Quality Laboratory Services

Posted by:  :  Category: Medicare

QLS recently invested in the future of clinical testing by purchasing cutting-edge instrumentation from leading diagnostic manufacturers. With a substantial daily volume ordered by more than 5,000 physicians, clinics, and nursing homes, Quality Laboratory Services remains steadfastly vigilant in providing the most precise and accurate results possible due to its state-of-the-art methodologies.
Source: qualitylaboratory.com

SNP Model Of Care (MOC) Summaries

Models of Care (MOCs) are considered a vital quality improvement tool and integral component for ensuring that the unique needs of each beneficiary enrolled in a Special Needs Plan (SNP) are identified and addressed. In 2010, the Patient Protection and Affordable Care Act (ACA) reinforced the importance of the MOC as a fundamental component of SNP quality improvement by requiring the National Committee for Quality Assurance (NCQA) to execute the review and approval of SNPs’ MOC based on standards and scoring criteria established by CMS. The MOC is comprised of the following clinical and non-clinical elements:
Source: cms.gov

Primary Care Doctors & Specialists in NYC

View your health record and manage your care with our myACPNY patient portal.  Communicate securely with your doctor and Care Team, view lab results, get Rx refills and more—any time, anywhere.
Source: acpny.com

Children’s Health Insurance Program (CHIP) Eligibility Requirements

Posted by:  :  Category: Medicare

Fill out an application through the Health Insurance Marketplace. If it looks like anyone in your household qualifies for Medicaid or CHIP, we’ll send your information to your state agency. They’ll contact you about enrollment. When you submit your Marketplace application, you’ll also find out if you qualify for an individual insurance plan with savings based on your income instead. Create an account or log in to an existing account to get started.
Source: healthcare.gov

Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) provides health coverage to eligible children, through both Medicaid and separate CHIP programs. CHIP is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.
Source: medicaid.gov

Contact Information and Websites of Organizations for Medicare

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Source: medicare.gov

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

Health Insurance Programs

Report of the Commissioner of Health and Insurance Superintendent to Governor David A. Paterson on the Partnership for Coverage Initiative on the Release of the Urban Institute Report, July 17, 2009 (PDF, 90KB)
Source: ny.gov

Costs of Medigap Policies

Posted by:  :  Category: Medicare

If you buy a Medicare SELECT policy: Medicare SELECT is a type of Medigap policy sold by some insurance companies in some states. If you buy a Medicare SELECT policy, you are buying one of the 10 standardized Medigap Plans A through N. Medicare SELECT policies require you to use specific hospitals and, in some cases, specific doctors to get full insurance benefits (except in an emergency). Generally, Medicare SELECT policies cost less than other Medigap policies. If you have a Medicare SELECT policy and you don’t use a Medicare SELECT hospital or doctor for non-emergency services, your costs will be higher. You will have to pay some or all of what Medicare doesn’t pay. Medicare will pay its share of approved charges no matter which hospital or doctor you choose.
Source: medicare.gov

Compare Medicare Supplement (Medigap) Plans and Rates in Your Area

"Times have changed since my mother had an AARP J plan and I was totally confused by the options available. Stan walked me through the process in a very educational, methodical, friendly way, and I feel secure now that we’re making the correct decision to provide the best possible coverage for my husband." – Pat K.
Source: medigap360.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

Michigan Medicare Supplements

Medigap Companies: Admiral Life Insurance Aetna Life Insurance American Continental Insurance American National Life Insurance Anthem Life American Pioneer Life Insurance American Republic Insurance Bankers Fidelity Life Insurance Blue Cross and Blue Shield Central Reserve Life Insurance Christian Fidelity Life Insurance Combined Insurance Company Conseco Insurance Company Continental General Insurance Continental Life Insurance Company Equitable Life and Casualty Insurance Family Life Insurance Company Forethought Insurance Company Genworth Life Insurance Company Gerber Life Insurance Company Globe Life and Accident Insurance Golden Rule Insurance Company Great American Life Insurance Guarantee Trust Life Insurance Humana Insurance Company Lincoln Heritage Life Insurance Loyal American Life Insurance Marquette National Life Insurance Mutual of Omaha Insurance Company National States Insurance Company New Era Life Insurance Company Old Surety Life Insurance Company Pacificare Life Assurance Company Pennsylvania Life Insurance Company Philadelphia American Life Insurance Physician’s Life Insurance Company Provident American Life & Health Reserve National Insurance Company Royal Neighbors of America Sierra Health and Life Insurance Southwest Service Life Insurance Standard Life and Accident Insurance State Mutual Insurance Company Sterling Investors Life Insurance Sterling Life Insurance Company Unicare United American Insurance Company United Commercial Travelers (UCT) United National Life Insurance United of Omaha Life Insurance United Teacher Associates United World World Corp Insurance Company
Source: medigap360.com

Medicare: What Are Medigap Plans?

