Medicare Resource Material
Beneficiaries not subject to the “hold harmless” provision will pay $121.80, as calculated reflecting the provisions of the Bipartisan Budget Act signed into law by President Obama last week. Medicare Part B beneficiaries not subject to the “hold-harmless” provision are those not collecting Social Security benefits, those who will enroll in Part B for the first time in 2016, dual eligible beneficiaries who have their premiums paid by Medicaid, and beneficiaries who pay an additional income-related premium. These groups account for about 30 percent of the 52 million Americans expected to be enrolled in Medicare Part B in 2016. [read more]
2016 Star Ratings Data and Technical Notes
Complete data set of all measurement ratings for Medicare Advantage medical and Part D Prescription drug plans offered in 2016. The Fact Sheet gives and overall description of how Star Ratings are compiled along with high and low performers. The 2016 Report Card is an Excel spreadsheet that lists all the plans by contract number and how they measured against 47 different items.
- 2016 Star Ratings Facts Sheet
- 2016 Technical Notes 2015 Performance Data Measurements
- 2016 Report Card Master Table 2015
- 2016 Low Performing Icon
For a full review visit 2016 Medicare Advantage Star Ratings complete data set
Updated for 2015, the Medicare training presentation reviews the qualifications and eligibility for Medicare when a person has End-Stage Renal Disease. There is a power point presentation and a training workbook that can be downloaded.
If you are enrolled in Medicare, you do not need to do anything with Covered California. If you have Medicare you are covered. No matter how you receive your Medicare benefits, whether through Original Medicare or a Medicare Advantage Plan, you will have the same benefits and security you have now. You will receive new benefits, such as more preventive services and increased savings on brand-name drugs. [Read More]
CMS releases First Round of Home Health Compare Quality of Patient Care Star Ratings
Link to full news release -> Ratings to Help Consumers Compare and Choose Among Home Health Agencies
Today, the Centers for Medicare & Medicaid Services (CMS) for the first time published star ratings on Home Health Compare, CMS’s public information website for Home Health Agencies. Star ratings can help consumers more quickly identify differences in quality and make use of the information when selecting a health care provider. In addition to summarizing certain data about Home Health Agency performance for consumers, star ratings can also help the agencies identify areas for improvement.
Medicare Supplement or Medigap Training
The lessons in this Medigap training module discuss how Medigap policies work with Medicare, what Medigap policies cover, how they are structured, and when to buy a Medigap Policy. The materials—up to date and ready to use—are designed for information givers/trainers who are familiar with the Medicare program, and would like to have prepared information for their presentations. Download the workbook and presentation.
Medicare Preventive Services Training
Training presentation and workbook that covers Medicare approved preventive heath care services that are either no cost or low cost to the Medicare beneficiary. It covers the conditions for some of the tests to be covered in full, new tests added for 2015, and when some lab or office visits will require a copayment. Visit Medicare Preventive No Cost Services page.
Medicare Prescription Drug Plan Training
Prescription drug coverage for Medicare beneficiaries can be confusing. Under different health care scenarios, some drugs may be covered by Part A, Part B or Part D of Medicare. In addition, many Medicare beneficiaries may be unaware that they might qualify for extra help to pay for their medications. The Centers for Medicare and Medicaid Services have put together a training presentation, workbook and job aids to address some of the moving parts of drug coverage under Medicare. Go to Medicare Prescription Drug Plan Training Post for more information and downloads
Medicare Coordination of Benefits
Which insurance pays first, Medicare or another plan? Will Medicare pay if someone else is liable for my injuries? Can I have Medicare and an ACA Marketplace individual health plan? Medicare developed specific training to answer all these questions and more with a slide presentation and workbook. Go to Medicare Coordination of Benefits, Payment, and Denials to download information.
Medicare Home Health Benefits
Medicare pays for you to get certain health care services in your home if you meet certain eligibility criteria and if the services are considered reasonable and necessary for the treatment of your illness or injury. This is known as the Medicare home health benefit. Download the Medicare Brochure.
Durable Home Equipment Bidding Process
The program replaces the outdated, inflated fee-schedule prices Medicare is currently paying with lower, more accurate prices.Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare pays for these items now.Medicare uses these bids to set the amount it will pay for those equipment and supplies under the competitive bidding program.Qualified, accredited suppliers with winning bids are chosen as Medicare contract suppliers. Download the brochure.
Medicare Guide to Choosing Hospitals
In an emergency, your life may depend on getting to the nearest hospital. When you can plan ahead, you and your doctor should discuss which hospital will best meet your health care needs. Information is available to help you make an informed choice. Whether you have Medicare or another type of insurance, this booklet can help you find and use information about hospital quality.
Are You Frustrated with Your Medicare Options?
- Should I take Part A?
- Should I take Part B and when?
- What about Part D?
- What’s the Difference between a Medicare Advantage Plan and a Medigap Plan?
- Can I get help with Medicare costs?
7 Steps to help you make the best Medicare choice for you.
- Read the information Medicare sends you to learn about the basics of Original Medicare: Parts A and B.
- Become familiar with the Part D Prescription Drug Plan, Medicare Advantage Plans and Medicare Supplements.
- Go to Medicare.gov to find out which plans are offered in your area.
- Review your lifestyle and finances to help guide you between the different options.
- Do you need help paying for Medicare costs? Contact Social Security and Medi-Cal to see if you qualify for help.
- Request information on the different plans you might be interested in and talk to family and friends to see what they are happy with. Never rely on one source, person or company for information.
- If you need additional clarification call me, Kevin Knauss Ph: 916-521-7216, and we will get your questions answered.
Medicare can be frustrating and confusing because there are so many choices and options. The good news is that every year you get to make a new choice, so you never have to feel locked in. Let’s get you the right answers now so you can go from being frustrated to back enjoying your life.