This document provides an overview of Freedom Health Medicare Advantage plans, including plan details, benefits, and enrollment information. It highlights that Freedom Health offers HMO and Special Needs Plans (SNPs) with varying premiums, out-of-pocket maximums, and benefits. The document reviews key aspects of the plans such as prescription drug coverage, preventive services, the provider network, and the enrollment process. Plan comparisons are provided through charts listing coverage details for different plans in specific counties.
NPS Pharmaceuticals is a global biopharmaceutical company focused on developing therapies for rare diseases. It has recently launched Gattex/Revestive (teduglutide) for the treatment of adult Short Bowel Syndrome in the US and EU. It is also developing Natpara (recombinant human parathyroid hormone 1-84) as a potential first approved replacement therapy for hypoparathyroidism, with a BLA submission planned for the US in the second half of 2013. The company has a proven track record of successfully developing and launching orphan drugs and is focused on executing its Gattex launch and advancing its pipeline to become a leading global orphan specialty drug company.
The document discusses the benefits of Medicare Advantage plans, including lower hospitalization rates and higher member satisfaction compared to Original Medicare. It provides information on Medicare eligibility, enrollment periods for Medicare Advantage and Part D prescription drug plans, and the types of additional coverage options available with Medicare like Medicare Supplement plans. The document also outlines important details about Medicare Advantage plans, such as continued payment of Part B premiums, use of network providers, and the stages of prescription drug coverage including the deductible, coverage gap, and catastrophic coverage thresholds.
This SMMC provider webinar talks about the implications for recipients who are eligible for both the Long-term Care and Managed Medical Assistance programs.
This presentation shows providers how to verify a patient's Medicaid eligibility before providing services to them as part of the Managed Medical Assistance program.
This presentation discusses Assisted Living Faciltiies (ALFs) and Adult Family Care Homes (AFCHs) and how they fit in to the new Long-term Care program under Statewide Medicaid Managed Care.
This document provides information about becoming a dispensing partner to help distribute medications during a public health emergency. It discusses the history of public health preparedness efforts. As a dispensing partner, an organization would open its location as a dispensing site to provide prophylaxis more quickly to its employees, clients, and families. Becoming a partner involves training, registering with the health department, developing a dispensing plan, and obtaining additional resources. The health department can assist with answering questions and developing an appropriate plan. Legal protections are in place for dispensing partners under the PREP Act and HIPAA exemptions during declared emergencies.
This SMMC provider webinar talks about specialty plans involved in the SMMC program. These plans are designed to provide services tailored for individuals with a particular diagnosis, such at HIV/AIDS, Mental Illness, CHF, COPD, or Diabetes.
NPS Pharmaceuticals is a global biopharmaceutical company focused on developing therapies for rare diseases. It has recently launched Gattex/Revestive (teduglutide) for the treatment of adult Short Bowel Syndrome in the US and EU. It is also developing Natpara (recombinant human parathyroid hormone 1-84) as a potential first approved replacement therapy for hypoparathyroidism, with a BLA submission planned for the US in the second half of 2013. The company has a proven track record of successfully developing and launching orphan drugs and is focused on executing its Gattex launch and advancing its pipeline to become a leading global orphan specialty drug company.
The document discusses the benefits of Medicare Advantage plans, including lower hospitalization rates and higher member satisfaction compared to Original Medicare. It provides information on Medicare eligibility, enrollment periods for Medicare Advantage and Part D prescription drug plans, and the types of additional coverage options available with Medicare like Medicare Supplement plans. The document also outlines important details about Medicare Advantage plans, such as continued payment of Part B premiums, use of network providers, and the stages of prescription drug coverage including the deductible, coverage gap, and catastrophic coverage thresholds.
This SMMC provider webinar talks about the implications for recipients who are eligible for both the Long-term Care and Managed Medical Assistance programs.
This presentation shows providers how to verify a patient's Medicaid eligibility before providing services to them as part of the Managed Medical Assistance program.
This presentation discusses Assisted Living Faciltiies (ALFs) and Adult Family Care Homes (AFCHs) and how they fit in to the new Long-term Care program under Statewide Medicaid Managed Care.
This document provides information about becoming a dispensing partner to help distribute medications during a public health emergency. It discusses the history of public health preparedness efforts. As a dispensing partner, an organization would open its location as a dispensing site to provide prophylaxis more quickly to its employees, clients, and families. Becoming a partner involves training, registering with the health department, developing a dispensing plan, and obtaining additional resources. The health department can assist with answering questions and developing an appropriate plan. Legal protections are in place for dispensing partners under the PREP Act and HIPAA exemptions during declared emergencies.
This SMMC provider webinar talks about specialty plans involved in the SMMC program. These plans are designed to provide services tailored for individuals with a particular diagnosis, such at HIV/AIDS, Mental Illness, CHF, COPD, or Diabetes.
Camille Graves is seeking full-time employment utilizing her experience in the United States Air Force and various administrative roles. She has over two years of active duty service in the Air Force as well as experience as an administrative assistant at dental offices performing tasks such as scheduling appointments, submitting insurance claims, and maintaining patient records. Graves is proficient in various software programs and aims to utilize her organizational and customer service skills gained through military service and previous positions.
The document provides information about verifying recipient eligibility for Florida's Statewide Medicaid Managed Care Long-Term Care Program (SMMC LTC). It emphasizes the importance of accurately checking if a recipient is enrolled in a Long-term Care plan and eligible for services on the date of service before rendering care. It outlines new aid categories for Medicaid Pending and loss of eligibility periods, and how to identify these on eligibility verifications. Providers are instructed to always contact the recipient's Long-term Care plan for authorization and claims submission if they are enrolled.
Please share this video with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● An overview of the court case including the main details, the plaintiffs, and what they were seeking,
● Analysis of the evidence presented during the proceedings,
● What the decision means for patients and producers, and
● Things to come for medical marijuana in Canada
View the video: https://youtu.be/n80-7qGiEnU
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
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The Hawaii State Hospital is the only publicly funded psychiatric hospital in Hawaii that provides 24/7 inpatient psychiatric services. It has a mission to provide assessment, treatment and rehabilitation for individuals suffering from mental illness who are primarily court-ordered. It operates under the Department of Health and has a budget of over $50 million. While its budget is based on a 168 patient census, it routinely cares for over 200 patients due to lack of community alternatives. The majority of its patients are forensic admissions court-committed to its custody.
This document provides an overview of Medicare, including what it is, how it works, and enrollment details. Medicare is a federal health insurance program for those aged 65 and older or with disabilities. It has multiple parts that provide coverage for different healthcare areas like hospital stays, doctor visits, and prescription drugs. Individuals are automatically enrolled in Medicare based on other benefits they receive, or they can apply during initial, delayed, or general enrollment periods.
This presentation outlines the specific requirements for Hospice providers with respect to the Statewide Medicaid Managed Care (SMMC) Long-term Care program in Florida.
This document provides an overview of Medicare, including:
- Parts A and B which cover hospital insurance and medical insurance. Part C includes Medicare Advantage Plans and Part D covers prescription drug coverage.
- Original Medicare and Medicare Advantage Plans (like HMOs and PPOs) are choices for coverage. Extra help is available for those with limited income.
- Eligibility, enrollment periods, premiums, deductibles, and cost sharing are explained for different parts and plan options. Programs like Medicaid and Medicare Savings Programs also help cover costs.
The document provides an agenda and information for a Doctors Care Program group information session for new and returning applicants in 2012. The session will cover paperwork requirements, percentage payments, primary care physicians and specialists, hospital services, prescriptions, on-site services, renewal processes, frequently asked questions, and next steps. Attendees will learn about eligibility, cost sharing, rules regarding respectful behavior, appointment attendance, and following treatment plans in order to qualify for the community care program.
This document provides an overview of Medicare, including its parts (A, B, C, and D) and enrollment details. It summarizes what is covered by Parts A and B, including hospital stays, skilled nursing facilities, home health care and hospice. It also discusses Medigap plans which supplement coverage gaps in Original Medicare.
This provider webinar has been customized to inform hospice providers about how they can participate in the Statewide Medicaid Managed Care Managed Medical Assistance (MMA) program.
CCM Presentation for KYPCA Final Draft-111115Jacqueline Todd
This document discusses chronic care management (CCM) services and billing requirements under Medicare. It defines CCM as care management for patients with two or more chronic conditions expected to last over a year. Key points include: CMS began paying separately for CCM services in 2015; eligible providers can furnish and bill for CCM; at least 20 minutes of CCM services must be provided per month to bill using CPT code 99490; and an electronic health record meeting "CCM Certified Technology" standards is required to document certain elements of the care plan and services.
