Medicare is removing social security number from ID card.

Medicare Bob on Bay News 9

The House Approves a “Doc Fix Bill”.

The Story of Medicare: A Timeline (2015)

House Passes Medicare Bill

CMS finalizes 2016 payment and policy updates for Medicare Health and Drug Plans

CMS NEWSFOR IMMEDIATE RELEASE

April 6, 2015

Contact: CMS Media Relations

(202) 690-6145 | go.cms.gov/media

CMS finalizes 2016 payment and policy updates for Medicare Health and Drug Plans

Rate Announcement Details Plan Payments and Other Program Updates for 2016

 

The Centers for Medicare & Medicaid Services (CMS) today released final Medicare Advantage (MA) and Part D Prescription Drug program changes for 2016 that provide fair and accurate payments to plans, and encourage the delivery of high-quality care for all populations.

 

“These policies strengthen Medicare Advantage for current and future consumers by encouraging higher quality care,” said Andy Slavitt, acting CMS Administrator. “As the Medicare Advantage marketplace continues to grow, consumers are getting access to better care through more choice and competition. Seniors and people with disabilities, including the dual-eligible population, will continue to have an extensive choice of plans, affordable premiums, and better and more transparent information about provider networks and pharmacies.”

 

The Medicare Advantage and the Part D Prescription Drug programs’ enrollments and quality continue to grow and improve since the Affordable Care Act became law. Medicare Advantage has reached record high enrollment each year since 2010, a trend continuing in 2015 with a cumulative increase of more than 40 percent since 2010. At the same time, premiums have fallen by nearly 6 percent from 2010 to 2015. And, more than 90 percent of Medicare beneficiaries have access to a $0 premium Medicare Advantage plan.

 

The finalized policies fully consider the many comments received during the public comment period. Particular care is being taken to ensure that plan sponsors have the right incentives to care for dual eligible populations over the long term. The Rate Announcement finalizes changes in payments that will affect plans differently depending on the characteristics of those plans. On average, the expected revenue change is 1.25 percent without accounting for the expected growth in coding acuity that has typically added another 2 percent.  The final revenue increase is larger than the February advance notice largely because the Medicare actuaries recently updated Medicare per capita spending estimates for 2014 and 2015. Medicare per capita spending in 2014, 2015 and 2016 is still expected to be below historical standards.

 

Today’s announcement drives important improvements to the star rating system, additional accuracy and transparency of provider networks, and continues to promote improvements in quality of care for beneficiaries. The policies in the Rate Announcement and final Call Letter reflect Secretary Burwell’s commitment to a Medicare program – including Medicare Advantage – that delivers better care, spends health care dollars more wisely and results in healthier people. In the Final Call Letter, CMS continues to update the Star Ratings measures to drive improved quality for Medicare Advantage and Part D enrollees. To enhance program integrity and payment accuracy, Medicare Advantage plans will continue to be provided stringent oversight for improper payments, just like other providers in the Medicare program.

 

Lastly, the final policies will provide enrollees with greater information to make informed and timely decisions about their care and their coverage. The Final Call Letter takes steps to require Medicare Advantage plans to maintain accurate provider directories in a timely manner and make those directories widely available. These steps will help enrollees better understand the providers and choices available to them. In addition, CMS will ensure that Part D sponsors provide clear and accurate access to information on preferred cost sharing pharmacies in their networks so that all beneficiaries have access to affordable coverage.

 

To view a fact sheet on the 2016 Rate Announcement and final Call Letter, please visit: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-04-06.html

# # #

Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter @CMSgov

Shared by: Robert Bache

Twitter @MedicareBob

 

 

 

 

 

You’re getting this message because you subscribed to get email updates from the Centers for Medicare & Medicaid Services (CMS).

Update your subscriptions, modify your password or email address, or stop subscriptions at any time on your Subscriber Preferences Page. You will need to use your email address to log in. If you have questions or problems with the subscription service, please contact subscriberhelp.govdelivery.com.

This service is provided to you at no charge by Centers for Medicare & Medicaid Services (CMS).

This e-mail was sent to Ebache.robert.bache@gmail.com using GovDelivery, on behalf of the Centers for Medicare & Medicaid Services (410-786-5473) · 7500 Security Boulevard · Baltimore MD 21244

 

United Healthcare / AARP is offering 3 PPO Medicare Advantage Plans in Pinellas County Florida for 2015:

United Healthcare / AARP is offering 3 PPO Medicare Advantage Plans in Pinellas County Florida for 2015:

(Call 1-855-368-4717 to enroll)

