BCBS of IL Provider Finder

Posted by:  :  Category: Medicare

Blue Cross Community MMAI (Medicare-Medicaid Plan) is provided by Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an independent licensee of the Blue Cross and Blue Shield Association. HCSC is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Enrollment in HCSC’s plan depends on contract renewal.
Source: bcbsil.com

Blue Cross Medicare Advantage Providers

If you would like a Provider Directory mailed to you, you may call customer service at: Blue Cross Medicare Advantage Plans 1-877-774-8592 TTY/TDD 711 or Lovelace Medicare Advantage Plans at 1-877-895-6448 TTY/TDD 711 or complete the online request form.
Source: bcbsnm.com

Complaints about a doctor, hospital, or provider

You may have a complaint about improper care (like claims of abuse to a nursing home resident) or unsafe conditions (like water damage or fire safety concerns). To file a complaint about improper care or unsafe conditions in a hospital, home health agency, hospice, or nursing home, contact your State Survey Agency. The State Survey Agency is usually part of your State’s department of health services.
Source: medicare.gov

Medicare Eligibility, Age, Qualifications And Requirements

Posted by:  :  Category: Medicare

You can also qualify for premium-free Part A benefits on your spouse’s work record if he or she is at least age 62 and you are at least age 65. You also may qualify on the work record of a divorced or deceased spouse. Following the Supreme Court’s 2015 ruling, people in same-sex marriages can qualify for Medicare on their spouse’s work record, regardless of where they live or where they were married.
Source: aarp.org

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

Medicare Eligibility and Enrollment

good as Medicare’s or better, you shouldn’t be charged a late penalty as long as you sign up within the deadlines. After insurance from an employer ends, you must sign up for Part B within 8 months and for Part D within 63 days. Keep in mind that an insurance policy from an employer with fewer than 20 employees works differently with Medicare. If you work for a company of that size, you should sign up for Medicare when you are first eligible. You will not incur penalties if you don’t, but without Medicare Part B coverage, you could be without coverage for outpatient services.
Source: webmd.com

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 and Enrollment

Medicare: Am I Eligible? AARP’s Medicare Question and Answer Tool works as an online planning resource, designed to assist those who are eligible for Medicare benefits as well as those who are unsure. The Medicare Q and A Tool acts also as a guide, explaining in plain English eligibility, how to enroll, when to enroll and how to choose the best plan for you. AARP’s Medicare Question and Answer Tool is a starting point toward an informed decision about your Medicare coverage and your eligibility.
Source: aarp.org

Compare Medicare Advantage & Supplemental Plans

Medicare supplement plans offer benefits in addition to the benefits offered by 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

Health Insurance Plans for Individuals & Families, Employers, Medicare

Posted by:  :  Category: Medicare

UnitedHealthcare offers health insurance plans to meet the needs of individuals and employers. Plus we offer dental, vision and many other insurance plans to help keep you and your family healthy. 
Source: uhc.com

Compare Medicare Advantage & Supplemental Plans

Medicare supplement plans offer benefits in addition to the benefits offered by 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 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

Specialty Benefit Solutions (SBS)

Each Specialty Benefit Solutions (SBS) package contains Dental, Vision, Life/AD&D*, WorkLife services and health discounts. Since the entire package is accessed through one ID card and one toll-free number, convenience is just the beginning.
Source: uhc.com

What is Medicare Tax? definition and meaning

Posted by:  :  Category: Medicare

Tax deducted from the wages of every legally working American that is used to pay for the Medicare program provided to individuals over the age of 65. This is typically another line item included on an employee’s paystub. At the end of year, the employer will provide the employee with a W-2 and this will include the total amount deducted from the individual’s paycheck for the Medicare tax. The tax was implemented under the Federal Insurance Contributions Act.
Source: investorwords.com

House GOP Health Plan Eliminates Two Medicare Taxes, Giving Very Large Tax Cuts to the Wealthy