ICD-10 Transition Update: What Health Lawyers Need to KnowPYA, P.C.
This document provides an overview of ICD-10 and the transition from ICD-9 to ICD-10 for healthcare organizations. It discusses the regulatory timeline requiring compliance by October 1, 2014, the differences between ICD-10-CM for diagnoses and ICD-10-PCS for procedures, organizational and financial impacts, and risk mitigation strategies for the transition. The transition represents a significant change that will impact coding, clinical documentation, claims processing, billing systems, and vendor relationships. Proper planning is needed to assess readiness and minimize risks to operations and revenue during the transition period.
The document summarizes key aspects of Medicare and Medicaid programs in the United States. Medicare provides health coverage to elderly and disabled populations, while Medicaid covers low-income and poor populations. Both programs were established in 1965 and set minimum coverage standards, though Medicaid is jointly funded by federal and state governments. The document outlines eligibility criteria and coverage details for both programs and how they have evolved over time.
The Centers for Medicare and Medicaid Services (CMS) is the largest health payer in the United States, covering almost 90 million Americans. Medicare, the federal health insurance program for adults over age 65 and other qualified individuals, accounts for more than 48 million of those Americans through expenditures of more than $545 billion. But what is Medicare? How does it work? What should helping professionals and caregivers know about the program? This session will provide a broad overview of the Medicare program’s Parts A and B as well as introduce the CMS National Training Program as a resource for further training and information.
This presentation provides a comprehensive review and forecast of the trends in Medicare Medical Review by numerous Medicare Contractors and is appropriate for all SNF Management, nursing staff, and therapy professionals. The presentation provides insight on the tidal wave of newly exposed compliance issues at the eye of the storm, leading to remote and on-site audits in the long-term care industry. Presentation highlights the historical drought in audits and the tornado effect the current scrutiny is causing amongst the SNF providers. Learn strategies to prepare records before the impending audit storm. Avoid slip ups on the seemingly invisible black ice of Medicare non-compliance. Become aware of the most recent CMS updates impacting the RAI process and subsequently reimbursement. Create an anemometer for Managers and staff to read the winds of change and create clear visibility for accurate and compliant records.
1. Learn to summarize the multiple types of Medicare Contractor Audits and associated Compliance themes.
2. Understand the trends and triggers in Compliance Audits and Common Provider Pitfalls.
3. Learn strategies for appealing Medicare Claim Denials.
Health insurance claim | Health Care DomainH2kInfosys
H2K Infosys provides online IT training and placement services worldwide. It acknowledges proprietary rights of trademarks and product names mentioned in training materials for learning purposes only. Students shall not use or sell such materials for private gain or to third parties. H2K does not guarantee or take responsibility for products and projects discussed in training.
HIGHLIGHTED: Dissemination of Patient-Specific Information from Devices by De...NextWorks
This is the highlighted version of FDA's Guidance for Industry: Dissemination of Patient-Specific Information from Devices by Device Manufacturers from June 2016.
When these guidances come out, I typically go through them and highlight the most relevant portions for those who need to skim through or refresh their memory.
Health south investor_reference_book_q1_2014_final_withfairlawnhealthsouth_ir
HealthSouth reported its Q1 2014 earnings. It provides inpatient rehabilitation services through hospitals and satellite clinics across the US. In Q1 2014, its revenues were $2.3 billion and it treated over 130,000 inpatients. HealthSouth aims to differentiate itself through clinical best practices, supply chain efficiencies, and scale. It has grown its patient volumes faster than the industry in recent years through bed expansions and new hospitals.
Medicaid is a government health insurance program for low-income families and individuals established in 1965 under President Lyndon B. Johnson as part of the Social Security Amendments. It is administered by individual states according to federal guidelines and provides coverage for various medical services and benefits. While states pay 50% of costs, there is ongoing controversy around eligibility requirements and costs as states aim to reduce spending through managed care programs while maintaining federal funding.
The Medicare Gals discuss Coverage Gaps, Medicare Part C, Supplements, Medicare Part D, Phases of Coverage for Part D and Things to Consider When Choosing a Part D Plan.
Anand Kumar Sahani is seeking a challenging position in engineering and technology that allows him to use his interpersonal and technical skills. He has over 4 years of experience in telecommunications and networking. Currently he is a Senior Engineer at Tata Communication Limited where he is responsible for fault management, troubleshooting routing protocols, and resolving issues for enterprise customers. Previously he has worked at Wipro InfoTech and Tata Communications providing technical support, provisioning VPNs, and coordinating with field engineers to resolve network issues. He has expertise in protocols like OSPF, MPLS, BGP and skills in Cisco, Alcatel and Juniper routers and switches.
Camille Graves is seeking full-time employment utilizing her experience in the United States Air Force and various administrative roles. She has over two years of active duty service in the Air Force as well as experience as an administrative assistant at dental offices performing tasks such as scheduling appointments, submitting insurance claims, and maintaining patient records. Graves is proficient in various software programs and aims to utilize her organizational and customer service skills gained through military service and previous positions.
The document provides information about verifying recipient eligibility for Florida's Statewide Medicaid Managed Care Long-Term Care Program (SMMC LTC). It emphasizes the importance of accurately checking if a recipient is enrolled in a Long-term Care plan and eligible for services on the date of service before rendering care. It outlines new aid categories for Medicaid Pending and loss of eligibility periods, and how to identify these on eligibility verifications. Providers are instructed to always contact the recipient's Long-term Care plan for authorization and claims submission if they are enrolled.
Please share this video with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● An overview of the court case including the main details, the plaintiffs, and what they were seeking,
● Analysis of the evidence presented during the proceedings,
● What the decision means for patients and producers, and
● Things to come for medical marijuana in Canada
View the video: https://youtu.be/n80-7qGiEnU
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
YouTube - https://www.youtube.com/user/Survivornetca
The Hawaii State Hospital is the only publicly funded psychiatric hospital in Hawaii that provides 24/7 inpatient psychiatric services. It has a mission to provide assessment, treatment and rehabilitation for individuals suffering from mental illness who are primarily court-ordered. It operates under the Department of Health and has a budget of over $50 million. While its budget is based on a 168 patient census, it routinely cares for over 200 patients due to lack of community alternatives. The majority of its patients are forensic admissions court-committed to its custody.
This document provides an overview of Medicare, including what it is, how it works, and enrollment details. Medicare is a federal health insurance program for those aged 65 and older or with disabilities. It has multiple parts that provide coverage for different healthcare areas like hospital stays, doctor visits, and prescription drugs. Individuals are automatically enrolled in Medicare based on other benefits they receive, or they can apply during initial, delayed, or general enrollment periods.
This presentation outlines the specific requirements for Hospice providers with respect to the Statewide Medicaid Managed Care (SMMC) Long-term Care program in Florida.
This document provides an overview of Medicare, including:
- Parts A and B which cover hospital insurance and medical insurance. Part C includes Medicare Advantage Plans and Part D covers prescription drug coverage.
- Original Medicare and Medicare Advantage Plans (like HMOs and PPOs) are choices for coverage. Extra help is available for those with limited income.
- Eligibility, enrollment periods, premiums, deductibles, and cost sharing are explained for different parts and plan options. Programs like Medicaid and Medicare Savings Programs also help cover costs.
The document provides an agenda and information for a Doctors Care Program group information session for new and returning applicants in 2012. The session will cover paperwork requirements, percentage payments, primary care physicians and specialists, hospital services, prescriptions, on-site services, renewal processes, frequently asked questions, and next steps. Attendees will learn about eligibility, cost sharing, rules regarding respectful behavior, appointment attendance, and following treatment plans in order to qualify for the community care program.
This document provides an overview of Medicare, including its parts (A, B, C, and D) and enrollment details. It summarizes what is covered by Parts A and B, including hospital stays, skilled nursing facilities, home health care and hospice. It also discusses Medigap plans which supplement coverage gaps in Original Medicare.
This provider webinar has been customized to inform hospice providers about how they can participate in the Statewide Medicaid Managed Care Managed Medical Assistance (MMA) program.
CCM Presentation for KYPCA Final Draft-111115Jacqueline Todd
This document discusses chronic care management (CCM) services and billing requirements under Medicare. It defines CCM as care management for patients with two or more chronic conditions expected to last over a year. Key points include: CMS began paying separately for CCM services in 2015; eligible providers can furnish and bill for CCM; at least 20 minutes of CCM services must be provided per month to bill using CPT code 99490; and an electronic health record meeting "CCM Certified Technology" standards is required to document certain elements of the care plan and services.
