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

Registration & Attestation

CMS allows an eligible professional to designate a third party to register and attest on his or her behalf. To do so, users working on behalf of an eligible professional must have an Identity and Access Management System (I&A) web user account (User ID/Password), and be associated to the eligible professional’s National Provider Identifier (NPI). If you are working on behalf of one or more eligible professionals and do not have an I&A web user account, please visit I&A Security Check to create one. (Note: States will not necessarily offer the same functionality for registration and attestation in the Medicaid EHR Incentive Program. Check with your State to see what functionality will be offered.)
Source: cms.gov

Medicare enrolment application form (3101)

This information was printed Wednesday 19 April 2017 from humanservices.gov.au/customer/forms/3101 It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.
Source: gov.au

Medicare Coverage Database – Centers for Medicare & Medicaid Services

Posted by:  :  Category: Medicare

01/12/2017: CMS has determined that the Medicare Administrative Contractors (MACs) in Jurisdictions 5, 6, 8 and 15 will not be further consolidated. It is anticipated that for these four (4) jurisdictions, their LCDs and Articles details pages will be updated in late April 2017 to reflect their numbered jurisdiction. The display on the document detail pages will be changed from “N/A” to the specific jurisdiction number  in the Jurisdiction Column.  Currently, other MAC jurisdictions have their lettered jurisdiction displayed in this field.
Source: cms.gov

Get Medicare Part D Quotes in Seconds

As could be expected, prices for Humana policies rocketed for the 2015 calendar year. Mean premiums for Humana Part D jumped from $21.80 to $38.70. Medicare Part D is priced at $41.55 and Part D Medicare comes in at the slightly lower price of $38.80. Humana’s standalone market share coverage has dropped to 18.6% whereas their Medicare Part D policies have increased to a market share of 12.8%.
Source: medicareaide.com

How Original Medicare works

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’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

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 Advantage Plan, Original Medicare Choices

Medicare Advantage (MA) offers an alternative way of receiving your benefits through local or regional private plans, which are most often health maintenance organizations (HMOs) or preferred provider organizations (PPOs). Each plan must include everything covered by traditional Medicare, but may offer more benefits and/or lower copays. Most plans charge a monthly premium (in addition to the Part B premium), and most include Part D drug coverage. Your choice of doctors and other providers may be restricted to those in the plan’s network and geographical area—although PPOs allow you to go out of network for a higher copay. Each plan can, each calendar year, change its premiums, its extra benefits and its copays, or withdraw from Medicare You cannot buy a medigap policy to cover out-of-pocket costs in a Medicare Advantage plan. But each plan has an annual limit on out-of-pocket costs.
Source: aarp.org

How Original Medicare, Medicare Advantage differ

For example, your Medicare Advantage plan might have a $15 copay when you see the doctor. That means you’ll pay $15 every time you see the doctor, no matter how much the visit costs your health insurance company. If you have Original Medicare, you’ll pay 20 percent of the total cost of the visit. If the visit costs $200, you pay $40.
Source: bcbsm.com

Medicare Guide: Original Medicare only covers 80% of Part B

“One of the tips for shopping for a Medigap plan is that when you’re looking at a certain plan, the cost can vary. But all the insurance and all the coverage is the same, so, in that situation, you can really pick by price when you’re in that sleeve,” she says. “You’re not going to get more from a Plan F if you pay more for a different company’s plan.”
Source: nydailynews.com

Pay Part A & Part B premiums

Posted by:  :  Category: Medicare

4. Pay by credit card or debit card. Complete the bottom portion of the payment coupon on your Medicare bill, and sign it. You’ll need to provide the account information as it appears on your card and the expiration date. Most credit cards today only have the month and year in expiration date field. If your credit card only has a month and year in the expiration date, fill in the month and year on the payment coupon and leave the day field blank. Mail your payment to the address above.
Source: medicare.gov

Medicare 2017 costs at a glance

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 Provider Utilization and Payment Data: Physician and Other Supplier

The Physician and Other Supplier Public Use File (Physician and Other Supplier PUF) provides information on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. The Physician and Other Supplier PUF contains information on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service. This PUF is based on information from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program. The data in the Physician and Other Supplier PUF covers calendar years 2012 through 2014 and contains 100% final-action physician/supplier Part B non-institutional line items for the Medicare fee-for-service population.
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

Australian Psychological Society : Medicare rebates for mental health services provided by psychologists: Information for clients

