Medicare Premiums for 2011 Frozen or Hiked for Beneficiaries, Boomers

Posted by:  :  Category: Medicare

There will be three "standard" Part B premium levels next year, a situation brought about by the freezing of Social Security cost-of-living adjustments in 2010 and 2011. Under existing law, when COLAs do not rise, standard Part B premiums must be frozen too — but only for people whose premiums are deducted from their Social Security checks. This means that in 2011 many people will pay the same premiums as they did in 2009 or 2010, but others will pay the new higher standard amount for 2011.
Source: aarp.org

Medicare Premium rates, Medicare coinsurance rates, and Medicare deductibles Rates for 2011

Medicare Part A: Medicare part A pays for inpatient hospital care, skilled nursing facilities, and some other healthcare benefits. For each benefit period Medicare will pay all covered costs except the Medicare Part A deductible during the first 60 days (In 2011 the Medicare Part A deductible is $1,132), and coinsurance amounts for hospital stays that last between 60 days and no more than 150 days.
Source: medicareplanstoday.com

Annual Statistical Supplement, 2011

Beginning January 1, 2006, upon voluntary enrollment in either a stand-alone PDP or an integrated Medicare Advantage plan that offers Part D coverage in its benefit, subsidized prescription drug coverage. Most FDA-approved drugs and biologicals are covered. However, plans may set up formularies for their drug coverage, subject to certain statutory standards. (Drugs currently covered in Parts A and B remain covered there.) Part D coverage can consist of either standard coverage or an alternative design that provides the same actuarial value. (For an additional premium, plans may also offer supplemental coverage exceeding the value of basic coverage.) Standard Part D coverage is defined for 2006 as having a $250 deductible, with 25 percent coinsurance (or other actuarially equivalent amounts) for drug costs above the deductible and below the initial coverage limit of $2,250. The beneficiary is then responsible for all costs until the $3,600 out-of-pocket limit (which is equivalent to total drug costs of $5,100) is reached. For higher costs, there is catastrophic coverage; it requires enrollees to pay the greater of 5 percent coinsurance or a small copay ($2 for generic or preferred multisource brand and $5 for other drugs). After 2006, these benefit parameters are indexed to the growth in per capita Part D spending (see Table 2.C1). In determining out-of-pocket costs, only those amounts actually paid by the enrollee or another individual (and not reimbursed through insurance) are counted; the exception is cost-sharing assistance from Medicare’s low-income subsidies (certain beneficiaries with low incomes and modest assets will be eligible for certain subsidies that eliminate or reduce their Part D premiums, cost-sharing, or both) and from State Pharmacy Assistance Programs. A beneficiary premium, representing 25.5 percent of the cost of basic coverage on average, is required (except for certain low-income beneficiaries, as previously mentioned, who may pay a reduced or no premium). For PDPs and the drug portion of Medicare Advantage plans, the premium will be determined by a bid process; each plan’s premium will be 25.5 percent of the national weighted average plus or minus the difference between the plan’s bid and the average. To help them gain experience with the Medicare population, plans will be protected by a system of risk corridors, which allow Part D to assist with unexpected costs and to share in unexpected savings; after 2007, the risk corridors became less protective. To encourage employer and union plans to continue prescription drug coverage to Medicare retirees, subsidies to these plans are authorized; the plan must meet or exceed the value of standard Part D coverage, and the subsidy pays 28 percent of the allowable costs associated with enrollee prescription drug costs between a specified cost threshold ($250 in 2006, indexed thereafter) and a specified cost limit ($5,000 in 2006, indexed thereafter).
Source: ssa.gov

2011 Medicare Part D Program Compared to 2010, 2009, 2008 and 2007

Pharmaceutical manufacturers will be required to provide certain beneficiaries access to discount prices for certain brand drugs purchased under Medicare Part D. The manufacturer discount prices will be equal to 50% of the plan’s negotiated price defined (minus any applicable dispensing fees). These discount prices must be applied prior to any prescription drug coverage or financial assistance provided under other health benefit plans or programs and after any supplemental benefits provided under the Part D plan. The discounted prices will be charged at the pharmacy (point-of-sale). The beneficiary will not have to do additional paperwork, etc. to receive the benefit. These manufacturer discount prices will be made available to Part D enrollees who are in the coverage gap or donut hole (they have reached or exceeded the initial coverage limit and have incurred costs below the annual out-of-pocket threshold). Medicare beneficiaries will not be eligible to receive these discount prices if they are enrolled in a qualified retiree prescription drug plan or are eligible for the low-income subsidy. The costs paid by manufacturers towards the negotiated prices of drugs covered under this manufacturer discount program shall be considered incurred costs for eligible beneficiaries and applied towards their out-of-pocket threshold. This means that the total negotiated retail drug price will be applied to the TrOOP and will count toward getting out of the doughnut hole.
Source: q1medicare.com