However, you may have to wait up to six months for coverage if you have a pre-existing health condition. The insurer through which you buy your Medigap policy can refuse to cover out-of-pocket costs for pre-existing conditions during that period. After six months, the Medigap policy must cover the pre-existing condition. The exception to this rule is if you buy a Medigap policy during your open enrollment period and have had continuous “creditable coverage,” or a health insurance policy for the six months before buying a policy. The Medigap insurance company cannot withhold coverage for a pre-existing condition in that case.
Source: webmd.com

Supplemental Security Income (SSI) Benefits

Posted by:  :  Category: Medicare

Although this is not a SSI application, we can use most of the information you provide to start the disability process. Once you finish the online process, a Social Security representative will contact you for any additional information needed for the SSI application.
Source: ssa.gov

Benefits for People with Disabilities

The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. While these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.
Source: ssa.gov

Social Security Disability Insurance

Generally, the person qualifying for benefits is determined to be capable of managing their own financial affairs, and the benefits are disbursed directly to them. In the case of persons who have a diagnosed mental impairment which interferes with their ability to manage their own finances, the Social Security Administration may require that the person assign someone to be their representative payee. This person will receive the benefits on behalf of the disabled individual, and disburse them directly to payers such as landlords, or to the disabled person, while providing money management assistance (help with purchasing items, limiting spending money, etc.). The representative payee often does not charge a fee for this service, especially if it’s a friend or relative. Social service agencies who are assigned as payee are NOT prohibited from charging a fee, although the maximum fee is set by Social Security. The fee is the same for ALL recipients, except it can be larger for those with severe substance abuse problems (Social Security determines when a higher fee can be charged, not the representative payee.) Some states and counties have representative payee agencies (also called substitute payee programs) which receive the benefits on behalf of the disabled person’s social worker, and disburse the benefits per the social worker’s instructions. A payee can be very helpful in the instance of homeless individuals who need assistance paying down debts (like utility bills) and saving for housing.
Source: wikipedia.org

What is Social Security Disability Insurance?

Many beneficiaries have multiple conditions. Of the nearly 8.9 million individuals receiving disabled worker benefits at the end of 2013, 31 percent had mental impairments as the main disabling condition, or primary diagnosis. They include 4 percent with intellectual disability and 27 percent with other mental disorders. Musculoskeletal conditions – such as arthritis, back injuries and other disorders of the skeleton and connective tissues – were the main condition for 31 percent of the disabled workers. (Musculoskeletal conditions were more common among beneficiaries over the age of 50.) About 8 percent had heart disease or other conditions of the circulatory system as their primary diagnosis. Another 9 percent had impairments of the nervous system and sense organs. The remaining 21 percent include those with injuries, cancers, infectious diseases, metabolic and endocrine diseases, such as diabetes, diseases of the respiratory system and diseases of other body systems. Moreover, many beneficiaries have life-threatening conditions: about 1 in 5 men and nearly 1 in 6 women who enter the program die within five years.
Source: nasi.org

Health coverage options for people who get Social Security Disability Insurance (SSDI)

One exception: If you enrolled in a Marketplace plan before getting Medicare, you can keep your Marketplace plan as supplemental insurance when you enroll in Medicare. But if you do this, you’ll lose any premium tax credits and other savings for your Marketplace plan.
Source: healthcare.gov

Social Security Disability Application Help, Online Application Forms

By clicking the “I CONSENT” button, you give permission for GAR Disability Advocates, LLC and/or CBC Settlement Funding, LLC to call or email you regarding our services at the phone number that you have provided in the form above, even if that phone number is a wireless number and even if you have previously registered that phone number on a “do not call” list. You agree that GAR Disability Advocates, LLC may use an automatic telephone dialing system or artificial or prerecorded voice to contact you at the phone number you provided. You understand that giving permission to being contacted is not a condition of purchase or acceptance of property, goods or services of any kind.
Source: disabilityapplicationhelp.org

Social Security (United States)

