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

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Source: medicare.gov

AHCA: Medicaid Landing Page

In Florida, the Agency for Health Care Administration (Agency) is responsible for Medicaid.  The Agency successfully completed the implementation of the Statewide Medicaid Managed Care (SMMC) program in 2014.  Under the SMMC program, most Medicaid recipients are enrolled in a health plan.  Nationally accredited health plans were selected through a competitive procurement for participation in the program.
Source: fl.us

Medicare 2017 costs at a glance

Posted by:  :  Category: Medicare

The standard Part B premium amount in 2017 is $134 (or higher depending on your income). However, most people who get Social Security benefits pay less than this amount. This is because the Part B premium increased more than the cost-of-living increase for 2017 Social Security benefits. If you pay your Part B premium through your monthly Social Security benefit, you’ll pay less ($109 on average). Social Security will tell you the exact amount you’ll pay for Part B in 2017. You’ll pay the standard premium amount if:
Source: medicare.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

AARP® Medicare Supplemental Insurance by United Healthcare

Medicare Supplement Insurance Plans, insured by UnitedHealthcare Insurance Company. If you’re considering a Medicare supplement plan, talking to an agent/producer may offer the direct assistance you’re looking for.
Source: aarpmedicaresupplement.com

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

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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

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

Compare Medicare Part D Prescription Drug Plans

Keep in mind that just as costs can vary by plan, Medicare plans that include prescription drug coverage may also vary when it comes to the specific prescription drugs they cover. An easy way to make sure that your current medications are covered is to check the plan’s formulary (list of covered medications) before enrolling in a Medicare plan that includes prescription drug coverage. Keep in mind that formularies are subject to change. Your Medicare Prescription Drug Plan or Medicare Advantage Prescription Drug plan will notify you if necessary.
Source: ehealthinsurance.com

Prescription Drug Coverage

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 2017 costs at a glance

Posted by:  :  Category: Medicare

The standard Part B premium amount in 2017 is $134 (or higher depending on your income). However, most people who get Social Security benefits pay less than this amount. This is because the Part B premium increased more than the cost-of-living increase for 2017 Social Security benefits. If you pay your Part B premium through your monthly Social Security benefit, you’ll pay less ($109 on average). Social Security will tell you the exact amount you’ll pay for Part B in 2017. You’ll pay the standard premium amount if:
Source: medicare.gov

Yearly deductible for drug plans

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Source: medicare.gov

2016 Medicare Premiums and Deductibles

You may be able to avoid paying this late enrollment penalty if you delayed Medicare Part B because you had other health coverage, such as through an employer-sponsored group plan (either through your own or your spouse’s work). In this case, you can enroll through a Special Enrollment Period when you or your spouse stop working or that other health coverage ends, whichever comes first. If you have to pay a monthly premium for Medicare Part A, you may decide to delay enrollment in Part A as well and sign up during your Special Enrollment Period. If you enroll in Medicare with a Special Enrollment Period, you generally won’t have to pay a late enrollment penalty.
Source: medicare.com

MEDICARE Part A, B, C, & D PREMIUMS, DEDUCTIBLES FOR 2011

Part A premiums are decreasing because spending in 2010 was lower than expected and the Affordable Care Act implemented policies that lower Part A spending due to payment efficiencies and efforts related to waste, fraud and abuse.  Part B premiums are increasing because of growth in the use of services like outpatient hospital care, home health and physician-administered drugs.  In addition, the premium accounts for a likely Congressional action to avert a precipitous decrease in physician payments, which the Administration supports, and has occurred every year since 2003.  The Administration is committed to permanent reform of the physician payment formula. By law, the standard premium is set to cover one-fourth of the average cost of Part B services incurred by beneficiaries aged 65 and over, plus a contingency margin. The contingency margin is an amount appropriate to (i) cover incurred-but-unpaid claims costs, (ii) provide for possible variation between actual and projected costs, and (iii) amortize any surplus assets or unfunded liabilities.  The remaining Part B costs are financed by Federal general revenues.  (In 2011, $2.5 billion in Part B expenditures will be financed by the new fees on manufacturers and importers of brand-name prescription drugs under the Affordable Care Act.  The revenue from these fees reduces the standard Part B premium by $0.90.)
Source: q1medicare.com