Medicare Advantage 2014 Spotlight: Plan Availability and Premiums

While many organizations offer Medicare Advantage plans, a few – particularly Humana, United Healthcare, and the Blue Cross and Blue Shield (BCBS) affiliates – have particularly large geographic spread and these organizations historically account for a disproportionate share of enrollment. In 2014, 44 percent of available plans are being offered by one of these three firms or affiliates (Table A4).  Plans offered by these firms are available to most beneficiaries.  Nationwide, 83 percent of Medicare beneficiaries will have access to one or more Humana plans, 73 percent will have access to a BCBS affiliated plan (including BCBS plans offered by Wellpoint), and 68 percent will have access to a United Healthcare plan (Exhibit 5; Table A5).  The general availability of these firms’ products has not noticeably changed from 2013 to 2014.  However, the similarities in BCBS offerings from 2013 to 2014 obscure a decline in availability of BCBS branded Wellpoint plans (declining from 88 plans to 55 plans between 2013 and 2014), which is mostly offset by the growth in plans offered by other BCBS affiliates (growing from 205 plans to 233 plans between 2013 and 2014).
Source: kff.org

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.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

Lower costs with assignment

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Source: medicare.gov

Extra Help with Medicare Prescription Drug Plan Costs

Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.
Source: ssa.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

Form 4029, Application for Exemption From Social Security and Medicare Taxes and Waiver of Benefits

Use the Comment on Tax Forms and Publications web form to provide feedback on the content of this product. Although we cannot respond individually to each comment, we do appreciate your feedback and will consider all comments submitted.
Source: irs.gov

CMS 855A Medicare Application

The CMS (Center for Medicare Services) brought about a historical change in home care in 2000 when they introduced OASIS ( Outcomes and Assessment Information Set). This OASIS document has given us the opportunity to do the right thing for our patients. We use it to assess the condition of this whole person. We can then treat this whole person because we know all of his systems, all of his needs, all of his comorbidities that may affect his healing. We no longer treat one symptom. Oasis helps us to be aware of how we make a difference. Oasis shows the nation in Home Health Compare on the internet how we have helped patients have less pain, have less shortness of breath, can be more independent with medications, heal wounds, and stay out of the hospital. Oasis shows Medicare the condition of our patient so they can use the payment system to provide us with a budget to take care of our patient. PPS (Perspective payment system) is the complex governmental system to ensure we have financial reimbursement to meet the needs of each specific patient. The Oasis questions give us clinical points, functional points and service points which fit into tables of payment. The government does want us to take care of people. It also wants to protect our taxpayers from fraud. Is this patient eligible to receive home care services paid for by Medicare? Is he homebound? Is there a skilled need? Are the visit needs intermittent? Is home health the reasonable and necessary way to care for this patient? Does this patient have a residence? Does he have a physician? Did you learn in Kindergarten to follow the rules? Everything goes better when we know the rules and follow them. Medicare has given us a great list of rules. These COP’s (Conditions of Participation) are made to protect our patients, and their rights. They also give us guidance to run our agencies. We can follow the rules and have qualified staff, have legal protection with physician orders, have clinical records with great documentation . When the surveyor comes to visit we need to show her that we follow the rules. If we are following the rules we get a good report card with no G tags which we will be proud to put up on the refrigerator just like the good old days. Click here for a list of CMS Medicare Contractors, including Palmetto GBA
Source: cmsmedicareapplication.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

CMS 855A Medicare Application

The CMS (Center for Medicare Services) brought about a historical change in home care in 2000 when they introduced OASIS ( Outcomes and Assessment Information Set). This OASIS document has given us the opportunity to do the right thing for our patients. We use it to assess the condition of this whole person. We can then treat this whole person because we know all of his systems, all of his needs, all of his comorbidities that may affect his healing. We no longer treat one symptom. Oasis helps us to be aware of how we make a difference. Oasis shows the nation in Home Health Compare on the internet how we have helped patients have less pain, have less shortness of breath, can be more independent with medications, heal wounds, and stay out of the hospital. Oasis shows Medicare the condition of our patient so they can use the payment system to provide us with a budget to take care of our patient. PPS (Perspective payment system) is the complex governmental system to ensure we have financial reimbursement to meet the needs of each specific patient. The Oasis questions give us clinical points, functional points and service points which fit into tables of payment. The government does want us to take care of people. It also wants to protect our taxpayers from fraud. Is this patient eligible to receive home care services paid for by Medicare? Is he homebound? Is there a skilled need? Are the visit needs intermittent? Is home health the reasonable and necessary way to care for this patient? Does this patient have a residence? Does he have a physician? Did you learn in Kindergarten to follow the rules? Everything goes better when we know the rules and follow them. Medicare has given us a great list of rules. These COP’s (Conditions of Participation) are made to protect our patients, and their rights. They also give us guidance to run our agencies. We can follow the rules and have qualified staff, have legal protection with physician orders, have clinical records with great documentation . When the surveyor comes to visit we need to show her that we follow the rules. If we are following the rules we get a good report card with no G tags which we will be proud to put up on the refrigerator just like the good old days. Click here for a list of CMS Medicare Contractors, including Palmetto GBA
Source: cmsmedicareapplication.com

