The Affordable Care Act & Medicare

Posted by:  :  Category: Medicare

You can save money on brand-name drugs. If you’re in the donut hole, you’ll also get a 55% discount when buying Part D-covered brand-name prescription drugs (60% in 2017). The discount is applied automatically at the counter of your pharmacy—you don’t have to do anything to get it. The donut hole will be closed completely by 2020.
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

Medicare Reform: How Soon Will Donald Trump Take Action?

House Speaker Paul Ryan is eager to overhaul Medicare, the federal insurance program for 56 million Americans ages 65-plus and younger people with certain disabilities. He has said that any effort to repeal Obamacare would have to include changes to Medicare. His proposal would transition Medicare to a program of “premium support,” whereby beneficiaries would get a fixed contribution from the government toward their care. This would likely mean that beneficiaries who choose the most comprehensive coverage would have to shoulder a higher portion of the cost themselves.
Source: time.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

ObamaCare Medicare: ObamaCare and Medicare

ObamaCare now requires that Advantage plans cannot charge enrollees more than traditional Medicare for chemotherapy administration, skilled nursing home care and other specialized services. Starting in 2014, Medicare Advantage plans cannot spend more than 15 % of their Medicare payment on administrative costs, insurance company profits and non-healthcare related items. These cost cutting measures are estimated to bring in $1,000 in savings to CMS per Advantage Plan member without reducing any benefits. This is expected to help decrease Medicare part B payments, especially for low income seniors. Remember: Medicare Advantage Plans must provide at a minimum what Original Medicare covers.
Source: obamacarefacts.com

How to compare Medigap policies

Posted by:  :  Category: Medicare

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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

Medicare Supplement Plans

Some states may offer Medigap plan options to beneficiaries under 65 who qualify for Medicare because of disability or certain conditions (such as end-stage renal disease). Federal law doesn’t require states to sell Medicare Supplement insurance to beneficiaries under 65. However, depending on where you live, some states may offer Medigap coverage to beneficiaries under 65; eligibility and the specific available options may vary by state. If you’re a Medicare beneficiary under 65 and interested in purchasing Medicare Supplement insurance, contact your state insurance department to learn if you’re eligible for Medigap coverage in your state.
Source: ehealthinsurance.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

Check Medicare Eligibility at www.CheckMedicare.com.

Posted by:  :  Category: Medicare

1. 24 hour availability is not a guarantee of service uptime. It is merely hours of service operation under normal operating conditions.   2. Works Best with Internet Explorer 10 with a resolution of 1024×768 or higher. The newest versions of Chrome & Firefox are also supported.   3. Average response time is 3-6 seconds, but may be up to 1 minute during peak times. This response time is affected by various factors including, but not limited to, network congestion, CheckMedicare.com server load, and the status of the CMS Medicare HETS system. If you experience consistent response times over 6 seconds please feel free to contact CheckMedicare.com support for system status or assistance.   © 2009-2016 ICS Software, Ltd. All rights reserved. All other copyrights and trademarks are copyrights and trademarks of their respective owners. This disclaimer relates and applies to all pages and content served by ICS Software, Ltd.
Source: checkmedicare.com

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

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Source: medicare.gov

Costs in the coverage gap

Posted by:  :  Category: Medicare

Mr. Evans reaches the coverage gap in his Medicare drug plan. He goes to his pharmacy to fill a prescription for a covered generic drug. The price for the drug is $20, and there’s a $2 dispensing fee that gets added to the cost. Mr. Evans will pay 58% of the plan’s cost for the drug (51% in 2017) and dispensing fee ($22 x .58 = $12.76 in 2016; $22 x .51 = $11.22 in 2017). The $12.76 amount ($11.22 in 2017) he pays will be counted as out-of-pocket spending to help him get out of the coverage gap.
Source: medicare.gov

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

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Source: medicare.gov

Medicare Part D Coverage Gap (“Donut Hole”)

Coverage gap, also known as the “donut hole”: While in the coverage gap, you’ll pay 45% of the plan’s cost for brand-name drugs and 58% of the plan’s cost for generic drugs in 2016. You’re out of the coverage gap once your yearly out-of-pocket drug costs reach $4,850 in 2016. Once you have spent this amount, you’ve entered the catastrophic coverage phase. The costs paid by you or someone on your behalf (such as a spouse or loved one) for Part D medications on your plan’s formulary, or list of covered drugs, will count toward your out-of-pocket costs and help you get out of the coverage gap* Additionally, manufacturer discounts for brand-name drugs count towards reaching the spending limit that begins catastrophic coverage. If your plan requires you to get your prescription drugs from a participating pharmacy, make sure you do so, or else the costs may not apply towards getting out of the coverage gap. Keep in mind that costs that are paid for you by other insurance you may have, such as prescription drug coverage through an employer, won’t count towards your out-of-pocket spending.
Source: medicare.com