ICD-10 Transition Update: What Health Lawyers Need to KnowPYA, P.C.
This document provides an overview of ICD-10 and the transition from ICD-9 to ICD-10 for healthcare organizations. It discusses the regulatory timeline requiring compliance by October 1, 2014, the differences between ICD-10-CM for diagnoses and ICD-10-PCS for procedures, organizational and financial impacts, and risk mitigation strategies for the transition. The transition represents a significant change that will impact coding, clinical documentation, claims processing, billing systems, and vendor relationships. Proper planning is needed to assess readiness and minimize risks to operations and revenue during the transition period.
The document summarizes key aspects of Medicare and Medicaid programs in the United States. Medicare provides health coverage to elderly and disabled populations, while Medicaid covers low-income and poor populations. Both programs were established in 1965 and set minimum coverage standards, though Medicaid is jointly funded by federal and state governments. The document outlines eligibility criteria and coverage details for both programs and how they have evolved over time.
The Centers for Medicare and Medicaid Services (CMS) is the largest health payer in the United States, covering almost 90 million Americans. Medicare, the federal health insurance program for adults over age 65 and other qualified individuals, accounts for more than 48 million of those Americans through expenditures of more than $545 billion. But what is Medicare? How does it work? What should helping professionals and caregivers know about the program? This session will provide a broad overview of the Medicare program’s Parts A and B as well as introduce the CMS National Training Program as a resource for further training and information.
This presentation provides a comprehensive review and forecast of the trends in Medicare Medical Review by numerous Medicare Contractors and is appropriate for all SNF Management, nursing staff, and therapy professionals. The presentation provides insight on the tidal wave of newly exposed compliance issues at the eye of the storm, leading to remote and on-site audits in the long-term care industry. Presentation highlights the historical drought in audits and the tornado effect the current scrutiny is causing amongst the SNF providers. Learn strategies to prepare records before the impending audit storm. Avoid slip ups on the seemingly invisible black ice of Medicare non-compliance. Become aware of the most recent CMS updates impacting the RAI process and subsequently reimbursement. Create an anemometer for Managers and staff to read the winds of change and create clear visibility for accurate and compliant records.
1. Learn to summarize the multiple types of Medicare Contractor Audits and associated Compliance themes.
2. Understand the trends and triggers in Compliance Audits and Common Provider Pitfalls.
3. Learn strategies for appealing Medicare Claim Denials.
Health insurance claim | Health Care DomainH2kInfosys
H2K Infosys provides online IT training and placement services worldwide. It acknowledges proprietary rights of trademarks and product names mentioned in training materials for learning purposes only. Students shall not use or sell such materials for private gain or to third parties. H2K does not guarantee or take responsibility for products and projects discussed in training.
HIGHLIGHTED: Dissemination of Patient-Specific Information from Devices by De...NextWorks
This is the highlighted version of FDA's Guidance for Industry: Dissemination of Patient-Specific Information from Devices by Device Manufacturers from June 2016.
When these guidances come out, I typically go through them and highlight the most relevant portions for those who need to skim through or refresh their memory.
Health south investor_reference_book_q1_2014_final_withfairlawnhealthsouth_ir
HealthSouth reported its Q1 2014 earnings. It provides inpatient rehabilitation services through hospitals and satellite clinics across the US. In Q1 2014, its revenues were $2.3 billion and it treated over 130,000 inpatients. HealthSouth aims to differentiate itself through clinical best practices, supply chain efficiencies, and scale. It has grown its patient volumes faster than the industry in recent years through bed expansions and new hospitals.
Medicaid is a government health insurance program for low-income families and individuals established in 1965 under President Lyndon B. Johnson as part of the Social Security Amendments. It is administered by individual states according to federal guidelines and provides coverage for various medical services and benefits. While states pay 50% of costs, there is ongoing controversy around eligibility requirements and costs as states aim to reduce spending through managed care programs while maintaining federal funding.
The Medicare Gals discuss Coverage Gaps, Medicare Part C, Supplements, Medicare Part D, Phases of Coverage for Part D and Things to Consider When Choosing a Part D Plan.
Anand Kumar Sahani is seeking a challenging position in engineering and technology that allows him to use his interpersonal and technical skills. He has over 4 years of experience in telecommunications and networking. Currently he is a Senior Engineer at Tata Communication Limited where he is responsible for fault management, troubleshooting routing protocols, and resolving issues for enterprise customers. Previously he has worked at Wipro InfoTech and Tata Communications providing technical support, provisioning VPNs, and coordinating with field engineers to resolve network issues. He has expertise in protocols like OSPF, MPLS, BGP and skills in Cisco, Alcatel and Juniper routers and switches.
This document discusses Medicare supplement (Medigap) insurance plans. It explains that although all Medigap plans offer the same basic benefits, premiums can vary between plans based on how the insurance company determines pricing. Premiums are typically based on either issue-age (when enrolled), attained-age (current age each year), or community rating (same price regardless of age). The document encourages working with an independent agent to compare options from the dozens of insurers offering Medigap, in order to find the best priced plan. It also clarifies that consumers can change plans at any time without restrictions.
Information Systems (IS) provides information for the activities in an organization. The main purpose of this research is, IS provides accurate and timely information necessary to facilitate the decision-making process and enable the organizations planning, control, and operational functions to be carried out effectively.
Information Systems (IS) is basically concerned with processing data into information and is then communicated to the various Departments in an organization for appropriate decision-making.
Brian Forbes Sr. is a retired U.S. Navy veteran of 24 years who now works as a teacher and part-time insurance salesman, specializing in helping seniors. He represents over a dozen reputable insurance companies with billions of assets in total such as Mutual of Omaha, Transamerica, Foresters, and Columbian Financial Group. His business model focuses on personal safety, security, and comfort for clients through one-way video communication and a secured server without pressure.
Vdamodar was born in a remote village in Kerala, India and had a primary education there but was unable to continue further due to financial constraints. He began working as a typist in Mumbai at age 17. Through part-time studies and self-learning, he acquired several qualifications and titles including diplomas, degrees, and fellowships in commerce, accountancy, and company secretarial practice. He worked in senior positions in India and the United Arab Emirates, helping companies with public offerings, financing, and expansion. Starting in the 1980s, he founded or expanded several business in trading, manufacturing, and the medical field in the UAE, India, Botswana and Zimbabwe. He also contributed to the community by
Radhey Raval is seeking new assignments as an MEP Engineer with over 4 years of experience in India and Qatar. He has experience managing all phases of MEP projects including planning, monitoring, controlling, coordination, administration and resource planning. His areas of expertise include MEP design, material management, site supervision, cost control, installation and commissioning of electrical, HVAC, plumbing and fire protection systems. He holds a Bachelor's degree in Electrical Engineering and certifications in AutoCAD, project management, construction safety and quality management.
Burial insurance or final expense insurance provides life insurance coverage until age 100 to cover funeral and end-of-life expenses. It has simpler application and qualification processes than other life insurance policies. The policies provide flexibility for beneficiaries to use the funds for expenses associated with a loved one's death, including funeral costs, travel costs for out-of-town family, and other costs that can add up. Final expense insurance also offers fixed premiums, cash value accumulation, and permanent coverage making it a wise investment for the future.
Este documento describe los conceptos básicos de los circuitos lógicos y su aplicación en el diseño de circuitos. Explica qué son los circuitos lógicos, las clases de circuitos lógicos (serie y paralelo), y los pasos para construir un circuito lógico a partir de una proposición lógica. Concluye resaltando la importancia de los circuitos lógicos y recomendando la práctica constante para comprender y aprender a formular y resolver estos tipos de circuitos.
Yasmin Bi Shaikh is seeking a challenging position that utilizes her qualifications and experience. She has a Bachelor of Commerce degree and is proficient in Microsoft programs, accounting, administration, data entry, customer service and marketing. Her work experience includes over 8 years as an Admin Manager and Account Assistant for a distribution and franchise company, where she handled accounting tasks, prepared reports, processed invoices and orders, managed staff, and assisted the managing director. She aims to contribute her skills in communication, organization, attention to detail, and ability to work efficiently under pressure.
Dailykart aims to provide a mobile app and website allowing users to order groceries online from nearby stores for delivery. This addresses issues with the unorganized local grocery sector like inconsistent delivery options and inability to check product availability. The app will connect users to local shops, incorporate gamification not seen in other online grocery platforms, and ensure quality products and fast delivery through the local shop network. This has the potential for high profits by addressing limitations of major competitors while exploiting the needs of customers for easy, convenient grocery shopping. An initial test launch in a small area will provide performance data to guide long-term strategy and goal-setting.
