A/B MAC Jurisdiction 6 - Part A and Part B Facts J6 processes FFS Medicare Part A and Part B claims for Illinois, Minnesota, and Wisconsin Total Number of Fee-for-Service Beneficiaries: 2,621,319 (as of 9/30/2021)
What are the requirements for Medicaid in Illinois?
Feb 22, 2013 · Under the demonstration, also called the "Medicare-Medicaid Alignment Initiative," Illinois and CMS will contract with health plans to coordinate the delivery of and be accountable for all covered Medicare and Medicaid services for participating Medicare-Medicaid enrollees. More information from CMS: Fact Sheet Three-Way Contract (PDF)
What Medicare region is Illinois?
Sep 16, 2018 · Original Medicare, Part A and Part B, is available for beneficiaries in every state throughout the nation, including Illinois. Medicare Part A covers inpatient hospital care, skilled nursing facility care, nursing home care (as long as custodial care isn’t the only care you need), home health services, and hospice care.
What is the timely filing limit for Illinois Medicaid?
Illinois, Minnesota, Wisconsin **HH + H for the following states: Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Michigan, Minnesota, Nevada, New Jersey, New York, Northern Mariana Islands, Oregon, Puerto Rico, US Virgin Islands, Wisconsin and Washington National Government Services, Inc. 8 Indiana, Michigan
Does Medicaid cover therapy in Illinois?
Jan 07, 2022 · Jurisdiction List. The below year specific lists will assist suppliers in determining which Medicare contractor to bill for certain HCPCS codes. 2022. 2021. 2020. 2019. 2018.
What Medicare region is Illinois?
Region 5, based in Chicago, serves Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin.
What states are in Medicare jurisdiction D?
DME MAC Jurisdiction D – DME Facts JD processes FFS Medicare DME claims for Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington, and Wyoming.Dec 28, 2021
What states are in Medicare Region B?
Jurisdiction B is serviced by CGS and includes Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin.Jun 29, 2016
What is the MAC for Illinois?
Medicaid Advisory CommitteeMedicaid Advisory Committee (MAC)
What jurisdiction is Palmetto GBA?
Palmetto GBA processes Part A, fee-for-service Medicare claims for Medicare beneficiaries through home health agencies and hospices in the following states: Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee and ...
What states does noridian Medicare cover?
Noridian now administers the Medicare program as a Medicare Administrative Contractor (MAC) for Jurisdictions E and F. Jurisdiction E serves Part A and Part B providers in the states of California, Hawaii and Nevada as well as Guam, American Samoa and the Northern Mariana Islands.Mar 23, 2022
What is Medicare Jurisdiction C?
DME MAC Jurisdiction C – DME Facts JC processes FFS Medicare DME claims for Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, and West Virginia.Dec 28, 2021
What is Medicare Region B?
Part B (Medical Insurance) Part B covers certain doctor's services, outpatient care, medical supplies, and preventive services. premium. The periodic payment to Medicare, an insurance company, or a health care plan for health or prescription drug coverage. will get deducted automatically from your benefit payment.
What does CGS Administrators stand for?
CGS Administrators, a subsidiary of Celerian Group, is a Medicare Administrative Contractor (MAC) for the Centers for Medicare and Medicaid Services (CMS), the agency that oversees Medicare.
How many jurisdictions are there in Medicare?
Centers for Medicare and Medicaid Services (CMS) announced in 2010 plans to reduce the number of A/B Medicare Administrative Contractors (MACs) from the current numbered 15 jurisdictions to 10 alphabetical jurisdictions over the next several years. At this time, there are 12 A/B Mac contract areas.
What is a Medicare carrier?
Carriers are private insurance companies acting under contract with the Health Care Financing Administration (HCFA) to processclaims by beneficiaries and providers for services or supplies covered under Medicare Part B. While most Stateshave jurisdiction for one State, a few carriers handle more than one State.
How many MACs are there Medicare?
Currently there are 12 A/B MACs and 4 DME MACs in the program that process Medicare FFS claims for nearly 56% of the total Medicare beneficiary population, or 36 million Medicare FFS beneficiaries.Jan 12, 2022
About Medicare in Illinois
Medicare beneficiaries in Illinois can receive their coverage through Original Medicare, Part A and Part B, and add coverage in the form of a stand...
Types of Medicare Coverage in Illinois
Original Medicare, Part A and Part B, is available for beneficiaries in every state throughout the nation, including Illinois. Medicare Part A cove...
Local Resources For Medicare in Illinois
1. Medicare Savings Programs in Illinois: Illinois has programs to help beneficiaries who are unable to pay their out-of-pocket Medicare costs. Any...
How to Apply For Medicare in Illinois
To qualify for Medicare, you must be either a United States citizen or a legal permanent resident of at least five continuous years.The Medicare en...
SPOTLIGHT & RELEASES
07/01/2021: CMS & IL released an updated Three-Way Contract and Summary of Contract Changes (effective 07/01/2021). More information can be found below.
Key Dates
September 14, 2016 - CMS, Illinois, & participating plans execute an updated three-way contract
MMAI Model
On February 22, 2013, the Department of Health and Human Services announced that the State of Illinois will partner with the Centers for Medicare & Medicaid Services (CMS) to test a new model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience.
What is Medicare Supplement?
Medicare Supplement insurance, also known as Medigap, is offered by private insurance companies. There are up to 10 standardized policy options in most states, each one marked with a letter. Plans of the same letter offer the same benefits no matter which insurance company offers the plan, but prices may vary.
What is Medicare Advantage Plan?
Medicare Advantage plans, also called Medicare Part C, are required to offer the same amount of coverage as Original Medicare (with the exception of hospice care), and some plans may include additional benefits, such as routine vision, dental, prescription drug coverage, and health wellness programs. Medicare Advantage plan details and costs are ...
Is Medicare Part D a stand alone plan?
Medicare Advantage plan details and costs are likely to vary by provider. Medicare Part D is optional prescription drug coverage. It must be purchased separately if you have Original Medicare. Illinois beneficiaries with Original Medicare can get this coverage through Medicare Prescription Drug Plans which are stand-alone plans available ...
Does Illinois have Medicare?
Medicare Savings Programs in Illinois: Illinois has programs to help beneficiaries who are unable to pay their out-of-pocket Medicare costs. Anyone can apply for these savings programs, but they are generally for Medicare beneficiaries whose income is below a government-set limit.
Can you get Medicare if you have Lou Gehrig's disease?
You may also qualify for automatic enrollment if you have amyotrophic lateral sclerosis (or Lou Gehrig’s disease); in this case, you’ll be automatically enrolled in Medicare starting the first month of disability benefits.
Does Illinois have Medicare Advantage?
Medicare beneficiaries in Illinois can receive their coverage through Original Medicare, Part A and Part B, and add coverage in the form of a stand-alone Medicare Part D Prescription Drug Plan and/or a Medicare Supplement (Medigap) insurance plan. Beneficiaries may also enroll in a Medicare Advantage plan, which lets them get their Original Medicare, Part A and Part B, coverage (with the exception of hospice care) through a private insurance company that is approved by Medicare. These plans could also include routine vision, dental, and even prescription drug coverage.
Current Maps and Lists
To find out who the current A/B and DME MACs are, use these maps and lists to help you determine which MAC is of most interest to you.
DME MACs
The DME MACs process Medicare Durable Medical Equipment, Orthotics, and Prosthetics (DMEPOS) claims for a defined geographic area or "jurisdiction," servicing suppliers of DMEPOS. Learn more about the DME MAC in each jurisdiction.
