Medicare – Think you’re discharged from the hospital too soon?
If you think you’re being asked to leave a hospital or other health care setting (discharged) too soon: You may have the right to ask for a review of the discharge decision by the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) before you leave. A BFCC-QIO is a type of quality improvement organization […]
The 4 Medicare Savings Programs
The four Medicare Savings Programs help eligible beneficiaries pay for Medicare costs through state assistance. These programs can cover Part A and Part B premiums, deductibles, coinsurance, and copayments depending on which program you qualify for. The Qualified Medicare Beneficiary (QMB) Program provides the most comprehensive coverage, paying for Part A premiums, Part B premiums, […]
Medicare Part D – How do I find out if my plan covers a service, drug, or supply?
You or your provider can get a decision, either orally or in writing, from your plan in advance to see if it covers a service, drug, or supply. You can also find out how much you’ll have to pay. This is called an “organization determination.” Sometimes you have to do this as prior authorization for […]
Advance directives & long-term care
Advance directives & long-term care Advance directives explain how you want medical decisions to be made when you’re too ill to speak for yourself. Types of advance directives A health care proxy is a document that names someone you trust to make health decisions if you can’t. This is also called a durable power of […]
Medicare & the Health Insurance Marketplace
If you don’t have (and don’t qualify for) Medicare, the Health Insurance Marketplace® can help you find coverage that fits your needs and budget. Depending on your situation, you may be able to choose the Marketplace instead of Medicare for your health coverage. I already have Medicare. Should I enroll in the Marketplace? No. The […]
Medicare covers these preventive services
• Abdominal aortic aneurysm screening • Alcohol misuse screening and counseling • Blood-based biomarker test • Bone mass measurement • Cardiovascular disease (behavioral therapy) • Cardiovascular screening • Colorectal cancer screening – Fecal occult blood test – Flexible sigmoidoscopy – Colonoscopy – Barium enema – Multi-target stool DNA test (like CologuardTM ) • Depression screening […]
Medicare Provides Hospice Care – At no cost
Under Medicare Part A, hospice benefits are outlined in the Medicare & You handbook. A doctor ordering hospice must certify that the patient has six months or less to live. A hospice patient agrees to comfort care (palliative care) instead of treatment to cure their illness, and they must sign a statement indicating that hospice […]
Medicare Innovation Projects
Medicare develops innovative models, demonstrations, and pilot projects to test and measure the effect of potential changes in Medicare. These projects help to find new ways to improve health care quality and reduce costs, and sometimes offer you extra benefits and services. Usually, they operate only for a limited time and for a specific group […]
Medicare and Opioid use disorder treatment services
Medicare covers opioid use disorder treatment services in opioid treatment programs. The services include medication (like methadone, buprenorphine, naltrexone, and naloxone), counseling, drug testing, individual and group therapy, intake activities, and periodic assessments. Medicare covers counseling, therapy services, and periodic assessments both in-person and, in certain circumstances, by virtual delivery (using audio and video communication […]
Medicare Diabetes Prevention Program
Medicare covers a once-per-lifetime health behavior change program to help you prevent type 2 diabetes. The program begins with weekly core sessions offered in a group setting over a 6-month period. In these sessions, you’ll get: • Training to make realistic, lasting behavior changes around diet and exercise. • Tips on how to get more […]