Lesley Sergeant is a British national with over 30 years of experience in ladies fashion manufacturing. She has extensive experience managing production from fabric sourcing to delivery with factories in China, Romania, Tunisia, and Morocco. Her skills include critical path management, fabric and component approval, quality control, and issue resolution. She is self-motivated, dedicated, and able to work under pressure to meet deadlines.
UnitedHealthcare Insurance Company has partnered with AARP to offer AARP Medicare Supplement Insurance Plans to individuals enrolled in Medicare Parts A and B. The plans are designed to help cover costs that Original Medicare does not cover, such as copays, coinsurance, and deductibles. They provide coverage for medically necessary care and offer member services. Customers consistently report high levels of satisfaction with the benefits and coverage provided by the AARP Medicare Supplement Insurance Plans.
The healthcare needs of the people have changed over time with the emergence of new ailments, and so has the healthcare industry. Following the steep rise in the cost of medical treatments, the necessity for some sort of cover to provide protection during a medical emergency has increased. Considering the changing lifestyle and needs of the people, the medical schemes in South Africa have also evolved over time.
Discover the top Medicare Advantage plans available in California, Florida, and Texas for the year 2023. Explore the process of effectively comparing these plans to ensure you can make well-informed healthcare choices. Delve into our blog for comprehensive insights on how to navigate these options and select the most suitable plan for your needs.
Uncover the leading Medicare Advantage plans offered in three prominent states: California, Florida, and Texas. This valuable information empowers you to assess various plans and their benefits, ultimately aiding you in making informed healthcare decisions.
Our blog provides a comprehensive guide on effectively comparing Medicare Advantage plans. By following our guidance, you can navigate through the intricacies of these plans, considering factors such as coverage, costs, and network availability. Armed with this knowledge, you can confidently choose a plan that aligns with your unique healthcare requirements.
For a deep dive into understanding how to make the best choice among Medicare Advantage plans in these states, explore our informative blog. Equip yourself with the insights necessary to secure a healthcare solution that caters to your well-being and peace of mind throughout 2023 and beyond.
The document is a sales presentation for WellCare Medicare Advantage and prescription drug plans. It discusses:
- The agent's background and mission to provide information about WellCare plans
- An overview of Medicare options including Original Medicare, Medicare Advantage, and prescription drug plans
- Specific benefits of WellCare plans like low premiums, more predictable costs, and additional benefits like vision/dental
- How members can access services through WellCare's network and prescription drug coverage through its formulary
The document provides an overview of the various benefits available to employees at lynda.com, including:
- Medical insurance options through Anthem including HMO and PPO plans
- Dental and vision insurance through MetLife and VSP respectively
- Income protection through life insurance, AD&D, short-term disability, and long-term disability
- Voluntary benefits like supplemental life insurance
- Retirement savings through a 401(k) plan
- Spending accounts for health, dependent care and transportation expenses
- Paid time off and other perks like an employee assistance program and discounts.
The document provides an overview of the Canadian pharmaceutical market, highlighting several key trends that will affect pharmaceutical manufacturers. The Canadian market, while smaller than some other countries, still ranks among the top 10 globally in drug spending. Launching a drug in Canada can be profitable if manufacturers understand the specific nuances of the market, such as Canada's complex reimbursement system with both public and private insurance. Health technology assessments play an important role in reimbursement decisions. Manufacturers must tailor their reimbursement and launch strategies to the target payer market, whether public or private plans. Health economic evidence is also becoming increasingly important for market access, pricing, and contracting in Canada.
The document provides an overview of navigating Medicare benefits and healthcare options in the US. It discusses qualifying for and enrolling in Medicare, including Parts A, B, C, and D. It also covers tools and resources for help paying premiums and medications, as well as planning for long-term care. Resources listed include Medicare.gov, Medicaid programs, and organizations that provide assistance.
Medicare 101 Presentation from Erin Hart, American HealthCare GroupMary Hagan
Erin Hart is an independent licensed Medicare Broker who helps retirees and seniors decide which Medicare benefit is the best choice for them. She meets with individuals or employer and community groups.
Medicare is federal health insurance for people aged 65 or older. It has different parts that cover various medical costs. Part A covers inpatient hospital stays and skilled nursing facilities. Part B covers outpatient services and has a monthly premium. Part D provides prescription drug coverage. Medicare Advantage plans are an alternative that bundle Parts A, B, and usually D. Supplemental Medigap plans help cover costs like copays and deductibles. Choosing the right Medicare plan requires understanding eligibility, costs, and coverage details for original Medicare versus Medicare Advantage and Medigap options.
White paper - Combating COVID19 - Payer in a Box BPaaS solutionsPaul Simon Arakkal
The U.S Healthcare Industry is going through an unprecedented 100 year phenomenon - COVID19. It has impacted clients, customers and their families. This White Paper points to Insurance in a Box BPaaS Solutions as a viable business option for Payers to combat COVID19 related healthcare and operational challenges.
- People with limited income may qualify for "Extra Help" programs that help pay Medicare costs. To learn more, contact the Social Security office or visit their website.
- The National Association of Health Underwriters can help you review your Medicare choices and find certified insurance professionals to assist you at no cost.
- There are specific enrollment periods and potential penalties for Medicare (Parts A, B, and D). Enrolling in supplemental plans, Medicare Advantage, or prescription drug plans also have regulations around enrollment periods. It's best to enroll in Medicare when first eligible.
MediMeals Investor Presentation - February 2017Cory Glazier
Clinical trials have proven irrevocably that heart disease and diabetes can be reversed through deliberate nutritional therapy with a shift to consuming a whole food, plant-based diet.
MediMeals is an evolutionary health service that makes it as easy for doctors to prescribe scientifically proven meal regimens as it has been to prescribe pharmaceuticals and surgery in the past.
We get nutritionally precise, delicious meals to our patients nationwide, on doctor's orders.
We have reduced the learning curve and time constraints to upgrading diet. Healing the body with food has never been as accessible.
Minimum Essential Coverage (MEC) plans with limited benefits and healthcare concierge services are described. MEC plans provide the minimum level of health insurance required under the Affordable Care Act to avoid penalties, through benefits like preventive care visits and generic prescriptions. Additional services include telemedicine, medical bill negotiation, and discounts. Employers can offer MEC plans to comply with ACA mandates while controlling costs. The document provides details on specific MEC plan options and support services available.
2020 Medicare AEP Campaign Highlights - Media LogicMedia Logic
UnitedHealthcare, Aetna Medicare, and Humana saw the largest enrollment gains during the 2020 Medicare Annual Election Period, increasing their enrollments by 8.3%, 16.7%, and 5.2% respectively. Many top plans focused their direct mail marketing campaigns on supplemental benefits like dental, vision, hearing and transportation assistance to differentiate themselves. Additional factors beyond marketing also influence enrollment growth, such as market competition, broker incentives, and plan benefits.
This document summarizes a webinar about increasing revenue from Chronic Care Management (CCM) programs. It discusses how the CCM program works, how practices can participate, and how the Discharge IQ application can help practices manage patients and maximize their CCM revenue. Discharge IQ is a mobile application that monitors chronic care patients daily through simple diagnostic questions. It alerts doctors to issues and helps manage large panels of chronic patients more efficiently to qualify for the $42 per month CCM reimbursement from Medicare.
This document summarizes insurance eligibility, coverage, and benefits for residential behavioral health settings. It finds that 84% of admissions in 2009 were insurance-based. It describes differences between in-network and out-of-network coverage for major insurance providers, as well as plan types like PPO, HMO, EPO, and POS. The document also outlines eligibility criteria, covered benefits, and patient financial responsibility. Finally, it reviews behavioral health levels of care and pre-admission screening information required.
SilverScript offers two Medicare Part D prescription drug plans - SilverScript Choice and SilverScript Plus - to provide affordable prescription drug coverage to eligible Medicare beneficiaries. The plans have $0 deductibles, low copayments, cover over 3,200 drugs, and include access to over 68,000 pharmacies nationwide as well as mail order drug delivery. A SilverScript agent can help enroll individuals and recommend the plan that best fits their health and budget needs.
This document provides an overview of Medicare Advantage plans offered by Freedom Health, including plan benefits, costs, and how to enroll. It highlights that Freedom Health is an NCQA accredited Medicare Advantage plan focused on preventive care with a network of local concierge offices. The document reviews Medicare Advantage basics, compares options to original Medicare, and outlines various extra benefits offered by Freedom Health plans like fitness memberships, over-the-counter allowances, and transportation. It also provides information on prescription drug coverage, the formulary, and cost-sharing stages. A primary care provider serves as a member's medical home to coordinate all care through Freedom Health's network of specialists, hospitals, and other providers.