Posted by:  :  Category: Medicare

Psychologists study the way people feel, think, act and interact. Through a range of strategies and therapies they aim to reduce distress and to enhance and promote emotional wellbeing. Psychologists are experts in human behaviour, and have studied the brain, memory, learning and human development. Psychologists can assist people who are having difficulty controlling their emotions, thinking and behaviour, including those with mental health problems such as anxiety and depression, serious and enduring mental illness, addictive behaviours and childhood behaviour disorders.
Source: org.au

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

Medicare Rebates for Psychology Treatment

PLEASE NOTE: Psychologists are able to offer you private health fund rebates if you have extras cover. Depending upon your health fund, you may be eligible for rebates for both individual and group therapy. These rebates significantly reduce the cost of your treatment. If you are unsure what your entitlements are, you are advised to check with your health fund before commencing treatment. You are not entitled to claim both your Medicare rebate and your private health fund rebate for any one given psychological session, you either claim under Medicare or under your private health fund, but not both.
Source: com.au

What is covered by Medicare?

Medicare is the basis of Australia’s health care system and covers many health care costs. You can choose whether to have Medicare cover only, or a combination of Medicare and private health insurance. Citizens and most permanent Australian residents are eligible for Medicare.
Source: gov.au

Medicare Information and Plan Comparisons

Posted by:  :  Category: Medicare

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

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 and Medical Insurance

While in the Catastrophic Benefit Period, in 2017, beneficiaries will be charged $3.30 for those generic or preferred multisource drugs with a retail price under $66 and 5% for those with a retail price greater than $66. For brand-name drugs, beneficiaries would pay $8.25 for those drugs with a retail price under $165 and 5% for those with a retail price over $165. Minimum beneficiary cost sharing in Catastrophic Benefit Period:  the greater of 5% or $2.65 (Generic drugs) and the greater of 5% or $6.60 (Brand-name drugs)
Source: joebaugher.com

Health Insurance, Medicare Insurance and Dental Insurance

At Humana, we go beyond insurance. We help provide a roadmap to a healthier you. By taking a personalized look at your life and your health, we can help you find the perfect plan and achieve your goals. Start becoming your best you. Start with healthy.
Source: humana.com

CHAMPVA SUPPLEMENTAL INSURANCE

Posted by:  :  Category: Medicare

An eligible CHAMPVA sponsor may be entitled to receive medical care through the VA health care system based on his or her own veteran status. Additionally, as the result of a recent policy change, if the eligible CHAMPVA sponsor is the spouse of another eligible CHAMPVA sponsor, both may now be eligible for CHAMPVA benefits. In each instance where the eligible spouse requires medical attention, he or she may choose the VA health care system or coverage under CHAMPVA for his/her health care needs. If you have been previously denied CHAMPVA benefits and you believe you would now be qualified, please submit an application following the guidelines as listed on the “How to apply” section.
Source: champva.us

Health Care Benefits for Dependents (CHAMPVA)

The Civilian Health and Medical Program of the Department of Veteran’s Affairs (VA) (CHAMPVA) is a comprehensive health care benefits program in which the VA shares the cost of covered health care services and supplies with eligible beneficiaries. The program is administered by the Chief Business Office Purchased Care located in Denver, Colorado. Due to the similarity between CHAMPVA and the TRICARE program (sometimes referred to by its old name, CHAMPUS) the two are often mistaken for each other. CHAMPVA is a VA program, whereas TRICARE is a DoD regionally-managed health care program for active duty and retired members of the uniformed services, their families, and survivors. In some cases a person may appear eligible for either program. However, anyone eligible for TRICARE is not eligible for CHAMPVA.
Source: benefits.gov

TRICARE and CHAMPVA Supplemental Insurance for Veterans

CHAMPVA is a program sponsored the Department of Veterans Affairs (VA) that helps pay for the cost of medical care. In order to be eligible for CHAMPVA, the individual cannot be eligible for TRICARE. CHAMPVA is available to the spouse or widow(er) and to the children of a 100% disabled veteran. While CHAMPVA helps pay for a portion of medical care, a supplemental insurance can help fill in the coverage gaps.
Source: vfwinsurance.com