Medicare Supplement Options

* Network restrictions apply. ** Policy forms UWMSP(A)-2010, UWMSP(F)-2010, UWMSP(F-HD)-2010, UWMSP(G)-2010, UWMSP(K)-2010, UWMSP(L)-2010, UWMSP(N)-2010, UWMSP-SEL(F)-2010, UWMSP-SEL(G)-2010, UWMSP-SEL(K)-2010, UWMSP-SEL(L)-2010, UWMSP-SEL(N)-2010.
Source: bcbstx.com

Blue Cross Blue Shield Medicare Coverage

In order for medical services to be considered for payment by Medicare, doctors, hospitals and other health care providers that are approved by Medicare must be used. Always check with your doctor or other health care providers to make sure he or she is Medicare-approved.
Source: bcbstx.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 Plan Finder for Health, Prescription Drug and Medigap plans

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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

Michigan Medicare Health Insurance Plans

Medicare is a health insurance program run by the government for people age 65 and older, and for people under 65 with certain disabilities. Understanding more about Medicare will make it easier to choose the right plan. Our Medicare 101 section has resources to help you do that.
Source: bcbsm.com

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

Medicare is a federal insurance program that covers hospitalization expenses as well as doctor and medical expenses. To be eligible for Medicare, one must be an American citizen 65 years or older, or younger with a qualifying disability.
Source: medicareconsumerguide.com

Medicare Plans are Confusing, We Make Medicare Less Frustrating.

Medicare Advantage insurance is a replacement to Original or Traditional Medicare Parts A and B – it is offered instead by private insurance companies. Medicare Advantage plans generally feature additional benefits and have less cost-sharing than Traditional Medicare, and you may be required to pay a monthly premium in exchange for the added benefits that the Medicare Advantage plan features. Medicare Advantage plans come in many different flavors and formats such as: HMO plans, PPO plans, PFFS plans, and special needs plans. Seniors may only enroll in Medicare Advantage plans if they already have both Medicare Part A and Medicare Part B and then only during specially designated enrollment periods. The Medicare enrollment periods change often, so please call us at: 1-(866)-866-7951 to find out when the next open enrollment period starts so you can enroll in this type of Medicare Plan.
Source: medicareplanstoday.com

Affordable Health Coverage

Posted by:  :  Category: Medicare

Rating and national average are based on Controlling High Blood Pressure 2013 ratings from the Healthcare Effectiveness Data and Information Set (HEDIS) for commercial plans published by the National Committee for Quality Assurance. HEDIS is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service. HEDIS is a registered trademark of the National Committee of Quality Assurance (NCQA). For more information, visit ncqa.org.
Source: kaiserpermanente.org

Federal Retirement Benefits: Federal Medicare

Enrolling in Senior Advantage for Federal Members or Medicare Plus for Federal Members will not affect the benefits you receive through the Federal Employee Health Benefits (FEHB) Program, although the network and other rules of Medicare may apply. FEHB Program coverage is described in FEHB brochures RI 73-003 (Northern California), RI 73-889 (Northern California: Fresno), RI 73-822 (Southern California), RI 73-019 (Colorado), RI 73-321 (Georgia), RI 73-005 (Hawaii), RI 73-047 (Mid-Atlantic States), and RI 73-004 (Northwest).
Source: kaiserpermanente.org

Kaiser Permanente Medicare Advantage Plans with Part D (Prescription Drug) Coverage

The following Kaiser Permanente plans offer Medicare Advantage and Part D coverage to California residents. Medicare Advantage plans, also known as Medicare Part C, are alternatives to original Medicare. These plans help cover the costs of services provided by hospitals, doctors, lab tests and some preventive screenings. These plans’ Part D component helps cover prescription drugs. Even if a plan’s monthly premium is $0, you would still pay the equivalent of the original Medicare premium. Not all plans shown here will be available to you; enter your zip code to see plans in your area. You can read about whether Medicare Advantage is right for you. If you only want plans with drug coverage, browse Prescription Drug (Part D) Plans.
Source: usnews.com

Affordable Care Act: Obamacare & Health Reform Facts

Choice and the information to make good choices — With Health Insurance Marketplaces and the requirement for easy-to-understand language in a Summary of Benefits and Coverage, Americans will have more information and more options to choose what is best for them.
Source: kaiserpermanente.org

