Tufts Health Plan Medicare Preferred

Posted by:  :  Category: Medicare

In 2016, 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

Tufts Health Plan Provider Manual

Chapter 1: Tufts Health Plan overview (PDF) Chapter 2: Doing business with us (PDF) Chapter 3: Quality (PDF) Chapter 4: Clinical affairs:    Chapter 4A: Care management (PDF)    Chapter 4B: Behavioral health (PDF)    Chapter 4C: Pharmacy (PDF)    Chapter 4D: Utilization review (PDF) Chapter 5: Claims procedures (PDF) Chapter 6: Credentialing procedures (PDF) Chapter 7: Rights and responsibilities (PDF) Chapter 8: Tufts Health Provider Connect (PDF) Chapter 9: Tufts Health Unify (Medicare-Medicaid Plan) (PDF)
Source: network-health.org

Keep Your Goddamn Government Hands Off My Medicare!

Posted by:  :  Category: Medicare

Or, to paraphrase various wingnut emails I’ve received, perhaps this old timer ought to get a job instead of freeloading off the system. I mean, why should I pay taxes to finance this guy who refuses to work? Of course the realistic answer is that healthy Americans of any age who aren’t spending thousands of dollars a month on gouged health care premiums tend to strengthen both our communities and our broader economy — including my best interests as well. Rising tides, lifting boats and all that. Another argument I’ve heard, by the way, is that seniors and veterans have earned their socialist health care. To which I usually respond: I see. So socialized health care is a reward for a job well done? Can I quote you?
Source: huffingtonpost.com

MyMedicare.gov: Secure Sign In

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: mymedicare.gov

Part C and D Performance Data

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 Advantage Plan Star Ratings Conference

Our 2016 conference was a great success! Stay tuned for our 2017 program dates. Our Medicare Conference is the best place to understand how to increase enrollment in your plan by appealing to new and old beneficiaries, maintaining and improving satisfaction with existing enrollees, and meeting the newest compliance guidelines to reduce penalties and provide the highest quality of care. Take a look at the new highlights below for 2017.
Source: medicarestarratingconference.com

5 Star Medicare Advantage Plan Ratings 2016

One of CMS (The Centers for Medicare & Medicaid Services) most important Medicare goals is to make the quality of Medicare Advantage plans for their beneficiaries transparent. In this effort, advantage plans are each year are rated on a scale ranging from 1 to 5 stars. One star represents poor performance, while a five-star rating is considered excellent. Plan Ratings are published each year in fall, before the open enrollment period begins and beneficiaries may enroll in or switch plans.
Source: medicareanswers.org

How to Apply for Medicare Part B Online

Posted by:  :  Category: Medicare

Review the Medicare rules before registering for Part B. Register for Part A within three months of your 65th birthday. Consider whether you should apply for Part B. You may not want to apply for Part B if you are still working and have health insurance coverage for outpatient services, unless your employer has less than 20 employees. Most literature recommends Part B if your employer has less than 20 employees, since the Part B coverage is your primary insurance under that circumstance. You have eight months after you quit working or after your employee insurance coverage ends to apply for Part B coverage without additional penalties.
Source: ehow.com

Health First Colorado (Colorado's Medicaid Program)

Posted by:  :  Category: Medicare

See a full list of benefits and co-payments in the Health First Colorado Benefits & Services Overview and learn more about your coverage and how to use it in the latest Health First Colorado Member Handbook.
Source: colorado.gov

Colorado Medicaid: eligibility, enrollment and benefits

One of the Affordable Care Act’s primary strategies for reducing the uninsured rate is Medicaid expansion to cover low-income, non-elderly adults without dependent children. Medicaid expansion was a required element of the ACA as originally written. However, a coalition of states challenged Medicaid expansion and several other provisions of the ACA, and the case ended up before the Supreme Court in 2012. While the Court rejected most of the challenges, it did rule that Medicaid expansion was optional.
Source: healthinsurance.org

