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

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Source: medicare.gov

Changes to Medicare With the Affordable Care Act

You can get most screening services without additional cost. Screenings are medical tests to find illnesses early, when they’re easier to treat. For instance, a mammogram is a screening for breast cancer. A colonoscopy checks for colon cancer. You can also be checked for diabetes, high blood pressure, and high cholesterol.
Source: webmd.com

5 Changes To Medicare in 2016 That May Raise Your Blood Pressure

Consider enrolling in Medicare now rather than waiting until 2016 if you are already eligible. You can also sign up for your Social Security benefits before the end of 2015 and enroll in the program to have your Medicare premiums deducted from your monthly payment. That will move you from the 30 percent “pick up the tab for everyone” group to the 70 percent “protected by no COLA” group. But if the reason you’ve been paying your premium directly is because you postponed collecting Social Security, the reduction in your Medicare Part B premium actually may not be enough of a savings to start Social Security before you intended. For each year after age 66 that you delay, there is an 8 percent increase in Social Security benefits (up until age 70) for life. Do the math.
Source: huffingtonpost.com

Medicare changes fiercely resisted

President Obama, in a journal article he wrote on ObamaCare in July, expressed his frustration with opposition to the changes, specifically citing the Medicare Part B drug proposal. He wrote that despite being able to work with some health groups, “others, like the pharmaceutical industry, oppose any change to drug pricing, no matter how justifiable and modest, because they believe it threatens their profits.”
Source: thehill.com

Home Health Agency (HHA) Center

The Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1648-F) that updates the Medicare Home Health Prospective Payment System (HH PPS) rates and wage index for calendar year (CY) 2017.  In the CY 2017 final rule, CMS implements the fourth and final year of the four year phase-in of the rebasing adjustments to the HH PPS payment rates as required by the Affordable Care Act.  In addition, CMS will decrease the national, standardized 60-day episode payment amount by 0.97 percent in CY 2017 to account for nominal case-mix growth between CY 2012 and CY 2014, which was not accounted for in the rebasing adjustments finalized in the CY 2014 HH PPS final rule.  CMS is also changing the methodology used to calculate outlier payments to a per-unit approach.  The CY 2017 final rule will result in a 0.7 percent decrease (-$130 million) in payments to HHAs.  
Source: cms.gov

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

MyMedicare.gov: Signing in for the First Time

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Source: mymedicare.gov

Getting started with Medicare

There are 2 main ways to get your Medicare coverage— Original Medicare or a Medicare Advantage Plan (like an HMO or PPO). Some people get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap). Learn about these coverage choices and 3 steps to help you decide how to get your coverage.
Source: medicare.gov

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 Advantage Drug Formulary

Generally, if you are taking a drug that was covered at the beginning of the year, we will not discontinue or reduce coverage of the drug during the coverage year except when we receive information from the FDA that a drug is no longer safe or effective. Complete information about these changes is included in the formulary documents above. Group Health Medicare Advantage plans cover both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.
Source: ghc.org

Medicare Plans for Different Needs

UnitedHealthcare is dedicated to helping people nationwide live healthier lives. Our goal is to simplify the health care experience, help you meet your health and wellness needs and carry on trusted relationships with care providers. We offer a wide range of Medicare Advantage, Medicare prescription drug and Medicare Special Needs Plans that might be a good fit for you.
Source: uhcmedicaresolutions.com

Medicare coverage of hospice care

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. The third benefit period begins on day 180 of hospice. After that, you must continue to have face-to-face meetings with a hospice doctor or nurse practitioner before the start of each following 60-day benefit period. The meeting must take place no earlier than 30 days before the new benefit period to confirm you still qualify for hospice care.
Source: medicareinteractive.org

Welcome to Arkansas Medicaid

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The Arkansas Department of Human Services (DHS), Division of Medical Services (DMS) is providing public notice of its intent to submit to the Centers of Medicare and Medicaid Services (CMS) a written application for extension and amendment of the 1115 Demonstration waiver for the Health Care Independence Program and to hold public hearings to receive comments on the extension application to the Demonstration Waiver. The State anticipates submitting an application to amend the Demonstration in fall of 2016 to replace the Health Care Independence Program implemented under the current 1115 waiver authority with Arkansas Works, a program reflecting the features now under consideration by the Governor, the Arkansas Legislative Task Force on Healthcare Reform, and the Arkansas Legislature.
Source: ar.us