In 2014, taxpayers with adjusted gross incomes above $1 million derived about 40 percent of their income from net capital gains, dividends, and taxable interest income; they received more than half of all income from these sources in 2014.  Taxpayers with incomes above $10 million received an average of 56 percent of their income from capital gains, dividends, and taxable interest income.  By contrast, these sources only made up about 3 percent of the income of people who made between $50,000 and $75,000.  IRS Statistics of Income, Individual Statistical Tables by Size of Adjusted Gross Income, Table 1.4, https://www.irs.gov/uac/soi-tax-stats-individual-statistical-tables-by-size-of-adjusted-gross-income.
Source: cbpp.org

Federal Withholding Tax Table

Update your payroll tax rates with these useful tables from IRS Publication 15, (Circular E), Employer’s Tax Guide. The charts include federal withholding (income tax), FICA tax, Medicare tax and FUTA taxes.
Source: suburbancomputer.com

ACA Repeal Would Lavish Medicare Tax Cuts on 400 Highest

Before health reform, Medicare taxes applied only to wage and salary and self-employment income, not to unearned income from wealth.  For low- and moderate-income working families, which have little unearned income, this meant that Medicare taxes applied to virtually all of their income.  In contrast, the wealthiest taxpayers owed no Medicare taxes on their unearned income, which represents a significant share of their income.
Source: cbpp.org

What is Form 8959: Additional Medicare Tax

If you had more than one type of income, such as W-2 income and self-employment income, you will have to complete all sections that apply. Once you complete Form 8959 and figure out the total Additional Medicare Tax you’re responsible for, the final section of the form subtracts the tax you paid through withholding and estimated tax payments to determine if there is any Additional Medicare Tax due — which ultimately gets reported on your 1040 form.
Source: intuit.com

What is Form 8919: Uncollected Social Security and Medicare Tax on Wages

A business may hire a worker as an independent contractor, but the worker may be classified as a paid employee by the Internal Revenue Service, depending on how their position is structured. An independent contractor generally decides how and when to complete their workload, so if an employer reserves the right to control that, they’re likely an employee. A worker who uses tools and equipment owned by the employer may be considered an employee, since a contractor usually has their own equipment.
Source: intuit.com

Medicare Supplement Plan F

Posted by:  :  Category: Medicare

* 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

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: bcbstx.com

Medicare Supplement High Deductible 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. ** This high deductible plan pays the same benefits as Plan F after one has paid a calendar-year $2,200 deductible. Benefits from High Deductible Plan F will not begin until out-of-pocket expenses are $2,200. 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 deductible. *** 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

Medicare Supplement Plan F

Under Fire: Many politicians and health economists believe plan F should be eliminated or modified because it provides first dollar coverage for people who purchase the plan. They believe people who do not have co-payments or deductibles to pay use medical services more often, which hurts the Medicare system as there are more claims submitted. There have been many attempts by various political figures to modify these plans by adding co-payments or a small deductible. However, a study completed by the National Association of Insurance Commissioners found people who have plans that offer first dollar coverage (Plan F & Plan C) do not seek more medical services than those who have a co-pay or deductible. For now, it seems Medicare Supplement F is safe.
Source: medicaresupplementshop.com

Medicare Supplement Plan F

Medicare Supplement Plan F, administered by Premera Blue Cross, allows the use of any Medicare contracted physician or hospital nationwide. The plan is designed to supplement your Medicare coverage by reducing your out-of-pocket expenses and providing additional benefits. It pays some Medicare deductibles and coinsurances, but primarily supplements only those services covered by Medicare.
Source: wa.gov

Compare Medicare Advantage & Supplemental Plans

Medicare supplement plans offer benefits in addition to the benefits offered by 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

Tufts Health Plan Medicare Preferred

Posted by:  :  Category: Medicare

In 2017, our HMO plans earned 5 out of a possible 5 Stars by the Center for Medicare and Medicaid Services. This rating combines the scores our plans received for the various medical and/or prescription drug services our plans offer.
Source: tuftsmedicarepreferred.org

HealthCare Administrative Solution

Participating organizations include Blue Cross Blue Shield of Massachusetts, Boston Medical Center HealthNet Plan, CeltiCare Health, Fallon Health, Harvard Pilgrim Health Care, Health New England, Medical Network, Neighborhood Health Plan, New Hampshire Healthy Families, Tufts Health Plan and Tufts Health Public Plans. A board of directors governs HCAS and the organization is managed and operated by an Executive Director.
Source: hcasma.org

