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

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Source: medicare.gov

Medicare Coding & Billing

New Physical Therapy Evaluation and Reevaluation CPT Codes PTs must begin using 3 new evaluation codes and a new reevaluation code beginning January 1, 2017. Now is the time to become familiar with them.
Source: apta.org

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, Medicaid and Medical Billing

When a Part A claim is processed by Medicare, Medicare pays the provider directly for the service rendered by the provider. On the other hand, in a Part B claim, who pays depends on who has accepted the assignment of the claim. If the provider accepts the assignment of the claim, Medicare pays the provider 80% of the cost of the procedure, and the remaining 20% of the cost is passed on to the patient. You should recognized that 80-20 breakdown: it’s a classic example of coinsurance.
Source: medicalbillingandcoding.org

Medicare Billing, Medicare Eligibility and Enrollment

Medicare Part B claims are filed with the information required in the CMS-1500 claim format which is usually transmitted electronically. If you are in the process of enrolling a provider in Medicare, a helpful resource is Medicare Enrollment – Completing the 855i by Solutions Medical Billing. This guide explains the Medicare enrollment forms necessary to complete the Medicare enrollment application correctly. If you’ve ever tried to fill out Medicare forms, you know this can be a confusing and time consuming process. Having a good guide to explain it and walk you through it can save a lot of time and effort.
Source: all-things-medical-billing.com

Medicare Advantage 2014 Spotlight: Plan Availability and Premiums

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While many organizations offer Medicare Advantage plans, a few – particularly Humana, United Healthcare, and the Blue Cross and Blue Shield (BCBS) affiliates – have particularly large geographic spread and these organizations historically account for a disproportionate share of enrollment. In 2014, 44 percent of available plans are being offered by one of these three firms or affiliates (Table A4).  Plans offered by these firms are available to most beneficiaries.  Nationwide, 83 percent of Medicare beneficiaries will have access to one or more Humana plans, 73 percent will have access to a BCBS affiliated plan (including BCBS plans offered by Wellpoint), and 68 percent will have access to a United Healthcare plan (Exhibit 5; Table A5).  The general availability of these firms’ products has not noticeably changed from 2013 to 2014.  However, the similarities in BCBS offerings from 2013 to 2014 obscure a decline in availability of BCBS branded Wellpoint plans (declining from 88 plans to 55 plans between 2013 and 2014), which is mostly offset by the growth in plans offered by other BCBS affiliates (growing from 205 plans to 233 plans between 2013 and 2014).
Source: kff.org

Annual Statistical Supplement, 2011

d. Standard premium rate for voluntary enrollment by certain aged and disabled individuals not otherwise entitled to Hospital Insurance (HI). (Most individuals aged 65 and older and many disabled individuals under age 65 are insured for HI benefits without payment of any premium.) Beginning in 1994, a reduced premium is available to premium-paying HI enrollees with at least 30 quarters of Medicare-covered employment (either their own or through a current or former spouse if the marriage meets certain duration criteria). In most cases, a surcharge applies for beneficiaries who enroll after their initial enrollment period.
Source: ssa.gov

Medicare Information and Plan Comparisons

While health care was not central to the 2016 Presidential campaign, the election’s outcome will be a major determining factor in the country’s future health care policy. A number of issues have garnered media attention, including the future of the Affordable Care Act (ACA), rising prescription drug costs, and the opioid epidemic.
Source: medicare.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

Medicare Information Office

3/3/17 FOR IMMEDIATE RELEASE The Acting Inspector General of Social Security, Gale Stallworth Stone, is warning citizens about a nationwide telephone “imposter phishing” scheme. The Social Security Administration and its Office of the Inspector General have received several reports from citizens across the country about persons receiving phone calls from individuals posing as OIG investigators. The caller indicates an issue exists pertaining to the person’s Social Security account or Social Security number and directs the person call a non-SSA telephone number to address the issue.
Source: alaska.gov

Contact Social Security By Phone

By calling 1-800-772-1213, you can use our automated telephone services to get recorded information and conduct some business 24 hours a day. If you cannot handle your business through our automated services, you can speak to a Social Security representative between 7 a.m. and 7 p.m. Monday through Friday. Generally, you’ll have a shorter wait time if you call during the week after Tuesday. If you are deaf or hard of hearing, call our toll-free TTY number, 1-800-325-0778, between 7 a.m. and 7 p.m. Monday through Friday.
Source: ssa.gov

Application Form and Instructions

Posted by:  :  Category: Medicare

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.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

Form 4029, Application for Exemption From Social Security and Medicare Taxes and Waiver of Benefits