SilverScript offers two Medicare Part D prescription drug plans - SilverScript Choice and SilverScript Plus - to provide affordable prescription drug coverage to eligible Medicare beneficiaries. The plans have $0 deductibles, low copayments, cover over 3,200 drugs, and include access to over 68,000 pharmacies nationwide as well as mail order drug delivery. A SilverScript agent can help enroll individuals and recommend the plan that best fits their health and budget needs.
Brian Forbes Sr. is a retired U.S. Navy veteran who now works as a teacher and part-time insurance salesman. He has been helping seniors with their insurance needs for the last 8 years. He is licensed to sell insurance in multiple states so he can help customers all over the United States. He enjoys assisting seniors and ensuring they have the best insurance plans at affordable prices.
United American's accidental death policy provides $3,000 of coverage for the policyholder, $3,000 for a spouse, and $2,000 per child. No premium is due for the first year and coverage begins when the application is signed. Accidents are a leading cause of death for those aged 1 to 44 and the fifth overall. The policy is noncancelable and guaranteed renewable up to age 70 with $10 annual premiums due after the first year.
The document describes Legacy Safeguard's services which include a Legacy Planning Guide software to help users store important documents and records, a personal member webpage to share memories and stories with family and friends, and advisors who can help guide a user's family with funeral planning and provide other assistance upon the user's death to ease their burden. The services aim to help users preserve their legacy and celebrate their life while planning for end of life arrangements.
The document describes Legacy Safeguard, a service that helps users preserve their legacy for future generations. It does this by providing a Planning Guide to record family values, personal information, financial accounts, and personal wishes. This helps loved ones have access to important details and reduces stress. Membership provides end of life planning assistance, a personal webpage to share one's legacy, and support services to help families with arrangements and grief. The goal is to protect families and users' legacies.
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The report *State of D2C in India: A Logistics Update* talks about the evolving dynamics of the d2C landscape with a particular focus on how brands navigate the complexities of logistics. Third Party Logistics enablers emerge indispensable partners in facilitating the growth journey of D2C brands, offering cost-effective solutions tailored to their specific needs. As D2C brands continue to expand, they encounter heightened operational complexities with logistics standing out as a significant challenge. Logistics not only represents a substantial cost component for the brands but also directly influences the customer experience. Establishing efficient logistics operations while keeping costs low is therefore a crucial objective for brands. The report highlights how 3PLs are meeting the rising demands of D2C brands, supporting their expansion both online and offline, and paving the way for sustainable, scalable growth in this fast-paced market.
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During the budget session of 2024-25, the finance minister, Nirmala Sitharaman, introduced the “solar Rooftop scheme,” also known as “PM Surya Ghar Muft Bijli Yojana.” It is a subsidy offered to those who wish to put up solar panels in their homes using domestic power systems. Additionally, adopting photovoltaic technology at home allows you to lower your monthly electricity expenses. Today in this blog we will talk all about what is the PM Surya Ghar Muft Bijli Yojana. How does it work? Who is eligible for this yojana and all the other things related to this scheme?
2. 2
Table of Contents............................................................2
Important Disclaimers.....................................................3
Plan Presentation ..........................................................4
Medicare Advantage Basics .............................................5
Why Choose Freedom Health?..........................................6
More Benefits & More Savings .........................................7
Visit Our Concierge Office................................................8
Preventive Services.........................................................9
Formulary Information ...................................................10
Prescription Drugs........................................................11
Your Medical Home.......................................................12
Freedom Health Plans ...................................................13
Enrollment ...................................................................14
What to Expect After You Enroll .....................................15
Your Freedom ID Card...................................................16
Benefit Overview...........................................................17
Plan Finder..............................................................18-19
Plan Benefits...........................................................20-27
How to Use Your Benefits and Services......................28-33
Member Portal .............................................................34
Maximum Out of Pocket (MOOP) ....................................35
How to Enroll................................................................36
Over-the-Counter Health Related Supplies ..................37-39
Questions ....................................................................40
Table of Contents
3. 33
Freedom Health is an HMO plan with a Medicare contract and a contract with the Florida Medicaid
program. Enrollment in Freedom Health depends on contract renewal.
This information is not a complete description of benefits. Contact the plan for more information.
Benefits, premiums and/or co-payments/co-insurance 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.
You must continue to pay your Medicare Part B premium. Limitations, co-payments and restrictions may
apply. Benefit amounts may vary based on plan and county.
The Part B premium is covered for full dual members of Special Needs Plans.
Our dual eligible Special Needs plans are available to anyone who has both Medical Assistance from the
State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of
Extra Help that you receive.
Our chronic condition Special Needs plan is available to anyone with Medicare who has been diagnosed
with Diabetes, Cardiovascular Disease, Chronic Heart Failure, or Chronic Obstructive Pulmonary Disease
(COPD).
Freedom Health is accredited by the National Committee for Quality Assurance. NCQA Health Plan
Accreditation evaluates how well a health plan manages all parts of its delivery system --physicians,
hospitals, other providers and administrative services -- in order to continuously improve the quality of
care and services provided to its members.
Freedom Health has been approved by the National Committee for Quality Assurance (NCQA) to operate
a Special Needs Plan (SNP) until 2018 based on a review of Freedom Health’s Model of Care.
A sales person will be present with information and applications. For accommodation of persons with
special needs at sales meetings call 1-888-796-0946, TTY: 711.
HMO eligible beneficiaries may enroll in the plan only during specific times of the year.
HMO-SNP eligible beneficiaries can enroll at any time.
Contact the Plan for more information at the number listed on the back page.
Important Dates
each year
October 1:
Oct 15 – Dec 7:
Important Disclaimers
4. 4
Name of Benefit Consultant: _________________________
Prospective Members: please write the name of the plan representative with
whom you are meeting.
This Presentation will cover Freedom Health’s Medicare
Advantage HMO Plans and Medicare Advantage HMO Special
Needs Plans and will highlight the following information:
Your Current Medicare Coverage
Comparing Medicare Advantage to Original Medicare
Freedom’s Benefit Plan Options
Choosing the Best Plan for You
How to Enroll in a Freedom Health Medicare Advantage
HMO Plan or HMO-SNP Plan
Plan Presentation
5. 5
What is Medicare?
Medicare is federal health
insurance for:
people 65 and older,
younger people with certain
disabilities, and
people with end-stage renal
disease
(with limited exceptions).
Medicare Advantage Basics - Are you Eligible?
You must have both Medicare parts “A” and “B”.
You must be a permanent resident in the area
where the plan is offered.
People with End Stage Renal Disease are not
eligible for Medicare Advantage (with limited
exceptions).
6. 6
Why Ch se Freedom Health?
Freedom Health is...
Owned and operated by doctors
Focused on preventive care
Headquartered in Tampa, FL
Accredited by NCQA with a
“Commendable” rating.
An HMO plan with a Medicare
contract and a contract with the
Florida Medicaid program.
4.0 Overall Medicare Star Rating*
1
2
3
4
5
6
7. 7
More Benefits + More Savings = Better Value!
Here are some of the best reasons to join!
Receive a monthly over-the-counter allowance from $10 to $45
each month based on plan selection. That’s a savings between
$120 and $540 over the course of a year! Easy online ordering
or phone your order in! Your order is shipped to you at no cost.
Get a SilverSneakers®
Fitness Membership at no cost to you!
With access to thousands of locations, you will have use of the
equipment, pools, saunas and other amenities. You can also
order a SilverSneakers®
Steps home fitness kit if that is more
convenient!
Save with a Part B premium refund on select plans. That’s a
savings between $36 to $80 each month or between $432
to $960 over the course of a year applied back to your social
security check!
Valuable Vision, Dental and Hearing benefits.
Receive between 4 and 12 one way Transportation trips on our
Freedom Medicare, Platinum or Chronic SNP plans depending
on the plan. Our Dual SNP plans offer 12 round transportation
trips.
Stay healthier with an array of Preventive Services at NO COST
to YOU! Receive an Annual Wellness Visit, screenings, vaccines
and many other services to keep you on track.
Brand and Generic prescription drug coverage is available on
plans that offer part “D” coverage. Gap coverage is available on
select plans.
With our home delivery pharmacy, you will receive 3 months
supply for 2 months copay on most plans with prescription drug
coverage. Easy ordering and delivery within 10 days. You can
also sign up for automated mail order delivery.