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

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The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Australian Government Department of Human Services

This information was printed Thursday 3 November 2016 from humanservices.gov.au/ 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 Information, Help, and Plan Enrollment

Humana is a Medicare Advantage [HMO, PPO and PFFS] organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. [Benefits, premiums and/or member cost-share] may change on January 1 of each year. The [Formulary, pharmacy network, and/or provider network] may change at any time. You will receive notice when necessary.
Source: medicare.com

Australia’s Leading Health Insurance Provider

For kids we provide no hospital excess on every one of our family hospital covers. We also offer 100% back on included extras at Members’ Choice providers, as part of our Growing Family and Settled Families packaged covers. This only applies to child and student dependants. Only up to annual limits and waiting periods apply, including 12 months for some dental services.
Source: com.au

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

Medicare coverage of preventive care services

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You may have costs for some of these preventive services if your doctor makes a diagnosis during the service or does additional tests or procedures. Doctors do diagnostic tests and procedures when patients have distinct symptoms of a condition or a history of that condition.  For example, if your doctor finds and removes a polyp during a colonoscopy, the colonoscopy is diagnostic and costs will apply.  Also, if during your
Source: medicareinteractive.org

Medicare coverage of flu shots

The flu season usually runs from November through April. Therefore, Medicare may cover a flu shot twice in one calendar year. For example, if you get a shot in January 2015 for the 2014/2015 flu season, you could get another shot in October 2015 for the 2015/2016 flu season.
Source: medicareinteractive.org

How Original Medicare works

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Source: medicare.gov

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

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

What is Original Medicare?

Unless you choose otherwise, you will have Original Medicare. You can instead decide to get your Medicare benefits from a Medicare Advantage Plan, also called a Medicare private health plan. Remember, you still have Medicare if you enroll in a Medicare Advantage Plan. This means that you must still pay your monthly Part B premium (and your Part A premium, if you have one). Each Medicare Advantage Plan must provide all Part A and Part B services offered by Original Medicare, but can do so with different rules, costs, and restrictions that can affect how and when you receive care.
Source: medicareinteractive.org

Original Medicare Archives

You’re generally eligible for Original Medicare (Part A and Part B) when you turn 65 or receive disability benefits, whether or not you’re married. If you’re married and haven’t worked in a paying job or didn’t work enough quarters, you may still qualify for… Read more
Source: medicare.com

Original Medicare, Part A and Part B

Each year, you generally must pay a set amount (a deductible) for your health care before Medicare pays its share. Then, Medicare pays its share, and you pay your share (coinsurance) for covered services and supplies. If you have Medicare Part A, you can generally get the covered services listed in Part A Benefits. If you have Medicare Part B, you can generally get the covered services listed in Part B Benefits. You usually pay a monthly premium for Medicare Part B. You generally don’t need to file Medicare claims. Providers (like doctors, hospitals, skilled nursing facilities, and home health agencies) and suppliers are required by law to file Medicare claims for the covered services and supplies you get.
Source: ehealthmedicare.com

Original Medicare standard appeals

If your QIC appeal is successful, your service or item will be covered and you are done with your appeal. If your appeal is denied and your health item or service is worth at least $150 in 2016, you can move on to the third level of appeal – the Administrative Law Judge Hearing (ALJ).  You must file your appeal to the ALJ within 60 days of the date on your QIC denial letter. If you decide to appeal to the ALJ, you may want to contact a lawyer or legal services organization to help you with this or later steps in your appeal—but this is not required. The ALJ should issue a decision within 90 days.
Source: medicareinteractive.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 Provider Utilization and Payment Data

As part of the Obama administration’s work to make our health care system more affordable and accountable, data are being released that summarize the utilization and payments for procedures, services, and prescription drugs provided to Medicare beneficiaries by specific inpatient and outpatient hospitals, physicians, and other suppliers. These data include information for common inpatient and outpatient services, all physician and other supplier procedures and services, and all Part D prescriptions. Providers determine what they will charge for items, services, and procedures provided to patients and these charges are the amount that providers bill for an item, service, or procedure.
Source: cms.gov