Texas Medicaid Application

Posted by:  :  Category: Medicare

Pregnant women can qualify for Texas Medicaid program if their income is at or below 185% of Federal Poverty Level (FPL) despite the fact that federal guidelines require pregnant women to be at or below 133%. State of Texas has taken the initiative to extend Medicaid benefits to pregnant women with higher income by relaxing income eligibility.
Source: benefitsapplication.com

How to Qualify For Medicaid and CHIP Health Care Coverage

If your state has not expanded Medicaid: You may qualify based on your state’s existing rules. These vary from state to state and may take into account income, household size, family status (like pregnancy or caring for young children), disability, age, and other factors. Because each state and each family situation is different, there’s no way to find out if you qualify without filling out an application.
Source: healthcare.gov

Massachusetts MassHealth (Medicaid)

Posted by:  :  Category: Medicare

Massachusetts Medicaid (MassHealth) pays for health care for certain low and medium income people living in Massachusetts. MassHealth offers health-care benefits directly or by paying part or all of your health-insurance premiums. MassHealth offers different types of coverage based on your age, whether you are a parent, pregnant, disabled HIV positive or have breast or cervical cancer, and whether you work for a small employer. MassHealth will decide if you are eligible and give you the most complete coverage that you qualify for.
Source: benefits.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

What are the Medicare Premiums and Coinsurance Rates for 2010?

Medicare Part A will pay for care in a skilled nursing facility, inpatient hospital, and a bit of home health care. For every benefit duration, Medicare will pay all the covered prices except for the Medicare Part A deductible (in 2010, it equaled to $1,100) in the first 60 days and hospital stay coinsurance amounts which last over 60 days and not more than 150 days.
Source: mymedicare.com

2010 Medicare Fee Schedule Published // ACEP

Practice expense:  Results of the AMA-coordinated practice expense survey (PCPI) have been incorporated by CMS and will be phased in over a 4-year period. Emergency medicine will realize a slight (2%) increase in practice expenses, with a small increase in levels 4 and 5 and larger increases in levels 1-3.  The American College of Cardiology, which had reductions to PE, is planning to take its fight to Congress to have the survey discarded. ACEP strongly supported the survey.
Source: acep.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

How do you look up your Medicare number?

A Medicare number includes a person’s social security number followed by a small code that consists of letters or letters with numbers depending on various factors. It is also called a Medicare claim number on documents from the provider. Because the number is primarily made up of a person’s social security number, it is not easy to look it up if lost or forgotten.
Source: reference.com

Medigap & Medicare Advantage Plans

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 Advantage vs. Medicare Supplement

Medigap plans cover out-of-pocket costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. Some plans may help pay for other benefits Original Medicare doesn’t cover, such as emergency health coverage outside of the country or the first three pints of blood. Medigap plans don’t include prescription drug benefits. If you don’t already have creditable prescription drug coverage (coverage that is at least as good as the Part D benefit), you’ll need to buy a separate stand-alone Medicare Part D Prescription Drug Plan to cover the costs of your medications. Also, Medicare Supplement plans generally don’t offer extra benefits like routine dental, vision, or hearing coverage beyond what’s already covered by Medicare.
Source: ehealthinsurance.com

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

How to compare Medigap policies

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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

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: 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

Medicare Supplement Plan F

* A benefit period begins on the first day you receive services 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. ** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
Source: bcbsil.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

Diabetes supplies & services

Posted by:  :  Category: Medicare

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.
Source: medicare.gov

Blood sugar (glucose) test strips

It’s also important to ask your suppliers if they participate in Medicare before you get DME. If suppliers are participating suppliers, they must accept assignment. If suppliers are enrolled in Medicare but aren’t “participating,” they may choose not to accept assignment. If suppliers don’t accept assignment, there’s no limit on the amount they can charge you.
Source: medicare.gov

Medicare: American Diabetes Association®

Medicare Part B covers insulin pumps and pump supplies (including the insulin used in the pump) for beneficiaries with diabetes who meet certain requirements. From January 1, 2014 until December 31, 2016, insulin pumps and pump supplies (but not insulin) are included in the Medicare Competitive Bidding Program in 9 areas of the U.S. This means beneficiaries in these 9 areas with Original Medicare (not Medicare Advantage) generally must use a Medicare contract supplier for Medicare to help pay for these items. Learn more about the program here or by calling 1-800-MEDICARE (800-633-4227).  After December 31, 2016, insulin pumps and pump supplies will no longer be part of the Medicare Competitive Bidding Program which means beneficiaries in these 9 areas can use any Medicare supplier that provides insulin pumps and supplies. It is important to ask if the Medicare supplier “accepts assignment” for insulin pumps and pump supplies. This means the supplier will accept the Medicare-approved amount as payment in full, and you cannot be charged more than 20% coinsurance (after you meet your deductible). If a supplier does not accept Medicare assignment, you may be charged more than the 20% coinsurance. Be sure to check with the supplier to find out what your payment will be. 
Source: diabetes.org

Health Insurance Costs Like Premiums & Deductibles

Posted by:  :  Category: Medicare

In almost any area of your life, if you don’t have a clear idea of your expenses, you may feel like you’re not in control. But, when you get clear about all the costs, you feel in control, helping you make the right choices. To get a clear understanding of your health insurance costs, the first step is to look at all the key types of costs, not just obvious expenses. It’s a lot like adding up your automobile expenses – some of the clear costs include your car payment, insurance, gas, oil changes and repairs. Less obvious costs include the finance charge on your payment, windshield wiper fluid and parking tickets. Let’s take a look at obvious health insurance costs and some examples.
Source: medmutual.com