CHAMPVA Supplemental Insurance

Yes, if you live or travel overseas (excluding Iraq, North Korea and Cuba), the supplement provides the same benefits as if you were in the U.S. Reimbursement for health care claims in foreign countries is based on reasonable and customary billed amounts. Your deductible and cost share will be the same as if you were in the U.S. Medicare does not provide benefits for services provided overseas. However, if you are 65 or over, you must enroll in Medicare Part B. CHAMPVA will continue as your primary benefit option for the period of time you are overseas. As a result, the CHAMPVA Supplement Plan will also continue. You will receive the same level of benefits provided to those under age 65.
Source: champva.us

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

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 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

Turning Medicare Into a Premium Support System: Frequently Asked Questions

An important issue for plans (and consumers) is how the Medicare marketplace would be governed.  In many proposals for a premium support system, it is unclear how the marketplace would be regulated or even which federal agency would regulate it.  Many premium support proposals would maintain an annual open enrollment period, guaranteed issue requirements, and some form of risk adjustment.  However, other factors that affect plans would change or are not specified.  For example, many proposals do not specify whether premiums would be community rated or age-rated, or whether plans would be required to offer Medicare benefits.  Many proposals would also “grandfather” current beneficiaries (not requiring them to enroll in the premium support system) which would create two separate systems – one for beneficiaries who are “grandfathered” and a separate system for new enrollees aging onto the program – and insurers could be required to maintain plans that operate under two different sets of rules and payments.
Source: kff.org

Original Medicare (Part A and B) Eligibility and Enrollment

Posted by:  :  Category: Medicare

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

Learn What to do If you Already Have Medicare Health Coverage

Yes. Coverage from an employer through the SHOP Marketplace is treated the same as coverage from any job-based health plan. If you’re getting health coverage from an employer through the SHOP Marketplace based on your or your spouse’s current job, Medicare Secondary Payer rules apply.
Source: healthcare.gov

What does Medicare cover (Parts A, B, C, and D)?

companies to provide Medicare benefits. These Medicare private health plans, such as HMOs and PPOs, are known as Medicare Advantage Plans. If you want, you can choose to get your Medicare coverage through a Medicare Advantage Plan instead of through Original Medicare.
Source: medicareinteractive.org

State of Oregon: Oregon Health Plan

Posted by:  :  Category: Medicare

The state remains committed to ensuring all Oregonians have access to high-quality, affordable health care. OHA is committed to working with our federal partners to continue the success we’ve had in our state. In the meantime we’ll stay true to Oregon’s track record of health innovation and our success in delivering greater access, better outcomes and lower costs for Oregonians.
Source: oregon.gov

Health Insurance, Central Oregon, and the Pacific Northwest

We offer Individual and Group Health insurance through all the major carriers in Oregon. Our goal is to help individuals, families, and businesses find the best plan based on their needs at the best value. We are here to assist with plan design, coverage questions, and the quoting process. With over twelve years of experience we are familiar with the challenges in the health insurance field. Whether you are looking for a Health Plan, Dental, Vision, or Medical Supplement we are here to advise.
Source: cascadehealthinsurance.com

Moda Health — Provider of Group and Individual Dental and Medical Insurance Plans

If you are creating an account for an adult member of your family, that member must have given you permission to set up an account in his/her behalf. If permission has not been provided, you may be violating the privacy of that individual’s information.
Source: modahealth.com

Oregon Individual & Family Health Plans

Depending on the health insurance company, Oregon individual and family health insurance rates for couples can be based on the age of the youngest person on the policy. Some couples with an age difference of several years may find they save money by applying for the same plan rather than individually. Couples that are only a few years apart might be able to reduce their total costs by applying for separate health insurance plans. If you decide to apply for a health insurance plan as a couple, make sure the plan you choose covers the benefits both of you need.
Source: ehealthinsurance.com

Oregon health insurance: find affordable coverage

When it comes to overall health, The Commonwealth Fund’s Scorecard on State Health System Performance for 2015 ranked Oregon 15th out of the 50 states – a dramatic jump from its 24th ranking in 2014. The state performed 31 percent better from one year to the next, seeing improvements in all five categories: Access & Affordability, Prevention & Treatment, Avoidable Hospital Use & Cost, Equity, and Health Lives. Were the state to see 208,313 more adults obtain health insurance, it would improve to the level of the best-performing state for that indicator. Its ranking for percentage of uninsured adults ages 18 to 64 was 23rd.
Source: healthinsurance.org

LifeWise Health Plan of Oregon Home

LifeWise Health Plan has exited the state of Oregon. For current LifeWise customers, coverage will continue through the duration of their current plan year, with most plans ending by Dec. 31, 2016. Learn more.
Source: lifewiseor.com