8. 8
Visit our Concierge Offices
Hillsborough/Pinellas/Polk
5403 N. Church Ave., Tampa
Toll Free: 1-888-211-9918
Indian River/Martin/St. Lucie
1187 S. US Hwy. 1, Vero Beach
Toll Free: 1-888-274-8575
Lake/Marion/Sumter/Volusia
2102 SW 20th Pl.,Building 200,
Suite 201, Ocala
Toll Free: 1-888-420-2539
www.freedomhealth.com.
Brevard/Orange/Osceola/Seminole
950 S. Winter Park Dr., Suite 340, Casselberry
Toll Free: 1-888-364-7905
Charlotte/Manatee/Sarasota
3874 E. SR 64, Bradenton
Toll Free: 1-888-850-5315
Citrus/Hernando/Pasco
8373 Northcliffe Blvd., Spring Hill
Toll Free: 1-888-211-9921
Collier/Lee
6831 Palisades Park Ct., Suite 1, Ft. Myers
Toll Free: 1-888-272-2992
Our Local Concierge Centers Offer:
(replacement cards, PCP changes, etc.)
Member Services: TTY: 711
Healthcare is local – whether it’s your doctor, your specialist, or your insurance
provider. We’re headquartered in Tampa, Florida with local concierge centers
throughout the State.
Visit or Call Us at a Location Near You
Concierge Hours of Operation: 8am - 5pm,
Monday - Friday
10. 10
Formulary Information
The plan has four (4) cost-sharing tiers. Every drug on the plan’s Drug List is in one of
four cost-sharing tiers. To find out which cost-sharing tier your drug is in, look it up in
the plan’s Formulary. Then refer to the benefits section for plan-specific cost-sharing.
How do you find your drugs in the Formulary?
There are two ways to find your drug within the formulary:
1) Alphabetical Listing
The Index of the Formulary provides an alphabetical list of all
of the drugs along with the page number where you can find
coverage information.
2) Medical Condition
Drugs in the formulary are grouped into categories depending
on the type of medical conditions that they are used to treat. For example, drugs
used to treat a heart condition are listed under the category “Cardiovascular
Agents”.
Initial Coverage Stage Drug Costs
Formulary(List of Covered Drugs)
PBP Plan Name
078 Freedom Medi-Medi Partial (HMO SNP)
087 Freedom Medi-Medi Full (HMO SNP)
11. 11
Prescription Drugs
How Much Do You Pay for Prescription Drugs?
Stage 3
Catastrophic
Coverage Stage
Once you have paid
enough for your drugs
to move onto this last
payment stage, the plan
will pay most of the cost
of your drugs for the
rest of the year.(2)
Stage 1
Initial Coverage Stage
The plan pays its
share of the cost of your
drugs and you pay your
share of the cost.
You stay in this stage
until your payments for
the year plus the plan’s
payments total $3,310.
Stage 2
Coverage Gap Stage/
Donut Hole
You pay 58% of the
generic drug cost and
the discounted cost for
brand drugs until the
yearly out-of-pocket drug
cost reaches $4,850,
unless you are already
getting Medicare Extra
Help.(1)
12. 12
Your Network Primary Care Provider (PCP) coordinates all of your
care. A network PCP is considered your “medical home”.
Benefits of a Medical Home
Your Medical Home
Hospital
Ancillary
DME Supplies Pharmacy
Wellness
Services
Network Specialist
Network PCP
13. Freedom Health Plans
The Freedom Health Medicare Advantage HMO are plans with and without
prescription drug coverage that offer many valuable benefits.
Freedom Health also offers two types of Special Needs Plans (SNPs). If you
qualify to join a Medicare SNP, you get all of your Medicare hospital and
medical health care services through the plan, including Medicare prescription
drug coverage:
with drug
coverage are plans available to anyone who has both Medical Assistance
from the State and Medicare. Premiums, co-pays, co-insurance, and
deductibles may vary based on the level of Extra Help you receive.
with drug coverage
are plans for those individuals who have been diagnosed with chronic or
disabling conditions such as:
Freedom Health has a plan for you!
- Cardiac Arythmias
- Coronary Artery Disease
- Peripheral Vascular Disease
- Chronic Venous Thromboembolic
Disorder
- COPD
- Bronchitis
- Asthma
- Pulmonary Fibrosis
13
14. 14
Enrollment
eligible individuals may enroll or end their enrollment in a MA plan. The AEP
occurs October 15th through December 7th of each year.
following January 1st of each year.
the year.
may be able to enroll with an earlier effective date.
Please call our Member Services
department for more information
or refer to the “Medicare & You”
handbook for more information on
enrollment periods. You can review
this handbook on the web by visiting:
www.medicare.gov/publications/
15. 15
What to Expect After You Enroll
You will receive a Freedom Health welcome packet
and other plan materials that include:
(Material covers may vary)
FRH12KITENV
P.O. Box 151137, Tampa, FL 33684
www.freedomhealth.com
Address Service Requested
2015
Evidence of Coverage
5
ge
2015 Provider andPharmacy Directory
Formulary
(List of Covered Drugs)
PBP Plan Name078 Freedom Medi-Medi Partial (HMO SNP)
087 Freedom Medi-Medi Full (HMO SNP)
ID: <0000000000> <0000>
<FIRST><MI><LAST>
Eff. Date: <Insert date>
PCP: <John Doe, M.D.>
Phone: <555-555-5555>
RxBIN#: 610011 RxPCN#: IRX
RxGrp#: MPDH5427 Issuer#: 80840
RxID#: <Insert member ID#>
Member Since
H5427 – PBP<number>
SAMPLE00000000> <0
T><MI <LAST>
M
16. 16
ID: <0000000000> <0000>
<FIRST><MI><LAST>
Eff. Date: <Insert date>
PCP: <John Doe, M.D.>
Phone: <555-555-5555>
RxBIN#: 610011 RxPCN#: FRH
RxGrp#: MPDH5427 Issuer#: 80840
RxID#: <Insert member ID#>
Member Since
H5427 – PBP<number>
Identifies your plan
benefits for your
pharmacist
Your Freedom
identification number
The year you joined
Freedom Health
Name of your Freedom
Medicare Advantage
Plan
Your Plan Number
Up-front payments for
the plan benefits you
receive
Member Services
Toll-Free Number
Information for your
doctor, pharmacist or
hospital
<Freedom Plan Name>
Member Services: 1-800-401-2740
TTY/TDD: 1-800-955-8771 www.freedomhealth.com
Behavioral Health: <X-XXX-XXX-XXXX>
Provider Services (UM): <X-XXX-XXX-XXXX>
Pharmacy Technical Support: <X-XXX-XXX-XXXX>
Part D Prior Authorization: <X-XXX-XXX-XXXX>
Submit Claims to:
Freedom Health
Claims Department
P.O. Box 151348
Tampa FL 33684
EDI Payer ID: XXXXX
Urgent Care: <$>
ER: <$>
Your Freedom ID Card
SAMP00000000
T><MI><LAST>AMPLE0000> <
SAMPPLEP
SAMPLE
: 1-800-401-27
1-800-955-877 www.freedomh
lth: XXASAMPLSA
17. 17
Our Representative will show you the
specifics of your Freedom Health Medicare
Advantage plan benefits, using the Plan
Overview and the 2016 Formulary.
2016
Benefits
Benefit Overview
18. 18
Plan Type MAPD
Plan Name Freedom Medicare Plan Rx Freedom Platinum Plan Rx
Freedom VIP
Care
F
HMO HMO HMO-SNP
Plan ID#
County
059 060 088 089 091 092 093 094 070
Brevard X
Broward X
Charlotte X
Citrus X X X
Collier
Hernando X X
Hillsborough X X
Indian River X X
Lake X X X
Lee X
Manatee X X X
Marion X X X
Martin X
Miami-Dade X X
Orange X X X
Osceola X X X
Palm Beach X X
Pasco X X
Pinellas X X
Polk X X
Sarasota X X
Seminole X X X
St. Lucie X X
Sumter X X X
Volusia X
Plan Finder Chart
19. 19
Find a plan in your county
CSNP MA DSNP
P Freedom VIP
Savings
Freedom VIP
Savings COPD
Freedom VIP
Savings
Freedom VIP
Savings COPD
Freedom Savings
Plan
Freedom
Medi-Medi Partial
Freedom
Medi-Medi Full
HMO-SNP HMO-SNP HMO-SNP HMO-SNP HMO HMO-SNP
072 077 082 083 052 078 087
X X X X
X X X X
X X X X
X X X X X
X X X X
X X X X X
X X X X X
X X X X X
X X X X X
X X X X X
X X X X X
X X X X X
X X X X X
X X X X X
X X X X X
X X X X X
X X X X X
X X X X X
X X X X X
X X X X
X X X X X
X X X X X
X X X X X
X X X X X
X X X X X
28. 28
How to Use Your Benefits and Services
Member Services
Contact us at 1-800-401-2740. TTY users: 711,
8am - 8pm 7 days a week from Oct 1 - Feb 14 and
8am - 8pm Monday-Friday from Feb 15 - Sept 30.
