Medicare Coverage. Employees hired by the City prior to 1986 desiring Medicare coverage will be responsible for the 1.45% employee share Medicare cost and the City will provide the employer-matching share of 1.45%. (This percentage is subject to change by Medicare.)
Medicare Coverage. The Board will assume the premium cost of Medicare insurance for all active eligible employees age 65 and over who elects Medicare as primary payer. Election of Medicare as primary payer precludes the employee from all group medical plans. If the employee elects to continue primary coverage under our group medical plan, Medicare may provide secondary medical coverage for Part B, provided the employee enrolls in Medicare Part B and pays the premium.
Medicare Coverage. If you are admitted to the hospital and have a three night qualifying stay, and are then in need of Skilled Care, Medicare Part A would cover up to 100 days per illness. For days 1 through 20, Medicare Part A pays in full. For days 21 through 100, there is a mandatory co-pay, currently $185.50 per day (2021 rate), applies if the required insurance is not carried. This is why Willow Valley Communities require Residents to maintain a Medigap Plan with a rating of “C”or higher. If, after several days, weeks, or months in Skilled Care, you no longer meet the criteria for Medicare Part A, you will be notified that Medicare A will no longer cover your stay. At that point, your WVC Lifecare coverage would apply. Please refer to your WVC Resident’s Agreement to familiarize yourself with the accommodations and supplies that are covered. One of the benefits of being covered by Medicare Part A is that Medicare will pay for all of your prescription medications during a Medicare Part A qualified stay in Supportive Living. When your stay is no longer Medicare Part A qualifying, it is your responsibility to pay out-of-pocket for prescription medications, unless: You participate in a prescription drug insurance plan. PharMerica, our contracted pharmacy, works with most prescription drug insurance plans. Your specific coverage will determine your out-of-pocket expenses. We encourage you to contact your insurance carrier to verify this information as it applies to your specific policy. You will need to ask the following questions: Does my (our) insurance policy cover the Medicare coinsurance of $185.50 per day for days 21-100 in 2021? Does my (our) insurance policy cover outpatient physical, occupational, and speech therapy? Is my (our) insurance contracted with Willow Valley Communities to provide outpatient physical, occupational, and speech therapy? What is the deductible amount for which I/we am/are responsible prior to my insurance paying for any services? What is my (our) maximum annual “out of pocket expense”? Attached is a glossary of terms and information that you may find useful as you speak to your insurance carrier. You may find additional information at xxx.xxxxxxxx.xxx or you may call 1.800.Medicare or 0.000.000.0000.
Medicare Coverage. On August 2, 2002, Xxxxxx will become Medicare eligible and all coverage under the Company's medical plan (as may be in force from time to time) will cease. Effective that date, Xxxxxx will have the option of enrolling in the Medicare Supplement and Prescription Plan as may then be in effect and in accordance with its terms. If Xxxxxx enrolls in the Medicare Supplement and Prescription Plan, Xxxxxx will pay the premium cost to the insurance company as long as he participates in the Plan.
Medicare Coverage. The parties acknowledge and warrant that it is not the purpose of this agreement to shift to Medicare, Medicaid or any other government program the responsibility for payment of medical expenses for the treatment of industrial injury or occupational disease related conditions. To the best of the parties’ abilities, they have tried to be clear that this agreement covers only the medical conditions accepted and covered under Claim, as outlined in this agreement. Other medical conditions are not covered except as provided in Section #-Reopening. If the accepted medical conditions outlined in this agreement should worsen and require treatment, the Claimant understands and accepts responsibility to seek treatment for those conditions by following the process outlined in Section #–Reopening. The Claimant’s right to future treatment for the "Select Ind Inj/ Occ Dis" is not being compromised by this agreement; therefore the Claimant and the Department do not expect that there will be any impact to the Claimant’s Medicare benefits. Nevertheless, the Claimant knowingly and voluntarily accepts responsibility for this risk and waives any and all claims of any nature and/or damages against the Department should Medicare take such action, including but not limited to a Private Cause of Action against the Department under the Medicare Secondary Payer Act (MSP) pursuant to 42 USC § 1395y(b)(3)(A). If the Claimant decides to seek treatment for the accepted medical conditions outlined in this agreement without going through the Department and Medicare finds it covered and provided for treatment that should have been paid for by funds associated with the worker’s industrial insurance claim, the Claimant agrees to accept responsibility for all costs and penalties for that treatment assessed by Medicare, Medicare Secondary Payer Recovery Contractor, CMS, Collection agencies, or any other governmental entity’s claims, actions, judgments or settlements.
Medicare Coverage. Medicare coverage shall be offered in accordance with Assembly Bill 265 (1989) and Government Code section 22090.3, et seq., to be effective November 1992.
Medicare Coverage. Medicare coverage is considered to be the primary source of payment for home health agency services for eligible individuals age 65 and older and for certain disabled beneficiaries. NMAP does not make payment for services denied by Medicare for lack of medical necessity. NMAP may cover services denied by Medicare for other reasons if the services are within the scope of NMAP. Claims submitted to the Department for services provided to Medicare-eligible clients must be accompanied by documentation which verifies that the services are not covered by Medicare. 9-004.03 Copayment: For Medicaid copayment requirements, see 471 NAC 3-008. Home health agency services do not require a copayment from the client. 9-005 Billing Requirements: Home health agencies shall use Form CMS-1450 or the standard electronic Health Care Claim: Institutional transaction (ASC X12N 837) to request payment from NMAP. For claim submission instructions, refer to the Claim Submission Table in the appendix 000-000-00. HCPCS/CPT procedure codes used by NMAP are listed in the Nebraska Medicaid Practitioner Fee Schedule (see 471-000-509). Note: Durable medical equipment and medical supplies are billed under the home health agency provider number. REV. OCTOBER 15, 2003 NEBRASKA HHS FINANCE NMAP SERVICES MANUAL LETTER # 59-2003 AND SUPPORT MANUAL 471 NAC 13-000 CHAPTER 13-000 NURSING SERVICES 13-001 Standards for Participation: Providers of private-duty nursing services must be licensed by the Nebraska Department of Health and Human Services Regulation and Licensure as a home health agency or individual RN/LPN or the appropriate licensing agency of the state in which s/he practices. To participate in the Nebraska Medical Assistance Program (NMAP), the provider shall complete and sign Form MC-19, "Medical Assistance Provider Agreement" (see 471-000-90), and submit the completed form to HHS for approval and enrollment as a provider.
Medicare Coverage. All employees hired prior to April 1, 1986 will be provided an opportunity to participate in Medicare. Each unit member will individually elect whether or not to participate in the program after having been fully informed of current and future financial impacts. Coverage, if elected, will begin effective December 1, 1993.
Medicare Coverage. The parties agree to an effective date of June 1, 1995 for implementation of Medicare only coverage for certificated employees hired prior to April 1, 1986, pursuant to a PERS division.
Medicare Coverage. During the Employment Period, the Executive will be reimbursed for his and his spouses’ Medicare, Medicare Supplement and Part D coverage. The reimbursement will be grossed up for taxes. 1/26th of the total reimbursement will be included with the Executive’s bi-weekly pay. The reimbursement amount will be reviewed and adjusted annually as necessary. EXHIBIT B FORM OF RELEASE I, Xxxxxxx X. Xxxxxxx, am signing this General Release (“Release”), in conjunction with the Employment Agreement dated October 4th, 2021 (the “Agreement”) made by and between me and The trū Shrimp Company, Inc. (“the Company”). By my signature on this Release, I confirm the terms of that Agreement and agree that those terms are incorporated by reference and merged into this Release.