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

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Source: medicare.gov

2017 Florida Blue Medicare Regional PPO & HMO

A Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. These contracts are renewed annually, and the availability of coverage beyond the end of the current contract year is not guaranteed. Exclusions, limitations, copayments, coinsurance and deductibles may apply. The benefit information provided herin is a brief summary, not a comprehensive description of benefits. For more information, contact the plan. Medicare beneficiaries may enroll in BlueMedicare Regional PPO through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.
Source: securehealthoptions.com

Help fight Medicare fraud

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Source: medicare.gov

Research, Statistics, Data & Systems

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Source: cms.gov

Medicare Fraud Reporting Center

That final report included such absurdities as walkers for patients with purported sinus congestion, paraplegia or shoulder injuries. And hundreds of thousands of claims were lodged for diabetes-related glucose test strips for Medicare patients suffering purported breathing problems, bubonic plague or sexual impotence.
Source: medicarefraudcenter.org

23 Stunning Medicaid Fraud Statistics

1. In May of 2014, some 107 healthcare providers including doctors and nurses were arrested in several cities. These ones were charged with cheating the programs out of some $452 million in funds. 2. In 2010 federal officials arrested some 94 people who had filed false claims through Medicare and Medicaid, for a total of $251 million in fraudulent claims. 3. The Medicare Fraud Strike Force was formed by federal officials in 2007. The group visited some 1600 businesses in Miami at random, following up on billing to Medicare for durable medical equipment. Of those businesses, nearly one-third did not exist although they had billed Medicare for $237 million in the past year. 4. It was reported to one source that Russian and Nigerian mobs had moved to Florida from New York because it was easier to become involved with Medicaid fraud than it was to be involved with other organized crime activities. 5. A former official in New York City stated that some 40% of Medicaid payments in that city were “questionable.” 6. A story by the New York Times reported that a dentist in Brooklyn had filed 991 claims to Medicaid in one day alone. 7. The five states with the highest number of fraud cases include California, Texas, New York, Ohio and Kentucky. 8. In 2011, state governments recovered some $1.7 billion from fraudulent payouts. They spent an estimated $208 million to accomplish this. 9. In that same year, the federal government also recovered some $4.1 billion from fraudulent activity, but they too needed to spend hundreds of millions of dollars to do this. 10. In 2010 the Government Accountability Office or GAO reported that they had found some $48 billion in “improper payments” during the past year for Medicaid and Medicare. This amount was roughly 10% of the $500 billion that was paid out during the year. 11. That same year, U.S. Attorney General Eric Holder suggested that the amount of fraud was actually higher, somewhere between $60 and $90 billion in payouts. 12. The Department of Health and Human Services currently uses what is often called a “pay and chase” model for finding Medicare and Medicaid fraud. This is the practice of routinely paying out every claim as it comes in and then only pursuing those that seem blatantly fraudulent, such as a dentist filing 991 claims in one day. 13. The Department’s Secretary Kathleen Sebelius has stated that they are planning on pursuing pre-claim adjudication to analyze patterns in claims before they are paid out, and are looking to abandon the “pay and chase” model within the next few years. 14. Some estimate that private insurers lose 1% to 1.5% of their revenue to fraud alone and credit card fraud is estimated to be at around 0.05%, while Medicaid and Medicare numbers are closer to 10% to 15%. One reason for this discrepancy is that private insurers and businesses like credit card providers may be more willing to invest in software and other technology that allows them to spot fraud much more quickly than government programs, and to do so before those claims and charges are paid. 15. Spending for healthcare is estimated to reach some $3 trillion in the U.S. in 2014 alone, although this amount does not currently keep up with the rate of inflation. 16. Claims pursued by the federal government in 2012 included unlawful pricing by drug manufacturers, illegal marketing of products and medical devices that have not been approved of by the Food and Drug Administration, and violations of law in regards to kickbacks and self-referrals. 17. The year 2012 marked the third year in a row that the federal government recovered over $2 billion in these types of health care matters. 18. In 2012 the Civil Division Consumer Protection Branch, which files civil suits against those convicted of Medicaid and Medicare fraud, obtained almost $1.5 billion in judgments, fines, and other forfeitures against those convicted of such frauds. The department also obtained 14 convictions under what is called the Federal Food, Drug and Cosmetic Act. 19. As a means of preventing such fraud, punishments have become more severe. In a case reported on in The Economist, one owner of a mental health clinic received a penalty of 30 years in jail for false billing. 20. The number of fraud cases that have increased the most over the past few years include home health visits, as these are difficult to track and to prove or disprove in court. Durable medical equipment is also a large portion of the fraud cases, including electric wheelchairs and walkers. 21. Overbilling for HIV infusion is also a popular scam, despite there being a much more affordable and effective way of treating the disease. When one such fraudulent ring was shut down in Florida, it resurfaced in Detroit and Medicaid and Medicare were again scammed out of thousands of dollars, by the same perpetrator. 22. Medicare processors handle some 4.5 million claims every single day, which is also a reason for the high volume of fraud. 23. Many fraud cases also involve stealing the identities of patients. This allows doctors and other healthcare professionals and those who have nonexistent medical storefronts to bill these programs for equipment and medications.
Source: healthresearchfunding.org

