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| MA / MA-PD |
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Medicare Advantage Plans (MAs) and Medicare Advantage Plans with Prescription Drug Coverage (MA-PDs) are private plans that provide doctor and hospital services in place of Medicare and Medicare pays these private companies to manage the healthcare instead of paying for the beneficiary claims directly. Examples of MAs or MA-PDs that administer your Medicare Part A and Part B, as well as possibly providing Prescription Drug coverage are: Health Maintenance Organizations (HMOs), Private, Fee for Service Organizations (PFFS), or Preferred Provider Organizations (PPOs). Typically, the MA-PDs also provide additional value-added service to its Members such as additional covered days in the hospital. If you purchase a MA-PD plan, you do not need to purchase a PDP plan (see above) nor do you need a Medicare Supplement.
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| mail-service pharmacies |
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Mail-service pharmacies are used by many plans as a cost-saving and convenient alternative to retail pharmacies. Members typically order their drugs by phone, fax, email or Internet. Most prescription orders are filled and received by members in two to four days. Here's a look at how you'll save when you use our Preferred Mail Service to order a 90-day supply of a drug.
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| managed care |
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A medical delivery system that attempts to manage the quality and cost of medical services that individuals receive. Most managed care systems offer HMOs and PPOs that individuals are encouraged to use for their health care services.
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| maximum dollar limit |
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The maximum amount of money that an insurance company (or self-insured company) will pay for claims within a specific time period. Maximum dollar limits vary greatly. They may be based on or specified in terms of types of illnesses or types of services. Sometimes they are specified in terms of lifetime, sometimes for a year.
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| Medicaid |
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A federal medical assistance program that covers certain individuals and families meeting low income guidelines. Medicaid is jointly funded by the federal and state governments to assist the states in providing long-term care assistance to people who meet certain eligibility criteria.
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| Medicare Advantage Plans |
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Health plans offered by private insurance companies that contract with Medicare to provide Medicare coverage. Depending on where the beneficiary lives, Medicare Advantage Plans may be available both with and without Part D plans. Medicare Advantage Plans are also called Medicare Health Plans. The Medicare Advantage Plans used to be called the Medicare+Choice plans.
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| Medicare |
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The health insurance program run by the federal government for people age 65 and older, people with certain disabilities, and people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or kidney transplant).
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| Medicare Part D prescription drug plan |
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Insurance plans offering prescription drug coverage that meets the standards established by Medicare. Other Names for these plans include Part D prescription drug plans, PDPs, or MA-PDs. However, not all private insurance plans offering prescription drug coverage are Part D plans. You'll want to pay close attention to whether a plan is a Part D plan.
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| Medicare Prescription Drug Program (Part D) |
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The Medicare Prescription Drug Program (Part D) is insurance offered by the federal government and sold through private companies that helps pay for prescription drugs. The Medicare Prescription Drug Program became available to all Medicare beneficiaries on January 1, 2006.
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| Medicare Prescription Drug, Improvement and Modernization Act of 2003 |
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The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 is a federal law that brought the most dramatic changes to the Medicare program since it began in 1965. These changes include more affordable health care, prescription drug coverage to all people with Medicare, expanded health plan options, improved health care access for rural Americans, and preventive care services, such as flu shots and mammograms.
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| Medicare Supplements |
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Medicare Supplements or MediGap Plans provide additional coverage to your Original Medicare plans (Medicare A and B). For instance, Medicare Supplements will pay a portion of your Medicare Co-insurance. There are a series of Medicare Supplements that provide a variety of coverage options at varying premiums. Stand-alone Prescription Drug Plan (PDP) can be used together with your Medicare Supplements. A Medicare Advantage Plan (MA or MA-PD) cannot be used with a Medicare Supplement.
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| Medigap |
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See Medicare Supplements
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