Due to changing needs or personal preferences, a person may go back to work after retiring. In this case, it is possible to get Social Security retirement or survivors benefits and work at the same time. A worker who is of full retirement age or older may (with spouse) keep all benefits, after taxes, regardless of earnings. But, if this worker or the worker’s spouse are younger than full retirement age and receiving benefits and earn “too much”, the benefits will be reduced. If working under full retirement age for the entire year and receiving benefits, Social Security deducts $1 from the worker’s benefit payments for every $2 earned above the annual limit of $15,120 (2013). Deductions cease when the benefits have been reduced to zero and the worker will get one more year of income and age credit, slightly increasing future benefits at retirement. For example, if you were receiving benefits of $1,230/month (the average benefit paid) or $14,760 a year and have an income of $29,520/year above the $15,120 limit ($44,640/year) you would lose all ($14,760) of your benefits. If you made $1,000 more than $15,200/year you would “only lose” $500 in benefits. You would get no benefits for the months you work until the $1 deduction for $2 income “squeeze” is satisfied. Your first social security check will be delayed for several months—the first check may only be a fraction of the “full” amount. The benefit deductions change in the year you reach full retirement age and are still working—Social Security only deducts $1 in benefits for every $3 you earn above $40,080 in 2013 for that year and has no deduction thereafter. The income limits change (presumably for inflation) year by year.
Source: wikipedia.org

Get Approved for Disability Benefits

Disability Approval Guide provides tips, news and FREE evaluations. If your disability qualifies, we match you instantly with local experienced representative to help get your benefits or compensation approved.
Source: disabilityapprovalguide.com

Compare Medicare Supplement (Medigap) Plans and Rates in Your Area

Posted by:  :  Category: Medicare

"Times have changed since my mother had an AARP J plan and I was totally confused by the options available. Stan walked me through the process in a very educational, methodical, friendly way, and I feel secure now that we’re making the correct decision to provide the best possible coverage for my husband." – Pat K.
Source: medigap360.com

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

How to compare Medigap policies

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Source: medicare.gov

Medicare Supplemental Insurance Rates

For those with very limited incomes, a supplemental insurance plan may be financially hard to maintain. If that is the case for you, check to see if there is a company that can offer you a payment plan to help you in paying your premiums. Insurance providers want your business, especially in tough economic times, and you may be able to find a company that will happily work with you. There may also be plans available that do not require you to pay a deductible or co-pay. These plans will save you money, even if the premium may be somewhat higher.
Source: mymedicare.com

Medicare Supplement Plans

To be eligible to enroll in a Medicare Supplement plan, you must be enrolled in both Medicare Part A and Part B. A good time to enroll in a plan is generally during the Medigap Open Enrollment Period, which begins on the first day of the month that you are both age 65 or older and enrolled in Part B, and lasts for six months. During this period, you have the guaranteed-issue right to join any Medicare Supplement plan available where you live. You may not be denied coverage based on any pre-existing conditions during this enrollment period (although a waiting period may apply). If you miss this enrollment period and attempt to enroll in the future, you may be denied coverage or charged a higher premium based on your medical history.
Source: ehealthinsurance.com

How to Report Fraud and Suspected Fraud

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 Fraud Reporting Center

Medicare Whistleblowers are typically healthcare professionals who are aware of hospitals, clinics, pharmacies, Nursing Homes, Hospices, long term care and other health care facilities that routinely overcharge or seek reimbursement from government programs for medical services not rendered, drugs not used, beds not slept in and ambulance rides not taken. If you have information about a person or a company that is cheating the Medicare program (or any other government run healthcare program), you may be able to collect a large financial reward for reporting it here.
Source: medicarefraudcenter.org

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

Questions About Your Benefits

If you need a ride to the doctor or dentist’s office, hospital, drug store or any place you get Medicaid services, call us toll-free: Live in the Houston / Beaumont area? Call 1-855-687-4786. Live in the Dallas area? Call 1-855-687-3255. Everyone else can call 1-877-633-8747 (1-877-MED-TRIP). To get a ride, you or your child must be on Medicaid or be in the Children with Special Health Care Needs program. You also must not have any other way to get to the doctor or drug store. Before you call for a ride you must have already set up a time to see a doctor. To get a ride:
Source: texas.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

Massachusetts Medicaid, Health Insurance Marketplace Plans | CeltiCare Health Plan

It may be time for you to renew your MassHealth eligibility. If so, you recently received a letter from MassHealth in the mail. You need to complete a new application by the date in your letter. If you don’t, you may lose your health insurance coverage. Read More…
Source: celticarehealthplan.com

Massachusetts Medicaid Eligibility & Benefits Guide

Have you ever checked to see if you and your family are eligible for Medicaid? It seems like a simple question, but there are many individuals and families in America who are unaware that they actually qualify for Medicaid either because their state expanded it under the Affordable Care Act or because they only make a certain amount of money each year in the states that did not.
Source: govthub.com

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

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