Tufts Health Plan Foundation

“The momentum is building around age-friendly communities, and we are excited to partner with state and local leaders in their work to consider and include older adults,” said Nora Moreno Cargie, vice president, corporate citizenship for Tufts Health Plan and president of its Foundation. “We are proud collaborators on initiatives that promote cross-sector conversations, address challenges and inequities facing communities, and advance policies and practices that support people of all ages.”
Source: tuftshealthplanfoundation.org

HealthCare Administrative Solution

NOTE: In the Final Rule published in the Federal Register on April 15, 2010, CMS clarified that providers “who have met the fraud, waste, and abuse certification requirements through enrollment into the Medicare program or accreditation as a Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) are deemed to have met the training and educational requirements for fraud, waste, and abuse.”
Source: hcasma.org

New Hampshire Insurance Department

Special Fraud Alert from the Office of Inspector General (OIG) The OIG has received credible information that some Durable Medical Equipment (DME) suppliers continue to use independent marketing firms to make unsolicited telephone calls to Medicare beneficiaries marketing Durable Medical Equipment.  Section 1834(a)(17)(A) of the Social Security Act prohibits unsolicited telemarketing by Durable Medical Equipment Suppliers.  Please contact the OIG, US Department of Health and Human Services at 617-565-2664 if you have any information about DME suppliers engaging in these activities. 
Source: nh.gov

Medicare and Medicaid: MyMedicare.gov Help

Posted by:  :  Category: Medicare

MyMedicare.gov is part of the Medicare.gov website. MyMedicare.gov is an optional, free, and secure site designed to help you check the status of your eligibility, enrollment, and other Medicare benefits. It also lets you access your claims information almost immediately after your claims are processed by Medicare and provides your preventive health information 24 hours a day, seven days a week.
Source: mymedicare.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

How Do I Renew My Medicare Card?

Most of the time, it is easy to get a Medicare card renewed. The process can become frustrating, however, if the person needing to renew their Medicare card does not have the proper forms and identification. Some methods of renewing the Medicare card are: In person at the outlet store that offers this service, online renewal available by some states, or by phone. Some have said that a person cannot renew their card over the phone, but there have been a large number of Medicare card holders who have.
Source: seniorcorps.org

Brea man gets decade in prison in $2.9 million dollar Medicare fraud

Posted by:  :  Category: Medicare

Last month, Hong also pleaded guilty to committing health care fraud in a separate scheme, which federal authorities say involved claims for occupational- and physical-therapy services that were not actually provided to patients. The Medicare losses in the second scheme are estimated at $2.4 million, according to the Department of Justice.
Source: ocregister.com

Emergency department services

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

Donald Trump Gets Specific on Veteran's Affairs Policy Reform Plan

According to Trump, his plan will "ensure our veterans get the care they need wherever and whenever they need it," "support the whole veteran" by treating both their physical and mental health needs and "make the VA great again by firing the corrupt and incompetent VA executives who let our veterans down."
Source: nbcnews.com

Reading the Stars: Nursing Home Quality Star Ratings, Nationally and by State

Posted by:  :  Category: Medicare

In 2008, the Centers for Medicare and Medicaid Services (CMS) launched the Five-Star Quality Rating System on its Nursing Home Compare website to provide summary information to help consumers choose a nursing home in their area. CMS recently modified the methodology of these ratings, began posting more information about nursing home deficiencies from state health inspections, and is planning future steps to increase the star ratings’ reliability, as required by certain provisions in The Affordable Care Act (ACA) and the Improving Medicare Post-Acute Care Transformation Act (IMPACT). This issue brief presents national and state-level analysis of nursing homes quality scores based on these five-star ratings and discusses relevant policy considerations.
Source: kff.org

Reading the Stars: Nursing Home Quality Star Ratings, Nationally and by State

The nursing home population includes some of the oldest, frailest, more medically compromised and cognitively impaired people covered by Medicare or Medicaid. Nursing home residents—both short-term and longer term residents—are particularly at risk because they are often unable to care for themselves, and dependent on others to get by on a day-to-day basis. Medicare and Medicaid, which together account for more than half of all nursing home revenue, require facilities to meet minimum federal standards to help safeguard the health and safety of nursing home residents. Further, CMS has developed and improved the Nursing Home Compare website to provide consumers with both detailed and summary information on nursing home quality. Nonetheless, researchers, reporters and advocates have continued to identify serious quality concerns among some of the nation’s nursing homes, including those that relate to inadequate staffing, high rates of preventable conditions, such as pressure ulcers (bedsores), and fire safety hazards. A recent study, for example, found that almost one in five nursing homes had deficiencies that caused harm or immediate jeopardy to residents.
Source: kff.org