Health Care Fraud — FBI

The Bureau seeks to identify and pursue investigations against the most egregious offenders involved in health care fraud through investigative partnerships with other federal agencies, such as Health and Human Services-Office of Inspector General (HHS-OIG), Food and Drug Administration (FDA), Drug Enforcement Administration (DEA), Defense Criminal Investigative Service (DCIS), Office of Personnel Management-Office of Inspector General (OPM-OIG), and Internal Revenue Service-Criminal Investigation (IRS-CI), along with various state Medicaid Fraud Control Units and other state and local agencies. On the private side, the FBI is actively involved in the Healthcare Fraud Prevention Partnership, an effort to exchange facts and information between the public and private sectors in order to reduce the prevalence of health care fraud. The Bureau also maintains significant liaison with private insurance national groups, such as the National Health Care Anti-Fraud Association, the National Insurance Crime Bureau, and private insurance investigative units.
Source: fbi.gov

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

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Source: medicare.gov

Medicare Application Information

There is a special circumstances enrollment period for those who are signing up late because they were already covered by employer paid coverage during their “Initial Enrollment Period.” The special circumstance enrollment is called “Special Enrollment Period” (SEP) and gives you a window of eight months to get signed up. This window begins the month after your employment ended or group insurance ends (whichever ended first). There typically is no increased premium for your late enrollment because you actually had coverage through your employer during your IEP.
Source: medicare.net

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

About Medicare in New Mexico

I can help you compare the Medicare Advantage, Medicare Part D, and Medicare Supplement insurance plans available in your part of New Mexico. And who am I? Find out more about me by checking out my profile; just follow the View profile link below. I can speak with you by phone or send you information about plans by email; use the links below to tell me which way works better for you. If you’d like to learn more on your own, just click the “Compare Plans” button on this page. Or, if you’d like to speak with me or another licensed insurance agent right away, call us at 1-844-847-2659 (711 if you’re a TTY user) Monday through Friday, 8AM to 8PM ET, and we’ll gladly show you your options.
Source: medicare.com

NM Human Services Department

The Human Services Department invites you to participate in a public forum and provide meaningful comments about Medicaid’s Centennial Care program. The Department looks forward to receiving the public’s feedback about Centennial Care, nearing the end of its third year. Per its agreement with the federal government, the State may hold the public forum as part of its Medicaid Advisory Committee (MAC) meeting. The forum will take place at the next MAC meeting on Monday, November 14th, from 1-4 p.m. at the Garrey Carruthers State Library in Santa Fe (1209 Camino Carlos Rey, Santa Fe, NM 87505). Providers, members, advocacy groups and other parties interested in discussing the Centennial Care program are welcome to attend. We look forward to your participation. For more information, call 505-827-3101.
Source: nm.us

New Mexico Medicare Supplement Insurance

We’re CDIS of New Mexico Inc., an independent, authorized exclusive general agent for Blue Cross and Blue Shield of New Mexico. Our knowledgable staff of seasoned Medicare experts has been helping New Mexico seniors get the most of Medicare for years and it won’t cost you a dime. We know medicare can be confusing, so if you have questions, we have answers. Whether you’re just browsing or ready to pick a plan that is right for you today, we’re here to help. Shoot us an email or give us a call. You’ll be glad you did.
Source: newmexicomedicarehealth.com

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

Posted by:  :  Category: Medicare

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Source: medicare.gov