Use the Comment on Tax Forms and Publications web form to provide feedback on the content of this product. Although we cannot respond individually to each comment, we do appreciate your feedback and will consider all comments submitted.
Source: irs.gov

Medicare Extra Help Application

At the same time, you can start the application process for the Medicare Savings Programs that could increase your monthly income up to $134. You will also find out if there are other benefit programs that can save you money.
Source: benefitscheckup.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

Download claims with Medicare’s Blue Button

MyMedicare.gov’s Blue Button provides you an easy way to download your personal health information to a file. Once you’re in your MyMedicare.gov account, you can download the file of your personal data and save the file on your own personal computer. After you have saved it, you can import that same file into other computer-based personal health management tools. The Blue Button is safe, secure, reliable, and easy to use.
Source: medicare.gov

Medicare Card Information

It is very important to note that your Medicare card should be carefully guarded. Just as you would protect a credit card or your Social Security card, you should guard your Medicare card in the same fashion, as it contains sensitive information. In the wrong hands, such information as your name, signature and Social Security number could be copied or stolen. It could then be used to steal your identity (identity theft) or commit Medicare fraud. Therefore, only provide your Medicare card or information to hospitals and your direct health care providers.
Source: medicare.net

AARP Medicare Supplement Plan N

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One thing is certain. Medicare Advantage plans are changing and in many instances, monthly premiums are increasing. Some Advantage plans now cost more than a Medicare supplement. An Advantage plan will certainly  require cost sharing for hospital inpatient charges. Most plans require you to pay a couple hundred dollar co-pay, for a fixed number of days, as part of your cost sharing responsibility. You may even be required to pay more than if you had only Medicare. This is not the case with AARP Medicare supplement Plan N.
Source: seniorsupplementinsurance.com

Medicare Supplement Plan N

* 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

Compare Medicare Advantage & Supplemental Plans

Medicare supplement plans offer benefits in addition to the benefits offered by Original Medicare Parts A and B, and they are offered by private insurance companies. There are several different types of Medicare supplement plans available, including Plan A, Plan C, Plan F, Plan M and Plan N. Medicare supplement plans and Medicare Advantage plans are not complementary, so it is important to understand which type of policy makes the most sense for you. Our licensed sales agents are standing by to walk you through a comparison of the costs and benefits of each type of plan, and to help you choose a Medicare supplement plan that best meets your needs.
Source: medicaresolutions.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

Compare Medicare Supplement Plans A

Medicare Supplement insurance works differently in Massachusetts, Minnesota, and Wisconsin, which standardize their plans differently from the rest of the country. Insurance companies that sell Medicare Supplement insurance aren’t required to offer all plan types. However, any insurance company that sells Medigap insurance is required by law to offer Medigap Plan A. If an insurance company wants to offer other Medigap plans, it must sell either Plan C or Plan F in addition to any other plans it would like to sell.
Source: ehealthinsurance.com

Custom care & coverage just for you

Posted by:  :  Category: Medicare

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Source: kaiserpermanente.org

Kaiser Permanente California

WASHINGTON, D.C. — Nearly all Kaiser Permanente hospitals (pdf) have been given an A rating for patient safety — and none lower than a B — in a new national report card issued Wednesday by The Leapfrog Group. While Kaiser Permanente hospitals were rated among the safest in the country, hospitals nationwide fared far worse. Of the more than 2,600 hospitals that were graded in the report, nearly half (47 percent) received a C grade or lower. In California, it was a similar story. Of the 264 hospitals in California that were rated, 109 (or 41 percent) received a C grade or lower. The complete list of Leapfrog Hospital Safety Score results can be found at www.hospitalsafetyscore.org.
Source: kaiserinsuranceonline.com

Kaiser Permanente Washington

Our name may be new to some in Washington, but you might recognize our faces, healing hands, and caring hearts. That’s because doctors, nurses, and other providers who are now part of Kaiser Permanente have been serving local neighborhoods for years. We’re glad to be here, and proud to provide the coordinated, connected care that helps our members and our communities thrive.
Source: ghc.org

Affordable Care Act: Obamacare & Health Reform Facts

You should get more details from your employer about changes that may affect your plan in 2015. Check with your employer for information on how to get coverage. You may be able to select coverage through your employer, through the Small Business Health Options Program (SHOP) Marketplace, or directly from Kaiser Permanente. (Exception: Residents of Washington, D.C., purchasing health coverage on their own must buy coverage from the Marketplace.) You may be able to get federal financial help if you qualify. To do so, you would need to apply and get your coverage through the Marketplace.
Source: kaiserpermanente.org