PQA Measures Used By CMS in the Star Ratings & As Display Ratings Program

Understanding the CMS Quality Evaluation System There are multiple components to CMS’ evaluation of medication-related quality across Medicare Parts C and D. CMS creates plan ratings that indicate the quality of Medicare plans on a scale of 1 to 5 stars with 5 stars being the highest rating. The overall star rating is determined through numerous performance measures across several domains of performance. Each measure is awarded a star rating and the individual measure stars are then aggregated at the domain and summary level. Only a small number of plans receive a 5-star summary rating from CMS, with most plans receiving 3 to 4 stars. Medicare Advantage plans that include drug benefits (MA-PDs) are rated on performance measures for Parts C and D. For Part C, a subset of the HEDIS measure set from NCQA is used for evaluation. Medicare Part D stars are applicable to MA-PDs and stand-alone PDPs. The stars are assigned based on performance measures across four domains. The four Part D domains are: 1. Drug Plan Customer Service 2. Member Complaints, Problems Getting Services, and Choosing to Leave the Plan 3. Member Experience with Drug Plan 4. Drug Pricing & Patient Safety There are 15 individual measures of quality in the 2016 Part D ratings based on 2014 prescription drug claims). Medication safety and adherence measures are in the domain of Drug Pricing & Patient Safety. Five PQA measures are included in this domain for the 2016 Star Ratings. These include three of PQA’s medication adherence measures in the following therapeutic categories: HMG-CoA inhibitors (statins), Renin Angiotensin System Antagonists, and Oral Diabetes Medications. Two measures of medications safety or MTM are also included, High risk medications in the elderly and Comprehensive Medication Review (CMR) Completion Rate. The CMR Completion Rate measure is new for 2016. Each measure is assigned a weighting factor. Outcomes and Intermediate outcomes are weighted higher. The PQA measures in the plan ratings and their respective weighting are described on the following page. In addition to the plan ratings, CMS also uses the “Display Measures” to provide further evaluation of Part D plans. The Display Measures are not included in the plan ratings, but are used to facilitate quality improvement by the plans. The Display Measures include three PQA-supported measures of medication safety (drug-drug interactions; excessive doses of oral diabetes medications; Statin Use in Persons with Diabetes). An additional measure, HIV antiretroviral medication adherence, is reported to plans in their Safety Reports. CMS maintains a “Patient Safety website” that provides the benchmarks and scores to the plans across both the Display Measure and Plan Ratings Measures. Who Manages the Star Ratings System? CMS manages the star ratings system and uses contractor support for this effort. For example, CMS contracts with Acumen, LLC for the analyses of Medicare data to generate the rates for the medication measures. PQA maintains the PQA-supported performance measures and updates the technical specifications and drug-code lists for the measures every six months. PQA also shares new measures that are endorsed by PQA with CMS and provides some technical guidance on the use of the measures within the plan ratings. CMS tests updates to the PQA-supported measure specifications and drug-code lists and implements these as they deem appropriate.
Source: pqaalliance.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

Australian Psychological Society : Medicare and psychology

Medicare benefits are available for a range of specified psychology services for people with certain conditions, as summarised below. To receive psychological services under Medicare, a person must be referred by his/her GP or in some instances by a psychiatrist or a paediatrician. The full requirements for provision of psychological services in the following areas must be understood before services are provided. Select from the options below or browse the A-Z topic list. 
Source: org.au

More Medicare Information

If you live in Puerto Rico you will not receive Medicare Medical Insurance (Medicare Part B) automatically. You will need to sign up for it during your initial enrollment period or you will pay a penalty. To sign up, please call our toll-free number at 1-800-772-1213 (TTY 1-800-325-0778). You also may contact your local Social Security office. You can find your local Social Security office by using our Office Locator.
Source: ssa.gov