Medicare Part D coverage gap

The Medicare Part D coverage gap (informally known as the Medicare donut hole) is a period of consumer payment for prescription medication costs which lies between the initial coverage limit and the catastrophic-coverage threshold, when the consumer is a member of a Medicare Part D prescription-drug program administered by the United States federal government. The gap is reached after shared insurer payment – consumer payment for all covered prescription drugs reaches a government-set amount, and is left only after the consumer has paid full, unshared costs of an additional amount for the same prescriptions. Upon entering the gap, the prescription payments to date are re-set to $0 and continue until the maximum amount of the gap is reached: copayments made by the consumer up to the point of entering the gap are specifically not counted toward payment of the costs accruing while in the gap.
Source: wikipedia.org

The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid

State decisions about Medicaid expansion have implications for the potential scope of Medicaid under the ACA. If all states expanded their Medicaid programs, eligibility for Medicaid in non-expansion states would grow from less than half a million to 4.5 million. Though some of these people can currently purchase subsidized coverage through the Marketplace, there are advantages and disadvantages to Medicaid and private coverage in different states. For example, enrollees may face higher out-of-pocket costs and limited networks for Marketplace coverage than they would for Medicaid, whereas access to specialist care may be problematic in some state Medicaid programs. In addition, while people can enroll in Medicaid throughout the year, Marketplace enrollment is only available during a limited open enrollment period. Medicaid is designed to provide a safety net of coverage for low-income people, with benefits and provider networks targeted to this population and coverage available throughout the year as people’s circumstances change. There is no deadline for states to opt to expand Medicaid under the ACA, and debate continues in some states about whether to expand. If more states adopt the expansion, the coverage gap will shrink and more low-income adults will gain access to Medicaid eligibility.
Source: kff.org

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

Your Medicare coverage choices

Posted by:  :  Category: Medicare

There are 2 main ways to get your Medicare coverage— Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Some people get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap). Use these steps to help you decide what coverage you want:
Source: medicare.gov

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

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Source: medicare.gov

Medicare Information Source

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

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

Department of Human Services

SHIP produces and regularly updates charts detailing the various Medigap, Medicare Advantage and Part D drug plans offered in New Jersey. These charts have been posted here to help you compare plans and make an informed decision about which plan best fits your needs and budget. Please note, however, that since Medigap options and pricing can change at anytime during the year, it is recommended you call the company you are interested in to confirm the information/premiums provided on these charts prior to enrolling or making a coverage change. If you are receiving your Medicare coverage through
Source: nj.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

Georgia Medicaid: eligibility, enrollment and benefits

Some states have taken advantage of a part of the Affordable Care Act to expand Medicaid to adults under 65 who don’t have dependent children. The federal government is funding 100 percent of the expansion through 2016, but Georgia did not expand Medicaid during the first three years of implementation, so they missed out on the years of full federal funding. Starting in 2017, states will pay 5 percent of the cost of Medicaid expansion, and will pay 10 percent by 2020. After that, the 90/10 split between the federal and state governments will remain permanently in place.
Source: healthinsurance.org

Georgia Department of Community Health

ATLANTA (November 18, 2016) – Effective December 1, 2016 several individuals will take on key executive roles at the Georgia Department of Community Health (DCH) when Frank Berry assumes the role as Commissioner of the Department of Community Health.
Source: georgia.gov

What’s Medicare Supplement Insurance (Medigap)?

Posted by:  :  Category: Medicare

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

Medicare Supplement Plans

Some states may offer Medigap plan options to beneficiaries under 65 who qualify for Medicare because of disability or certain conditions (such as end-stage renal disease). Federal law doesn’t require states to sell Medicare Supplement insurance to beneficiaries under 65. However, depending on where you live, some states may offer Medigap coverage to beneficiaries under 65; eligibility and the specific available options may vary by state. If you’re a Medicare beneficiary under 65 and interested in purchasing Medicare Supplement insurance, contact your state insurance department to learn if you’re eligible for Medigap coverage in your state.
Source: ehealthinsurance.com

How to compare Medigap policies

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Source: medicare.gov

Medigap (Medicare Supplement Health Insurance)

A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will each pay its share of covered health care costs. Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium ($96.40 in 2011 for most beneficiaries). In addition, you will have to pay a premium to the Medigap insurance company. As long as you pay your premium, your Medigap policy is guaranteed renewable. This means it is automatically renewed each year. Your coverage will continue year after year as long as you pay your premium. In some states, insurance companies may refuse to renew a Medigap policy bought before 1992. Insurance companies can only sell you a “standardized” Medigap policy. Medigap policies must follow Federal and state laws. These laws protect you. The front of a Medigap policy must clearly identify it as “Medicare Supplement Insurance.” It’s important to compare Medigap policies, because costs can vary. The standardized Medigap policies that insurance companies offer must provide the same benefits. Generally, the only difference between Medigap policies sold by different insurance companies is the cost. You and your spouse must buy separate Medigap policies.Your Medigap policy won’t cover any health care costs for your spouse. Some Medigap policies also cover other extra benefits that aren’t covered by Medicare. You are guaranteed the right to buy a Medigap policy under certain circumstances. For more information on Medigap policies, you may call 1-800-633-4227 and ask for a free copy of the publication “Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare.” You may also call your State Health Insurance Assistance Program (SHIP) and your State Insurance Department. Phone numbers for these Departments and Programs in each State can be found in that publication.
Source: cms.gov