Chiropractic
For Chiropractors, call our Member Services
department or talk to your PCP for chiropractic
questions.
Dental, Vision &
Hearing
Freedom partners with Argus Dental for both Dental
and Vision services. Please call Member Services
for a provider listing, or review providers at www.
argusdentalvision.com. Hearing services are provided
by HearUSA. They can be contacted at 1-800-333-
3389.
Freedom has partnered with SilverSneakers®
to
all of our plans. Please visit their website at www.
silversneakers.com or call our Member Services
department for the most updated participating network
Please take your Freedom ID to the participating
Lab Services
Freedom Health partners with Quest Diagnostics to
provide clinical laboratory services. Call them directly
at 1-800-377-8448. TTY/TDD users call 711 or visit
their website at www.questdiagnostics.com for a
location near you.
Over-the-Counter
Health Related
Supplies
may contact us directly. A list of available supplies
are on page 37, along with ordering information. You
will receive supplies in approximately 7-10 business
days after you submit your order.
Podiatry
Participating podiatrists are listed in the Provider
Directory. Call our Member Services department or
talk to your PCP for podiatry questions.
Service How to Find It?
While you must stay within our network of providers, these companies were chosen through a
29. 29
Using Your Plan: Vision Benefits
All of our plans also offer vision
after each cataract surgery that includes
insertion of an intraocular lens. Corrective
lenses/frames (and replacements) needed
after cataract removal without a lens implant.
(continued on next page)
Vision Benefits
Freedom Savings Plan
(HMO): 052
Freedom Medi-Medi Partial
(HMO SNP): 078
Freedom Medi-Medi Full
(HMO SNP): 087
Freedom Medicare Plan Rx (HMO):
059, 060
Freedom VIP Care (HMO SNP): 070
Freedom VIP Savings (HMO SNP):
072, 082
Freedom VIP Savings COPD
(HMO SNP): 077, 083
Freedom Platinum Plan Rx (HMO):
088, 089, 091, 092, 093, 094
Covered
Services
Co-Pays Co-Pays Co-Pays
Eye Exams
31. Dental Benefits
Freedom Savings Plan
(HMO): 052
Freedom Medi-Medi Partial
(HMO SNP): 078
Freedom Medi-Medi Full
(HMO SNP): 087
Freedom Medicare Plan Rx
(HMO): 059, 060
Freedom VIP Care (HMO SNP): 070
Freedom VIP Savings
(HMO SNP): 072, 082
Freedom VIP Savings COPD
(HMO SNP): 077, 083
Freedom Platinum Plan Rx (HMO):
088, 089, 091, 092, 093, 094
Covered Services Co-Pays Co-Pays Co-Pays
(continued on next page) (continued on next page) continued on next page)
31
Using Your Plan: Dental Benefits
We all want a great smile, so all of our plans offer
include:
dental provider)
(excludes periodontal scaling, root planing and periodontal
maintenance)
33. 33
Using Your Plan: Hearing Benefits
on most plans:
years.
years.
featuring choice of style and
technologies.
Hearing Benefits
All Plans
Covered Services Co-Pays
Diagnostic Hearing
Exam
Routine Hearing Exam
Hearing Aids
34. Register & Do More Online
with our Member Portal!
Here are some of the benefits you will receive:
Place & track orders
for your over-the-
counter medication
and diabetic supplies.
Print and order your
ID CARD, provider
directory, formulary
and other Plan
materials.
View your claims
information.
Track your out-of-
pocket expenses.
(MOOP)
Personal
Health Tracker
Find a Plan Doctor,
Pharmacy, Hospital
and covered drug.
Gain access to
health & wellness
information.
Access important Plan
forms and documents
from central location.
Complete your Health
Assessment Form
NEW!
NEW!
34
35. 35
Inpatient Services
Outpatient Services
Services
Services (OT, PT, & ST)
Outpatient Medical
Services & Supplies
Training
Pneumonia)
Exams
The following services / benefits count towards your maximum out-of-
pocket (MOOP). The MOOP amount for most 2016 Freedom Health
Plans is $3,400.
Maximum Out Of Pocket Expenses
36. H
Record Your Important Information
Plan Name:
PBP Number:
Enrollment Application Number:
Effective Date:
Network PCP Name & Number:
Over-the-Counter Allowance per month:
How to Enroll:
1. Have your Medicare ID or proof of eligibility ready before you begin the
application process.
2. You may complete the application on paper or through our website:
www.freedomhealth.com.
can help with any of these methods. If you need help, finding an agent,
call our toll-free number.
3. Medicare beneficiaries may also enroll in Freedom Health through
the CMS Medicare Online Enrollment Center located at
http://www.medicare.gov.
4. Choose a primary care physician. Use our Provider Directory to find
or go to our website at www.freedomhealth.com and from
the Quick Links section, choose Provider Search.
5. Look up your prescriptions in our formulary booklet or go to our
website and from the Quick Links section, choose the Drug Search.
36
37. More Supplies To Ch se From!
or call:1-866-900-2688 TTY: 711
You receive
medications
by mail
3
2We process
your order
1Visit our
website or
call to place
your order
37
Monthly Over-The-Counter Allowance - Benefits you can use everyday!
Log on to:
www.freedomhealth.com
38. 38
Save Time & Money in Over-the-Counter S
Item
6I Generic Comparable of Chloraseptic
6K Halls Sugar Free Cough Drops
6L Generic Comparable of Mucus Relief
6M Generic Comparable of Cepacol
(7)
7A Generic Comparable of Collyrium Eye Was
7B Generic Comparable of Visine
7C Generic Comparable of Visine Tears
7E Generic Comparable of Zaditor
(8) First Aid Creams
8A Generic Comparable of Benadryl Cream
8B Generic Comparable of Bacitracin
8C Generic Comparable of Lotrimin
8D Generic Comparable of Cortisone
8E Generic Comparable of Zinc Oxide
8F Generic Comparable of Neosporin
8G Generic Comparable of Micatin
8H Generic Comparable of Debrox
(9) Firs
9A Generic Comparable of Ace Bandage 3"
9B
9C Cotton Balls
9D Ice Bag
9E Generic Comparable of J&J Gauze
9F Digital Themometer
9G Generic Comparable of Q-Tips
(10
10A Generic Comparable of Colace
10B Generic Comparable of Fibercon
10C Generic Comparable of Miralax
10D Generic Comparable of Fleet Enema
(11) Misc
11A Digital Blood Pressure Kit*
11B Blood Pressure Kit*
11C Generic Comparable of Band Aid
11D Generic Comparable of Coppertone Sunscreen
11E Generic Comparable of Dramamine
Item Item Description Qty. Price
(1) Allergies
1A Generic Comparable of Chlortrimeton Chlorpheniramine Maleate 4mg 24 $4
1B Generic Comparable of Benadryl Elixir Diphenhydramine HCI 12.5 mg 118ml $3
1C Generic Comparable of Benadryl Caps Diphenhydramine HCI 25 mg 24 $3
1D Generic Comparable of Ocean Saline Nasal Spray Deep Sea Nasal Saline 0.65% 44ml $3
1E Nasacort Allergy 24 Hour 10.8 ml $15
1F Flonase Fluticasone propionate (glucocorticoid) 50mcg 9.9 ml $15
(2) Analgesics
2A Generic Comparable of Tylenol Ex 500mg 100 $4
2B Generic Comparable of Bayer Aspirin Aspirin 325mg 100 $3
2C Generic Comparable of Zostrix 60g $7
2E Generic Comparable of Advil 24 $3
2F Generic Comparable of Ben Gay Muscle Rub 35g $3
2G Generic Comparable of Aleve Naproxen sodium 220 mg CPL 50 $7
2H Generic Comparable of Bayer Aspirin Low Dose 81 mg Aspirin EC (Delayed Release) 81 mg 120 $4
2I Generic Comparable of Tylenol PM Acetaminophen 500 mg/Diphenhydramine HCI 25 mg 50 $5
2J Generic Comparable of Bayer Aspirin Low Dose Chewable Aspirin 81 mg Chewable 36 $4
2K Generic Comparable of Icy Hot Patch Cold and Hot Patch 5 $8
2L Generic Comparable of Excedrin Headache Formula-Aspirin/Acetaminophen/Caffeine 100 $7
(3) Antacids
3A Generic Comparable of Tums-Ex Calcium Carbonate 750 mg 96 $5
3B Generic Comparable of Gas-X 100 $5
3C Generic Comparable of Zantac 75 Ranitidine 75 mg 30 $9
3D Generic Comparable of Alka Seltzer Antacid & Pain Relief 12 $6
(4) Anti-Diarrheals
4A Generic Comparable of Imodium Loperamide 2 mg 12 $4
4B Generic Comparable of Pepto Bismol 30 $5
(5) Anti-Hemorrhoidals
5A Generic Comparable of Cortaid Maximum Strength Hydrocortisone oint, USP 1% 28g $6
5B Generic Comparable of Preparation H Prompt Relief Hem Ointment 57g $7
5C Generic Comparable of Preparation H Suppositories Hemorrhoidal Suppositories 12 $13
(6) Cough/Cold
6A Generic Comparable of Robitussin Sugar-free Dm Sugar-free cough syrup 118ml $5
6B Generic Comparable of Vicks Medicated Chest Rub 100g $6
6C Mucinex Dm Mucinex DM 600 mg 20 $20
6D Generic Comparable of Afrin nasal Spray Nasal Spray 15ml $3
6H Generic Comparable of Tylenol Sinus Congestion & Pain Sinus-Acetaminophen/Phenylephrine HCI 24 $5
*These items are considered dual purpose items. Prior to ordering these items, the enrollee must have an appropriate conversation with the enrollee’s p
DISCLAIMERS:
1. OTC items may only be purchased for the enrollee; it is prohibited to purchase supplies
for family members, and friends.
