer, retiree or union prescription drug coverage, you will not be automatically enrolled in a Part D plan. If you will lose your retiree or union health coverage by enrolling in a Medicare private drug plan, you may not want to take Medicare drug coverage. You will need to contact your state Medicaid office to find out what steps you should take to decline Part D coverage and still keep your Medicaid.
Source: medicareinteractive.org

Department of Human Services

SHIP produces and regularly updates charts detailing the various Medigap, Medicare Advantage and Part D drug plans offered in New Jersey. These charts have been posted here to help you compare plans and make an informed decision about which plan best fits your needs and budget. Please note, however, that since Medigap options and pricing can change at anytime during the year, it is recommended you call the company you are interested in to confirm the information/premiums provided on these charts prior to enrolling or making a coverage change. If you are receiving your Medicare coverage through
Source: nj.us

Medicaid for the Elderly, Blind or Disabled

Estate Recovery Program The Estate Recovery Program provides information about which members and programs are affected, how the recovery of an estate is made in order to collect repayment for certain services, and situations where repayment may not be recovered from an estate.
Source: wisconsin.gov

Medicare Assistance: Support in the Community: Office of Aging And Disability Services

The OADS Aging Services and their partners are committed to providing consumers with assistance with navigating the Medicare. Whether a consumer needs assistance finding a Medicare Part D plan, a Medicare Supplement plan, money saving tips, legal assistance or reporting Medicare Fraud and Abuse, we can help! As part of the OADS Aging Services, Community Programs there are several programs that can help.
Source: maine.gov

MedicareHelp.org the Leading Medicare Help Site for Seniors.

We are here to help you find the best insurance at the lowest price. MedicareHelp.org is a website that helps you compare various insurance options to see which one suits your needs best. MedicareHelp.org offers comprehensive information on Medicare, Medicare Advantage, Medicare Part-D, and their providers. This site is 100% free to use and we are compensated by Ad revenue only. And we do not require personal information to use our site. We are not licensed nor do we sell any type of insurance, nor will we recommend, suggest, or endorse or become affiliated with any individual insurance company. In other words we are here to provide you unbiased information about your various insurance options.
Source: medicarehelp.org

Get the Most out of Medicare

Posted by:  :  Category: Medicare

OneExchange helps you choose the Medicare plan that best fits your medical needs and budget. Working with us will help you make informed and confident enrollment decisions. We apologize that our site is not fully accessible to customers using screen readers at this time. We are currently building a new site with accessibility in mind that will be launched in late 2017. Until then, we encourage you to call Willis Towers Watson at 1-866-322-2824 (#711) to speak to one of our expert benefit advisors.
Source: oneexchange.com

Medicare Insurance in Provo, Utah with Reviews

Posted by:  :  Category: Medicare

- helps you find the right local businesses to meet your specific needs. Search results are sorted by a combination of factors to give you a set of choices in response to your search criteria. These factors are similar to those you might use to determine which business to select from a local Yellow Pages directory, including proximity to where you are searching, expertise in the specific services or products you need, and the amount of useful content in the listing, such as consumer reviews, detailed descriptions and photos, to help you evaluate a business’s suitability for you. In addition, YP advertisers receive higher placement in the default ordering of search results on our sites and apps, and they may appear in sponsored listings on the top or side of the search results page.
Source: yellowpages.com

How to Become a Medicare Consultant: 8 Steps (with Pictures)

People who work within the healthcare field specializing in the US government’s Medicare health insurance program are called Medicare specialists or consultants. They hold a wide variety of jobs in customer service, billing, fraud prevention and more with government organizations, insurance companies and in hospitals, nursing homes and clinics. Becoming an expert in the Medicare program will allow you to apply for several different jobs. You will need to decide your educational path and gain years of work experience in dealing with Medicare. Learn how to become a Medicare consultant.
Source: wikihow.com

Social Security Tax / Medicare Tax and Self

Posted by:  :  Category: Medicare

The United States has entered into social security agreements with foreign countries to coordinate social security coverage and taxation of workers employed for part or all of their working careers in one of the countries. These agreements are commonly referred to as Totalization Agreements. Under these agreements, dual coverage and dual contributions (taxes) for the same work are eliminated. The agreements generally make sure that social security taxes (including self-employment tax) are paid only to one country. You can get more information on the Social Security Administration’s Web site.
Source: irs.gov

Anthem Medicare Insurance Plans

Posted by:  :  Category: Medicare

Medicare Advantage Plans offer approved Part C alternatives to the entire Original Medicare program that typically provide additional benefits. Plans offered by Anthem cover all your Medicare Part A and Part B benefits plus more, depending on your state and the particular plan you choose. Typical examples of added-value benefits are Anthems extensive preventive care coverage, wellness programs, and prescription drug benefits. These plans come in different formats, including Preferred Provider Organizations (PPOs), Regional PPOs, Health Maintenance Organizations (HMOs), and HMO Dual Eligible Special Need Plans (D-SNPs). They are predominantly branded as variations of the plan names MediBlue, Medicare Preferred, and Senior Advantage.
Source: medicaresolutions.com

Supplements & other insurance

Posted by:  :  Category: Medicare

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Source: medicare.gov

Costs of Medigap Policies

If you buy a Medicare SELECT policy: Medicare SELECT is a type of Medigap policy sold by some insurance companies in some states. If you buy a Medicare SELECT policy, you are buying one of the 10 standardized Medigap Plans A through N. Medicare SELECT policies require you to use specific hospitals and, in some cases, specific doctors to get full insurance benefits (except in an emergency). Generally, Medicare SELECT policies cost less than other Medigap policies. If you have a Medicare SELECT policy and you don’t use a Medicare SELECT hospital or doctor for non-emergency services, your costs will be higher. You will have to pay some or all of what Medicare doesn’t pay. Medicare will pay its share of approved charges no matter which hospital or doctor you choose.
Source: medicare.gov

Medicare Supplement Plan Premiums

In general, the more coverage the Medigap policy provides, the higher the premium amount. But because premiums can vary drastically, it pays to compare coverage and costs carefully. If you’d like help finding the right Medigap plan for you, just let me know. You can learn more about my Medicare experience below through my profile. Or, if you’d prefer to speak one-on-one, there’s also links to set up a phone call or have me email you some Medicare Supplement recommendations. If you’re ready to view plans now, you can do that, too: just use the Compare Plans buttons on this page to start browsing plans by zip code. Or, to discuss your Medicare options now by phone with a licensed insurance agent, use the instructions below.
Source: medicare.com

How Medicare Supplement Plan Premiums Prices May Vary

Medicare Supplement plans each typically charge a monthly premium for insurance coverage. This is separate from the Part B premium you pay for Original Medicare. There are 10 standardized Medigap plans offered in 47 U.S. states, each designated by a letter: A, B, C, D, F, G, K, L, M, and N. Not every plan type is offered in every state, but the benefits will be the same regardless of location or insurance company, although some companies may provide additional benefits.  Massachusetts, Minnesota, Wisconsin have their own state-specific standardized Medigap plans.
Source: planprescriber.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

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

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 Enrollment Archives

There are numerous Medicare election periods, each of them serving a different purpose when it comes to signing up for benefits. This article illustrates the difference between the two periods that sound incredibly similar. The Initial Enrollment Period (IEP)… Read more
Source: medicare.com