How Much You’ll Pay
For Medicare in 2011

Posted by:  :  Category: Medicare

Medicare just announced the 2011 rates for monthly premiums for Part B coverage of doctor’s visits and outpatient treatment and Part D coverage of prescription drugs. The big news for next year: For the first time, higher-income beneficiaries (about 5% of all Medicare recipients) will pay a Part D surcharge. They’ll pay the regular Part D premium to their private insurance plan and will pay the income-related adjustment to Medicare.
Source: kiplinger.com

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 Part A, B, C, & D PREMIUMS, DEDUCTIBLES FOR 2011

Part A premiums are decreasing because spending in 2010 was lower than expected and the Affordable Care Act implemented policies that lower Part A spending due to payment efficiencies and efforts related to waste, fraud and abuse.  Part B premiums are increasing because of growth in the use of services like outpatient hospital care, home health and physician-administered drugs.  In addition, the premium accounts for a likely Congressional action to avert a precipitous decrease in physician payments, which the Administration supports, and has occurred every year since 2003.  The Administration is committed to permanent reform of the physician payment formula. By law, the standard premium is set to cover one-fourth of the average cost of Part B services incurred by beneficiaries aged 65 and over, plus a contingency margin. The contingency margin is an amount appropriate to (i) cover incurred-but-unpaid claims costs, (ii) provide for possible variation between actual and projected costs, and (iii) amortize any surplus assets or unfunded liabilities.  The remaining Part B costs are financed by Federal general revenues.  (In 2011, $2.5 billion in Part B expenditures will be financed by the new fees on manufacturers and importers of brand-name prescription drugs under the Affordable Care Act.  The revenue from these fees reduces the standard Part B premium by $0.90.)
Source: q1medicare.com

2011 Premiums for Medicare Part B

Those who do not qualify under those conditions will be required to pay the new 2011 Part B premium of $115.40, which represents a 4.4 percent increase in premiums over 2010. This new rate is brought about by anticipated increases in what it costs to administer Part B benefits. Beneficiaries who make more than $85,000 individually or $170,000 jointly could face even higher premiums.
Source: emedicaresupplements.com

Compare Medicare Advantage & Supplemental Plans

Posted by:  :  Category: Medicare

Medicare Advantage insurance is offered by private insurance companies with a Medicare contract, and replaces Original Medicare Part A and Part B. You must continue to pay your Part B premiums. Medicare Advantage plans typically offer additional benefit options and have less cost-sharing than Original Medicare, and you may have to pay a monthly premium in return for the extra benefits. Medicare Advantage plans come in a variety of formats, such as HMO, PPO and PFFS plans, as well as special needs plans. Medicare beneficiaries can enroll in Medicare Advantage plans if they have Medicare Part A and Part B, but only during designated enrollment periods. These enrollment periods change from time-to-time, so please call us to get the most-up-to-date information.
Source: medicaresolutions.com

Medicare Supplement Comparison

Medicare Supplement policyholders may not go unscathed from the ongoing changes to Medicare. The decrease in the pool of healthcare providers who will accept Medicare in 2016 will limit the policyholder’s options. Reimbursement rates may also affect Medicare Supplement plans going forward with healthcare providers charging Part B excess charges to remedy situation to some extent. Along with the increase to Medicare Part B deductible may cause Medigap providers to increase the premiums for Plan F, and Plan G, which covers all or so of medical costs, more than what they would be normally raised.
Source: medicarehealthinsurancefacts.com