Don’t Miss the Health Insurance Deduction if You’re Self

If you’re an S corporation shareholder, the policy can be in your name or the S corporation’s name and either of you can pay the premiums. If the policy is in your name and you pay the premiums, the S corporation must reimburse you and include the premiums as wage income on your Form W-2.
Source: irs.gov

How Medicare works with other insurance

Posted by:  :  Category: Medicare

A conditional payment is a payment Medicare makes for services another payer may be responsible for. Medicare makes this conditional payment so you won’t have to use your own money to pay the bill. The payment is “conditional” because it must be repaid to Medicare if you get a settlement, judgment, award, or other payment later. You’re responsible for making sure Medicare gets repaid from the settlement, judgment, award, or other payment.
Source: medicare.gov

Supplements & other insurance

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 The Best Secondary Insurance With Medicare?

To supplement Medicare it’s best to have a Medicare Supplement Plan. These are standardized plans in most states. The highest level of coverage is the Plan F Medicare Supplement. It pays 100% of the co-pays and deductibles for Medicare covered treatments. The others to consider are Plan G which is the same as Plan F except you pay your Medicare Part B deductible which is less than $150 per year currently. You will often save $200 to $300 annually on your premiums choosing a plan G supplement over a Plan F. You can also consider the Medicare Plan N Supplement for an even lower premium but you will take on more doctor co-pays and a few less benefits. There is a high deductible version of Plan F where you have a much lower premium but you pay the first $2,070 in expenses each year but are covered 100% for costs above that. Medicare and your supplement do not cover prescription medicines so most people buy a Medicare Part D plan for those. None of these plans cover dental or eye doctors so some people buy additional coverage for those. All companies sell the exact same standardized Medicare Supplement Plans so it is the easiest type of insurance to shop and compare and lower your cost. A Plan F with one company may be as much as $500 per year cheaper with a different company and the coverage is exactly the same. It’s best to use an insurance broker who sells for many companies rather than sign up directly through one specific company. When there is a rate increase (they ALL have them) your broker can just re-shop the plans for you and help you get back to a lower premium.
Source: insurancelibrary.com

Medicare as a Secondary Insurance Customer

Often policies have a tendency to overlap or duplicate each other. Take young person’s Medicare health care plans for instance:  often these can reduce the amount paid out by a percentage via a ‘reduction in benefits’ clause, particularly if they are protected under their parent or guardian’s plan. Should this be the case, a secondary insurance policy will pay the balance that is not paid by the primary insurance policy.
Source: bestmedicaresupplement.com

Medicare can be primary or secondary to employer insurance

It is very important that you talk to your benefits manager at your job when you become eligible for Medicare, as your employer insurance will work differently with Medicare. Sometimes companies do not realize that you are eligible for Medicare and they may continue to pay primary when they should not be. When the company realizes they may be able to take back money they paid for your medical services while you should have had Medicare and you may be left very large bills.
Source: medicareinteractive.org

National health insurance

Posted by:  :  Category: Medicare

National schemes have the advantage that the pool or pools tend to be very very large and reflective of the national population. Health care costs, which tend to be high at certain stages in life such as during pregnancy and childbirth and especially in the last few years of life can be paid into the pool over a lifetime and be higher when earnings capacity is greatest to meet costs incurred at times when earnings capacity is low or non existent. This differs from the private insurance schemes that operate in some countries which tend to price insurance year on year according to health risks such as age, family history, previous illnesses, and height/weight ratios. Thus some people tend to have to pay more for their health insurance when they are sick and/or are least able to afford it. These factors are not taken into consideration in NHI schemes. In private schemes in competitive insurance markets, these activities by insurance companies tend to act against the basic principles of insurance which is group solidarity.
Source: wikipedia.org

National Health Information Center

The National Health Information Center (NHIC) is sponsored by ODPHP. NHIC supports public health education and promotion by maintaining a calendar of National Health Observances. In addition, NHIC helps connect health professionals and consumers to the organizations that can best answer their questions by providing up-to-date contact information for the most reliable resources.
Source: health.gov

National Health Insurance Administration Ministy of Health and Welfare

●2016-2017 Handbook of Taiwan’s National Health Insurance(English)-PDF file ●2016-2017 Handbook of Taiwan’s National Health Insurance(Japanese)-PDF file ●2016-2017 Handbook of Taiwan’s National Health Insurance(Thai)-PDF file ●2016-2017 Handbook of Taiwan’s National Health Insurance(Indonesian)-PDF file ●2016-2017 Handbook of Taiwan’s National Health Insurance(Vietnamese)-PDF file
Source: gov.tw

Physicians for a National Health Program

Business owner Richard Master knows firsthand how the dysfunctional U.S. health care system punishes not only patients, but also employers who are forced to spend more and more to insure their workers. His documentary, “Fix It,” makes a strong business case for addressing this festering problem, and includes interviews with many PNHP members. A trailer for the film can be accessed above, or you can view the full version for free by visiting the “Fix It” website.
Source: pnhp.org