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Last Updated: 01/21/2025
in Employees and Employers Clinical Review Criteria Lab Management - Genetic Testing | Prior Authorized Utilization Review | Lab Management (evicore.com) Radiology/Cardiology/US - Cardiology Solution | Cardiology Benefit Management | eviCore Medical Oncology - Medica...
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Last Updated: 07/27/2023
in Medicare Your Pharmacy Info Certain covered drugs have special rules or limits, like step therapy, prior authorization, and quantity limits, to keep you safe. Learn more about these and which drugs have them. How do I request a coverage determination or medical exception for...
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Last Updated: 09/26/2022
in Employees and Employers We know employees get sick or hurt, and when they do, they need health care. They can’t always avoid the bad stuff life throws at them, but it’s nice to help them through it. That’s why we’re here–to give them insurance for real life. We explain mo...
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Last Updated: 12/11/2024
in Medicare Your Pharmacy Info Better therapeutic outcomes for members with multiple conditions Our Medication Therapy Management Program (MTMP) is focused on improving therapeutic outcomes for Medicare Part D members. To qualify for MTMP, a member must meet all of the following...
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Last Updated: 09/19/2022
in Medicare Changing Plan Types The Annual Enrollment Period (AEP) is the time each year, chosen by the Centers for Medicare & Medicaid Services (CMS), when you can enroll in a plan or switch to a new one. Unless you qualify for a Special Enrollment Perio...
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Last Updated: 10/01/2024
in Medicare
When the Centers for Medicare & Medicaid Services (CMS) makes changes to the services that are covered, they update them through National Coverage Determinations. Learn more about National Coverage Determinations on their website . ...
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Medicare Part B is also called medical insurance, and it covers certain care from doctors, outpatient care, medical supplies and preventive care. Services like flu shots. Clinical research. Ambulances. Durable medical equipment. Mental healthc...
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Last Updated: 07/11/2023
in Medicare Your network is where you can get care. Our service areas are where we sell plans. We have service areas in North Carolina. Service Areas Sandhills Chatham, Hoke, Lee, Montgomery, Moore, Richmond, Scotland, Cumberland, Harnett, Johnston, Robeson,...
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The Part D late enrollment penalty is a an amount added to your Part D monthly premium because you didn't sign up for drug coverage when it was available to you. If you go without a Part D plan or a Medicare Advantage plan with drug coverage for 6...
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Medicare Advantage plans, or Part C plans, are plans from private companies, like us, that take the place of your Original Medicare. You can also add prescription drug coverage to combine Part A, Part B and Part D into one easy package.