Medicare Advantage Plans By State, Plan Comparison

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location. ©2015 Aetna Inc. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or copayments/coinsurance may change on January 1 of each year. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. Our dual-eligible Special Needs Plan is available to anyone who has both Medical Assistance from the state and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help that you receive. Please contact the plan for further details. You must continue to pay your Medicare Part B premium. The Part B premium is covered for full-dual members. This information is available for free in other languages. Please call our customer service number at 1-866-865-0662 (TTY: 711) OR Coventry Health Care at 1-877-988-3589 (TTY: 711), 8 a.m. to 8 p.m., seven days, from October 1 – February 14; 8 a.m. to 8 p.m. Monday – Friday, from February 15 – September 30. Esta información está disponible en otros idiomas de manera gratuita. Comuníquese con Servicios al Cliente al 1-866-865-0662 (TTY: 711), de 8 am a 8 pm, siete días a la semana, desde el 1º de octubre hasta el 14 de febrero, y de 8 am a 8 pm, de lunes a viernes, desde el 15 de febrero hasta el 30 de septiembre. Medicare beneficiaries may also enroll in Coventry plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 7 to 14 days. You can call First Health Part D at 1-866-865-0662 (TTY: 711), 8 a.m. to 8 p.m., local time, seven days, from October 1 – February 14; 8 a.m. to 8 p.m. Monday – Friday, from February 15 – September 30, if you do not receive your mail-order drugs within this timeframe. Members may have the option to sign-up for automated mail-order delivery. Cost sharing for members who get “Extra Help” is the same at preferred and network pharmacies. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to www.aetnamedicare.com
Source: coventryhealthcare.com

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

Medicare Supplement Comparison Chart

Although there are several plans to choose from, comparing and contrasting Medicare Supplement Plans (also called Medigap) is relatively simple. The Centers for Medicare and Medicaid Services (CMS) has designed all Medicare Supplement Plans currently available. There are a total of 10 plans, and they are set up in a letter system ranging from “Plan A” to “Plan N”. All 10 Medigap plans are “Standardized”, meaning if you compared one particular letter plan, with another plan of the same letter offered by a different insurance company, the benefits would be identical. The only difference between companies is the price they charge.
Source: medicaresupplementsolutions.com

Comparison Chart of All 10 Medicare Supplement Plans & Policies

To view a more detailed description of benefits for a specific plan, select an option below: Medicare Supplement Plan A Medicare Supplement Plan B Medicare Supplement Plan C Medicare Supplement Plan D Medicare Supplement Plan E (no longer offered) Medicare Supplement Plan F Medicare Supplement Plan G Medicare Supplement Plan H (no longer offered) Medicare Supplement Plan I (no longer offered) Medicare Supplement Plan J (no longer ofered) Medicare Supplement Plan K Medicare Supplement Plan L Medicare Supplement Plan M Medicare Supplement Plan N
Source: medicaresupplementsolutions.com

Things to know about Medicare Advantage Plans

Posted by:  :  Category: Medicare

Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you’ll pay nothing for covered services. This limit may be different between Medicare Advantage Plans and can change each year. You should consider this when choosing a plan.
Source: medicare.gov

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 Plans & Coverage: Part A, Part B, Part C, Part D

Medicare is a federal insurance program that generally covers hospitalization expenses as well as doctor and medical expenses. To be eligible for Medicare, One must be a legal permanent resident for the past five years or a U.S. citizen 65 years or older, or younger with a qualifying disability.
Source: medicareconsumerguide.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

California Health Advocates

We provide accurate, unbiased information about Medicare benefits and long-term care for Californians. Learn how Medicare works, ways to supplement your coverage, about low-income programs, prescription drugs and your long-term care options.
Source: cahealthadvocates.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.gov Nursing Home Compare

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 Insurance guidelines for Home Medical Supplies, Mid

Posted by:  :  Category: Medicare

Both Medicare and private health insurance plans pay for a large portion or sometimes even all costs associated with many types of medical equipment used in the home. This type of equipment is referred to as durable medical equipment or home medical equipment. The guide below will help you understand the Medicare guidelines related to home medical equipment. Most health insurance plans have similar rules to Medicare, but you should know that all private health insurance plans vary and the specific rules of your plan may differ from these Medicare guidelines. We accept most of the major health insurance plans. We would be happy to work with you and your insurance company to help you understand how your plan works as it relates to home medical equipment needed by you or a loved one.
Source: midislandmedical.com