Raising the Age of Eligibility for Medicare to 67: An Updated Estimate of the Budgetary Effects

Posted by:  :  Category: Medicare

Outlays for Medicare would be lower under this option because fewer people would be eligible for the program than the number projected under current law. In addition, outlays for Social Security retirement benefits would decline slightly because raising the eligibility age for Medicare would induce some people to delay applying for retirement benefits. One reason is that some people apply for Social Security at the same time that they apply for Medicare; another reason is that this option would encourage some people to postpone retirement to maintain their employment-based health insurance coverage until they became eligible for Medicare. CBO expects that latter effect would be fairly small, however, because of two considerations: First, the proportion of people who currently leave the labor force at age 65 is only slightly larger than the proportion who leave at slightly younger or older ages, which suggests that maintaining employment-based coverage until the eligibility age for Medicare is not the determining factor in most people’s retirement decisions. Second, with the opening of the health insurance exchanges, workers who give up employment-based insurance by retiring will have access to an alternative source of coverage (and may qualify for subsidies if they are not eligible for Medicare). This option could also prompt more people to apply for Social Security disability benefits so they could qualify for Medicare before reaching the usual age of eligibility. However, in CBO’s view, that effect would be quite small, and it is not included in this estimate.
Source: cbo.gov

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

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Source: medicare.gov

Medicare Age In Information

Do I need to maintain Medicare B coverage to keep my State of Maine health insurance policy? Yes.  If Medicare cancels your Medicare B coverage due to non-payment of premiums, you will automatically lose health insurance coverage with the State of Maine.  You would not be eligible to re-enroll after cancellation unless you satisfy your Medicare B premiums and Medicare reinstates your Medicare B coverage without a break in coverage.  If you are dis-enrolled due to non-payment of Medicare B premiums on four (4) separate occasions, you will permanently lose your eligiblity and cannot re-enroll in the State of Maine health plan.
Source: maine.gov

If I retire at age 62, will I be eligible for Medicare at that time?

If you’ve worked at least 10 years (40 quarters) while paying Medicare taxes, there is no monthly premium for your Medicare Part A (hospital insurance) benefits. But if you haven’t worked, or worked less than 10 years, you may qualify for premium-free Part A when your spouse turns 62, if she or he has worked at least 10 years while paying Medicare taxes. However, to be eligible for Medicare, you need to be 65 years old. You also need to be an American citizen or legal permanent resident of at least five continuous years.
Source: ehealthmedicare.com

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

Find a Medicare Insurance Plan

  Notice: Because of the lingering effects of Hurricane Matthew, the Medicare Annual Enrollment Period deadline has been extended to 12/31/16 – plans will go into effect on 1/1/17. If you have yet to make your election you may still have time. For information on Blue Medicare, call us at 1-800-665-8037, 7 days a week, 8 a.m. to 8 p.m.
Source: bcbsnc.com

Medicare in North Carolina

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.
Source: ehealthmedicare.com

Contact Information and Websites of Organizations for Medicare

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Source: medicare.gov

Medicare in North Carolina

Medicare Advantage, or Medicare Part C, is an option that provides your Original Medicare benefits through insurance companies that contract with Medicare. Many of them include prescription drug coverage; these are called Medicare Advantage Prescription Drug plans. Not every Medicare Part C plan may be available in every county in North Carolina. You continue paying your Medicare Part B premium when you have any Medicare Advantage plan. Medicare Part D is optional prescription drug coverage available from insurers that contract with Medicare. You can enroll in a stand-alone Part D Prescription Drug Plan to add to your Part A and Part B coverage, or you can enroll in one Medicare Advantage Prescription Drug plan to provide all of this coverage. Medicare Supplement plans, also called Medigap plans, are optional insurance policies that may cover certain out-of-pocket costs not covered by Original Medicare. There’s a range of Medigap policies; some may cover deductibles, copayments, and limited foreign travel emergency health care. You must be enrolled in Original Medicare (Part A and Part B) to qualify for a Medigap plan.
Source: medicare.com

What’s Medicare Supplement Insurance (Medigap)?

Posted by:  :  Category: Medicare

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

Supplements & other insurance

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Source: medicare.gov

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

Medicare Supplement Plans

Medicare supplement insurance companies can only sell you a standardized Medicare supplement policy identified by letters A through N. Each standardized Medicare supplement insurance policy must offer the same basic benefits, no matter which insurance company sells it. Cost and customer service are usually the only difference between Medicare supplement policies sold by different insurance companies.
Source: mutualofomaha.com

Medicare Supplement Plans

Some states may offer Medigap plan options to beneficiaries under 65 who qualify for Medicare because of disability or certain conditions (such as end-stage renal disease). Federal law doesn’t require states to sell Medicare Supplement insurance to beneficiaries under 65. However, depending on where you live, some states may offer Medigap coverage to beneficiaries under 65; eligibility and the specific available options may vary by state. If you’re a Medicare beneficiary under 65 and interested in purchasing Medicare Supplement insurance, contact your state insurance department to learn if you’re eligible for Medigap coverage in your state.
Source: ehealthinsurance.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