Medicare Advantage Plans and Medigap Policies
Medigap policy to cover deductibles
HHS Updates
Medigap (Supplemental Insurance) Policies
A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover.
Medicare – Concurrent Retirement & Disability Payments (CRDP)
The Department of Defense (DoD) is, and has been, making extra payments to retirees to overcome some or all the offset from retired pay associated with receipt of disability compensation from the Department of Veterans Affairs (VA). Retirees cannot receive benefits simultaneously under both of these programs.
Medicare – National Institute on Deafness and Other Communication Disorders
A gene associated with a rare form of progressive deafness in males has been identified by an international team of researchers funded by the National Institute on Deafness and Other Communication Disorders. The gene, PRPS1, appears to be crucial in inner ear development and maintenance.
Mental Disorders in Youth – Does Medicare Help
About half of American children and teenagers who have certain mental disorders don’t receive professional services, according to a new study.
Information and Instructions to Verify Social Security Numbers Online
There are two Internet verification options you can use to verify that your employee names and Social Security numbers match Social Security’s records. You can: Verify up to 10 names and SSNs (per screen) online and receive immediate results. This option is ideal to verify new hires.
Often employers ask to see an employee’s Social Security card
Often employers ask to see an employee’s Social Security card. But, do you really need to see the card? Since 1936, Social Security has issued over 30 different versions of the Social Security number (SSN) card which makes it difficult to recognize a valid card.
New Retirement Benefits – Medicare Does it Help?
The Department of Defense has two programs designed to reduce the reduction in retired pay due to receipt of Veteran Administration compensation, for certain disabled retirees. Concurrent Retirement and Disability Payments (CRDP) provides a 10-year phase-out of the offset to military retired pay due to receipt of VA disability compensation for members whose combined disability rating is 50% or greater . Members retired under disability provisions must have 20 years of service.
Medicare Open Enrollment Ending Shortly
Each year plans change what they cost and what they cover.
Medicare: Does the ADA Restrict Testing for Illegal Drug Use?
The ADA specifically permits testing for illegal drug use.
Medicare: Appeals Process – How does it work?
Once an initial claim determination is made, beneficiaries, providers, and suppliers have the right to appeal Medicare coverage and payment decisions. There are five levels in the Medicare Part A and Part B appeals process. The levels are:
Medicare: Proposed Rule for Payment under the Ambulance Fee Schedule
Proposed Rule for Payment under the Ambulance Fee Schedule (AFS) published 5/26/06 (See AFS Regulations and Notices link.) Section 4531 (b) (2) of the Balanced Budget Act (BBA) of 1997 added a new section 1834 (l) to the Social Security Act which mandated the implementation of a national fee schedule for ambulance services furnished as a benefit under Medicare Part B.
Medicare: Instructions on the Submission of OPPS ASP Data
Instructions on the Submission of OPPS ASP Data for Nonpass-Through Separately Payable Therapeutic Radiopharmaceuticals and Radiopharmaceuticals with Pass-Through Status.
Medicare and the American Recovery and Reinvestment Act (ARRA
On February 17, 2009, President Obama signed the American Recovery and Reinvestment Act (ARRA), which delayed the phase-out of the hospice wage index budget neutrality adjustment factor (BNAF) for FY 2009. Therefore we are posting a revised copy of the FY 2009 wage index (see Downloads section below), which includes a full (unreduced) BNAF. Please also see CR 6418 (Transmittal 1701, dated March 13, 2009 ) (see Downloads section below) for more information on the revision to the FY 2009 wage index.
The following two categories of dental services are excluded from Medicare coverage
A primary service (regardless of cause or complexity) provided for the care, treatment, removal, or replacement of teeth or structures directly supporting teeth, e.g., preparation of the mouth for dentures, removal of diseased teeth in an infected jaw.
Medicare Service – Statutory Dental Exclusions
Section 1862 (a)(12) of the Social Security Act states, “where such expenses are for services in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting teeth, except that payment may be made under part A in the case of inpatient hospital services in connection with the provision of such dental services if the individual, because of his underlying medical condition and clinical status or because of the severity of the dental procedure, requires hospitalization in connection with the provision of such services.”
Many seniors do not receive recommended preventive and primary care
Under health insurance reform, a senior would not pay anything for a screening colonoscopy or other preventive services. Reform will eliminate any deductibles, copayments, or other cost-sharing for obtaining preventive services, making them affordable and accessible