2. The following supplies are not covered as they are non-eligible supplies: Alternative
Medicines (Includes botanicals, herbals, probiotics, homeopathic, and neutraceuticals),
baby supplies, contraceptives, convenience & comfort supplies (insoles, gloves, etc.),
cosmetics, food products or supplements, replacement & attachments such as contact
lens containers or batteries.
3. To minimize mailing costs the plan may impose a limited ordering quantity per purchase.
4. This list is subject to change.
Orders will be shipped via UPS or USPS. Please allow 7-
receive your order from the time the order is placed.
6. Please consult with your doctor before using any OTC pro
7. All OTC supplies are generic comparable of Brand item. A
may be substituted for its Generic Comparable based on
8. All items are shipped based on manufacturer availability.
9. All items may not be available all the time.
10.If Generic Item is not acceptable, plan will not ship Brand
39. 39
Supplies. Choose From the Following List:
Item Description Qty. Price
Sore throat spray 177ml $5
Sugar Free Cough Drops 25 $4
Expectorant-Guaifenesin 400 mg 30 $7
Cepacol 16 $5
(7) Eye Care
e Wash Eye Wash 118ml $4
Redness Reliever Eye Drops 15ml $4
15ml $4
Eye-Itch Relief Antihistamine 5ml $15
eams & Ointments & Antiseptics
am Anti-Itch Cream 28g $3
Bacitracin 14g $6
Clotrimazole 1% Cream 28g $7
Hydrocortisone Cream 28g $5
Zinc Oxide Ointment 28g $8
1oz $6
Miconazole Nitrate 2% 28g $4
Ear wax removal .5oz $4
) First Aid Supplies
e 3" Elastic Bandage - 5 yards 1 $4
10 $2
Cotton Balls 100 $4
Ice Bag 9" 1 $9
Gauze Rolls - Assorted sizes 3 $4
1 $5
Cotton Swabs 300 $5
(10) Laxatives
Docusate sodium 100 mg 100 $5
Fiber-Lax 500 mg 60 $9
Clear Lax Powder 119g $11
Enema-Saline Laxative 133ml $3
Miscellaneous Items
Automatic Blood Pressure Kit 1 $29
1 $19
Adhesive Bandage 50 $3
screen Lotion Sunscreen Lotion SPF-30 113g $10
12 $4
Item Item Description Qty. Price
11F Pill Organizer 1 $7
11G DEX4 Glucose Tablets 50 $8
11H Pill Splitter Pill Splitter 1 $5
11I Eye Glass Wipes 1 box $4
11J Estroven Multi-Symptom Menopause Relief 30 $20
(12) Topical Foot & Topical Oral
12A Callus Remover Callus Removers 6 $4
12C Callus Cushion Callus Cushions 6 $3
12E Dental Flossers Dental Flossers 36 $3
12G Generic Comparable of Polident Denture Cleanser 40 $7
12H Toothpaste 2.7oz $4
12I Toothbrush 1 $3
12J Generic Comparable of Fixodent Denture Adhesives ADH CRM Fresh 1.4oz $5
(13) Vitamins & Minerals*
13A Fish Oil Fish Oil - 1200 mg. 90 $9
13B Prosight Supplement for eyes 60 $6
13C Allbee With C B Complex with C 100 $8
13D Vitamin B B Complex 100 $8
13E Vitamin C Vitamin C Chewable 500 mg. 100 $8
13F Generic Comparable of Centrum Multivitamin & Mineral 60 $6
13G Folic Acid Folic Acid 800 mcg 100 $5
13H Glucosamine Chondroitin Glucosamine Chondroitin 60 $15
13J Vitamin E Vitamin E 400 IU 100 $8
13K Vitamin D Vitamin D 1000 IU 100 $5
13L Antioxidant tablets 50 $7
13M Selenium Selenium 200 mcg 60 $7
13N Timed Release Niacin 60 $10
13O Generic Comparable of Lactaid Tab Lactase Enzyme Supplement 50 $9
13P Ferrous Sulfate Ferrous Sulfate - 325 mg 100 $3
13Q Generic Comparable of Citracal Calcium Citrate Calcium Citrate & Vitamin D 60 $7
13R Generic Comparable of Bayer One A Day Women’s One A Day Women's Multivitamin 60 $10
13S Generic Comparable of Os-Cal* Oyster Calcium + Vitamin D 100 $4
(14) Smoking Cessation
14B Generic Comparable of Nicorette 4mg 50 $24
(15) Sleep-Aids
15A Generic Comparable of Simply Sleep Sleep-tabs 25 mg 24 $4
15B Melatonin-Sleep Aid 60 $8
393939
Select from the items listed above and log on to:
or call: 1-866-900-2688, TTY: 711
Freedom Health is an HMO plan with a Medicare contract and a contract with the Florida Medicaid
program. Enrollment in Freedom Health, Inc. depends on contract renewal. This information is available
for free in other languages. Please call our Member Service Department at 1-800-401-2740 for additional
information. Hours are October 1 to February 14 from 8:00 am to 8:00 pm, 7 days a week and February
15 to September 30 from 8:00 am to 8:00 pm, Monday through Friday. TTY/TDD users should call 711.
Estainformaciónestádisponsiblegratuitamenteenotrosidiomas.Porfavor,llameanuestroDepartamento
de Servicios al Miembro al 1-800-401-2740 para información adicional. Los usuarios de TTY deben llamar
al 711. Nuestro horario es del 1ro de octubre hasta el 14 de febrero de 8 a.m. a 8 p.m., 7 días a la semana
y del 15 de febrero hasta el 30 de septiembre de 8 a.m. a 8 p.m. de lunes a viernes.
ee’s personal provider who
ow 7-10 business days to
TC products.
em. Any branded item
d on availability.
bility.
Brand Name Item.
40. SWe’re making it easier to find answers.
Try any of these four different ways:
1. Check the plan’s Evidence of Coverage
2. Visit a local Concierge Center
3. Go to www.freedomhealth.com
and search our website
4. Call Member Services
Still Have a Question?
Call Toll-Free: 1-800-401-2740
TTY: 711
8 am to 8 pm 7 days a week from October 1 to February 14
8 am to 8 pm Monday through Friday from February 15 - September 30.
We’re making it e
Try any of these
Check t
o find answers
different ways:
1. Check the plan’s Evidence of Co
2. Visit a local Concierge Center
3. Go to www.freedomh
and search our website
4. Call Member Service
Call Toll-Free: 1-8
TTY: 711
8 am to 8 pm 7 days a week from O
8 am to 8 pm Monday through Frid
40
43. To find out more details about
our plans, visit one of our concierge
centers listed on page 8, attend a
community event,(1)
or ask your
Freedom Health agent to stop by.
43
44. This information is available
for free in other languages.
Please call our customer
service number
Toll-Free at:
1-800-401-2740
TTY: 711
Hours:
8 am to 8 pm,
7 days a week from
October 1 to February 14
and
8 am to 8 pm,
Monday through Friday from
February 15th to September 30th.
www.freedomhealth.com