Quality Health Care Coverage Provider

We have medical facilities close to where you work and live. Joining Kaiser Permanente means, in many cases, your doctor, specialist, pharmacist, and more are located in one facility, which means you don’t have to spend the day going all over town just to get well.”>What’s in My Area? >
Source: kaiserpermanente.org

Noridian Clients, Medicare, Medicaid

Posted by:  :  Category: Medicare

Represents suppliers in Washington, Oregon, Idaho, Nevada, California, Arizona, Utah, Wyoming, Montana, North Dakota, South Dakota, Nebraska, Kansas, Iowa, Missouri, Alaska, Hawaii and the territories of Guam, American Samoa and N. Marina Islands.
Source: noridiansolutions.com

Local Coverage Determinations (LCDs) for Noridian Healthcare Solutions, LLC (19003, DME MAC)

NOTE: You either have javascript disabled or have saved the page locally. Your experience may not be optimal due to these factors. Please consider enabling javascript or revisiting this page to get an optimal MCD experience. (Due to browser security settings, directly clicking the previous link may not work, so you may need to copy and paste the following link [http://www.cms.gov/medicare-coverage-database/indexes/lcd-list.aspx?Cntrctr=139&name=Noridian%20Administrative%20Services%20(19003,%20DME%20MAC)&DocStatus=Retired&&ContrVer=1&CntrctrSelected=139*1&LCntrctr=139*1&bc=AgACAAIAAAAA&] into your browser.)
Source: cms.gov

Local Coverage Determinations (LCDs) for Noridian Healthcare Solutions, LLC (02402, MAC

NOTE: You either have javascript disabled or have saved the page locally. Your experience may not be optimal due to these factors. Please consider enabling javascript or revisiting this page to get an optimal MCD experience. (Due to browser security settings, directly clicking the previous link may not work, so you may need to copy and paste the following link [http://www.cms.gov/medicare-coverage-database/indexes/lcd-list.aspx?Cntrctr=247&ContrVer=1&CntrctrSelected=247*1&name=Noridian+Administrative+Services%2C+LLC+(02402%2C+MAC+-+Part+B)&s=56&DocType=All&bc=AggAAAAAAAAAAA%3D%3D&] into your browser.)
Source: cms.gov

Yearly deductible for drug plans

Posted by:  :  Category: Medicare

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Source: medicare.gov

Medicare Premiums and Deductibles for 2014

As you can see, premiums and deductibles can vary depending on the Medicare plans you select; and many costs have changed for Medicare plans in 2015. Would you like to ask me other questions? Learn more about me by clicking the orange button below my photo. There are also links below that let you schedule a phone appointment or have me email you more information. Want to compare plans on your own? Use the blue Find Your Plan button on the right side of this page. Or, for personalized assistance, just call us at 1-844-847-2659 (or TTY users, call 711).
Source: medicare.com

Medicare Supplement High Deductible Plan F

* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. ** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
Source: bcbstx.com

Medicare Supplement High Deductible Plan F

* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. ** This high deductible plan pays the same benefits as Plan F after one has paid a calendar-year $2,180 deductible. Benefits from High Deductible Plan F will not begin until out-of-pocket expenses are $2,180. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the plan’s separate foreign travel emergency deductible. *** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
Source: bcbsil.com

Medicare Part A Deductible

After the initial Part A deductible has been paid by the beneficiary during the first 60 days, Medicare will cover all other costs associated with a room, meals, doctor and nursing services, treatment, and exams. If a beneficiary needs to stay in the hospital beyond 150 days, or returns to the hospital with less than 60 days between visits and exceeds the 150 days in the process, they must pay the full cost of their treatment expenses.
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

Extra Help with Medicare Prescription Drug Plan Costs

Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.
Source: ssa.gov

Get help filing an appeal

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Source: medicare.gov

California Health Advocates: Medicare Policy, Advocacy and Education

Bonnie Burns, our Training and Policy Specialist, begins her 23rd term as one of the 20 appointed and funded consumer liaison representatives by the National Association of Insurance Commissioners (NAIC). Ms. Burns spearheaded the standardization of Medicare supplemental insurance, known as Medigap and has provided numerous Congressional testimonies guiding the standardization of long-term care insurance and the policies for financing long-term care.
Source: cahealthadvocates.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

EmblemHealth: Family & Individual Health Insurance Plans In New York

To view this Web site, you need to have JavaScript enabled in your browser. Don’t worry — you can still sign in to the secure myEmblemHealth Web site or search for a doctor using the links below. If you need help registering for the secure site, please call Customer Service at the number on the back of your ID card.
Source: emblemhealth.com