Local Coverage Determinations (LCDs) for Noridian Healthcare Solutions, LLC

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NOTE: You either have javascript disabled or have saved the page locally. Your experience may not be optimal due to these factors. Please consider enabling javascript or revisiting this page to get an optimal MCD experience. (Due to browser security settings, directly clicking the previous link may not work, so you may need to copy and paste the following link [http://www.cms.gov/medicare-coverage-database/indexes/lcd-list.aspx?Cntrctr=139&name=Noridian%20Administrative%20Services%20(19003,%20DME%20MAC)&DocStatus=Retired&&ContrVer=1&CntrctrSelected=139*1&LCntrctr=139*1&bc=AgACAAIAAAAA&] into your browser.)
Source: cms.gov

Noridian Medicare Services

As a payor, you’re in a unique position to affect care quality for your beneficiaries. By tapping into our care management expertise, data sources and system integration tools you can assist and incentivize providers for the quality of care instead of the quantity of services.
Source: noridiansolutions.com

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 Premiums And Deductibles 2017 (Part A and B)

Part A Deductible and Co-Insurance: (inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.
Source: medicareadvantagesupplementplans.com

The surprising news about 2017 Medicare premiums and deductibles you may have missed

However, the COLA this year was zero, so most people saw their Part B premiums frozen for 2016. However, about 30 percent of Medicare enrollees are not held harmless, and the 2016 premiums for most of them rose to $121.80 a month. This group includes people who do not yet receive Social Security, those new to Medicare, people whose Medicare premiums are not deducted from Social Security, lower-income Medicare enrollees who also receive Medicaid and people who pay higher-income premiums for Medicare.
Source: pbs.org

Medicare Part B Premiums and Deductibles in 2017

If you already have Medicare and you get Social Security benefits, you likely pay $109 per month, which is less than the standard premium. This is due to the “hold harmless” provision, which says those who have premiums taken from their Social Security won’t see their benefit checks reduced if premiums increase due to a cost-of-living adjustment (COLA).
Source: medicarehealthplans.com

Medicare Premiums and Deductibles for 2017

Medicare Part D covers outpatient prescription drugs and is solely offered by private insurance companies who contract with Medicare. Each insurer can design plans with varying benefits and costs provided that each plan is determined to be at least as good as the standard benefit design as regulated by Medicare. The average basic premium for Part D plans in 2017 is estimated to be $34 per month, an increase of 4.6 percent from 2016; however, like Part B, individuals are subject to income-related premium adjustments.[iv] The maximum deductible allowed in 2017 for Part D is $400, an 11 percent increase from 2016.[v] Upon reaching the deductible, beneficiaries enter the initial coverage period in which they pay 25 percent of their costs. Once overall costs exceed $3,700, the beneficiary enters the coverage gap, known as the “donut hole”. In the coverage gap, beneficiaries pay 51 percent of drug costs for generics and 40 percent for brand-name drugs. The True Out-of-Pocket (TrOOP) limit for Part D in 2017 is $4,950. Upon reaching this limit, beneficiaries enter catastrophic coverage and have limited cost-sharing for any remaining drug expenses for the year.
Source: americanactionforum.org

MedicareHelp.org the Leading Medicare Help Site for Seniors.

Posted by:  :  Category: Medicare

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

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

Medicare Information and Plan Comparisons

While health care was not central to the 2016 Presidential campaign, the election’s outcome will be a major determining factor in the country’s future health care policy. A number of issues have garnered media attention, including the future of the Affordable Care Act (ACA), rising prescription drug costs, and the opioid epidemic.
Source: medicare.org

Medicare Part A, Part B, Part C, Part D, Ohio, Medicare Supplement Quote

Offers health plan options run by Medicare-approved private insurance companies. Medicare Advantage Plans are a way to get the benefits and services covered under Part A and Part B. Most Medicare Advantage Plans cover Medicare prescription drug coverage (Part D). Some Medicare Advantage Plans may include extra benefits for an extra cost.
Source: medicareohiohelp.com

Health Insurance: Georgia Health Insurance, Inc

We stay up-to-date on all the latest insurance products and industry developments, ensuring the highest possible level of customer service. If you ever have questions, would like to review your plan, or see if there are better options available, help is always just a phone call or email away.
Source: ga-health-insurance.com

Extra Help Paying for Medicare Prescriptions

Aetna members can receive help applying for Extra Help. To get help with your application, call "My Advocate" at 1-866-706-6757 (TTY: 711). They’re available Monday through Friday, 9 a.m. to 6 p.m. ET. "My Advocate" is a service offered by an independent company.
Source: aetnamedicare.com