What is a Medicare PFFS plan?
Medicare Advantage Private Fee For Service (PFFS) plans are a type of Medicare Advantage Plan that is generally only available in rural areas where there are not many plan options available. PFFS plans do not require you to choose a primary care physician (PCP) or need a referral to see a specialist like HMO plans […]
Can a Medicare insurance agent help me understand how my other insurance interacts with Medicare?
Yes, a knowledgeable Medicare insurance agent can help you understand how your other insurance works with Medicare. They can review your current coverage and explain how Medicare coordinates with private insurance, such as employer-sponsored health plans, retiree benefits, or COBRA. An agent will guide you through the intricacies of primary and secondary payer rules, helping […]
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 […]
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 […]
What’s an “Advance Beneficiary Notice of Non-coverage” (ABN)?
If you have Original Medicare, your doctor, other health care provider, or supplier may give you a written notice if they think Medicare won’t pay for the items or services you’ll get. This notice is called an “Advance Beneficiary Notice of Non-coverage,” or ABN. The ABN lists the items or services that your doctor or […]
Understanding Your Medicare Card
As soon as you enroll in Medicare, you will receive your Medicare card. You must bring your Medicare card to all medical and health services appointments. If you are speaking with Medicare or your health insurance or prescription drug company, you should also have this information available. Here are detailed instructions on what to do […]
How to find Medicare Providers using the Medicare Lookup Tool
To find Medicare providers using the Medicare Lookup Tool, start by visiting Medicare.gov and clicking on “Find care” in the main navigation menu. This will take you to the provider search tool where you can search for doctors, hospitals, nursing homes, home health services, hospice care, rehabilitation facilities, long-term care hospitals, and dialysis facilities. Begin […]
Medicare Cognitive Assessments
During your regular visits (including your yearly “Wellness” visit), your provider may perform a cognitive assessment to check for Alzheimer’s disease and other dementias. The Medicare Part B (Medical Insurance) plan also covers a separate visit with your doctor or specialist to review your cognitive function, diagnose dementia or Alzheimer’s disease, and formulate a care […]
Medicare Drug Price Negotiation – When will Medicare drug discounts begin?
As a result of the Inflation Reduction Act Medicare bill be able to negotiate directly with drug manufacturers to lower the price of some of the costliest single-source brand-name Medicare Part B and Part D drugs. This law requires drug companies that raise their drug prices faster than the rate of inflation to pay Medicare […]
Medicare and the Mental Health Access Improvement Act
According to studies, seniors face a variety of mental health challenges. It is estimated that more than one in five adults over the age of 60 suffer from at least one mental or neurological disorder, including anxiety, cognitive impairment, depression, and other mood disorders. Marriage and family therapists and mental health counselors are now eligible […]