Insurance Plan Summary
InsurerUnitedHealthcare/Medicare CompleteUnitedHealthcare/Medicare CompleteUnitedHealthcare/Medicare Complete
PlanAARP MedicareComplete Choice Plan 2 R5287-001AARP MedicareComplete Choice H5532-001AARP MedicareComplete H1080-004
Plan TypePPOPPOHMO
Monthly Premium$0.00$29.00$0.00
Medical Coverage
Primary CareIn Network $15 copay; Out-of-Network $45 copayIn Network $15 copay; Out-of-Network $45 copay$5 copay
Specialist VisitsIn Network $50 copay; Out-of-Network $70 copayIn Network $50 copay; Out-of-Network $70 copay$45 copay
Routine Annual Physical$0 copay$0 copay$0 copay
Routine Annual Eye$50 copay (for up to 1 every year)$50 copay (for up to 1 every year)$45 copay (for up to 1 every year)
Inpatient Hospital CareIn Network $395 copay per day, days 1-4; Out-of-Network 40% of the costIn Network $395 copay per day, days 1-4; Out-of-Network 40% of the cost$335 copay per day, days 1-5
Diagnostic Tests, X-rays, & Lab Services$22 to $25 copay (or 20% of the cost)$13 to $16 copay (or 20% of the cost)$13 to $16 copay (or 20% of the cost)
Outpatient SurgeryIn Network 20% of the cost; Out-of-Network 40% of the costIn Network 20% of the cost; Out-of-Network 40% of the cost20% of the cost
Emergency Care$65 copay, waived if admitted$65 copay, waived if admitted$65 copay, waived if admitted
Urgent Care$30 to $40 copay$30 to $40 copay$30 to $40 copay
Ambulance$300 copay$250 copay$250 copay
Home Health Care$0 copay$0 copay$0 copay
Skilled Nursing$0 copay per day, days 1-20; $155 copay per day, days 21-64; $0 copay per day, days 65-100$0 copay per day, days 1-20; $155 copay per day, days 21-59; $0 copay per day, days 60-100$0 copay per day, days 1-20; $155 copay per day, days 21-59; $0 copay per day, days 60-100
Annual DeductibleN/AN/AN/A
Out-of-Pocket Maximum$6,700 to $10,000$5,900 to $10,000$5,900.00
Out-of-Network CoverageIt may cost more to get care from out-of-network providers, except in an emergency. See Plan Details for additional information.It may cost more to get care from out-of-network providers, except in an emergency. See Plan Details for additional information.It may cost more to get care from out-of-network providers, except in an emergency. See Plan Details for additional information.
Prescription Drug Coverage
Amount you pay for prescriptions up to $2,960
Pharmacy Deductible$200 for Tiers 3 and 4 only$250 for Tiers 3 and 4 only$220 for Tiers 3 and 4 only
Retail (one month)$2/$8/$45/$95/33%$2/$8/$45/$95/33%$2/$8/$45/$95/33%
Mail (three month)$4/$16/$125/$275/33%$4/$16/$125/$275/33%$4/$16/$125/$275/33%

Humana PPO Plans in Pinellas County for 2015

For 2015, Humana is offering 2 PPO Medicare Advantage Plans in Pinellas County Florida:

Call to enroll: 1-855-368-4717.

Insurance Plan Summary
InsurerHumanaHumana
PlanHumana Gold Plus H1036-141Humana Gold Plus H1036-052
Plan TypeHMOHMO
Monthly Premium$0.00$0.00
Medical Coverage
Primary Care$0 copay$0 copay
Specialist Visits$40 copay$35 copay
Routine Annual Physical$0 copay$0 copay
Routine Annual Eye$0 copay (for up to 1 every year)$0 copay (for up to 1 every year)
Inpatient Hospital Care$175 copay per day, days 1-5$120 copay per day, days 1-5
Diagnostic Tests, X-rays, & Lab Services$0 to $175 copay (or 20% of the cost)$0 to $120 copay (or 20% of the cost)
Outpatient Surgery$40 to $175 copay (or 20% of the cost)$40 to $120 copay (or 20% of the cost)
Emergency Care$65 copay, waived if admitted$65 copay, waived if admitted
Urgent Care$0 to $40 copay$0 to $35 copay
Ambulance$150 copay$150 copay
Home Health Care$0 copay$0 copay
Skilled Nursing$0 copay per day, days 1-20; $150 copay per day, days 21-100$0 copay per day, days 1-20; $150 copay per day, days 21-100
Annual DeductibleN/AN/A
Out-of-Pocket Maximum$6,700.00$5,000.00
Out-of-Network CoverageIt may cost more to get care from out-of-network providers, except in an emergency. See Plan Details for additional information.It may cost more to get care from out-of-network providers, except in an emergency. See Plan Details for additional information.
Prescription Drug Coverage
Amount you pay for prescriptions up to $2,960
Pharmacy DeductibleN/AN/A
Retail (one month)$0/$10/$45/$95/33%$0/$0/$15/$60/33%
Mail (three month)$0/$0/$125/$275$0/$0/$35/$170

Medicare Supplement Plan G

What is a Medicare Supplement Plan (Medigap)?

What is a Medicare Advantage Plan?

What is the difference between Medicare Advantage Plans and Medicare Supplement Plans?