In order to manage costs, Medicare Advantage (MA) plans are able to restrict their enrollees to a contracted network of health care providers that is “sufficient to provide access to covered services to meet the needs of the population served.”* Some … [Read more...] about Advocacy Tip for Medicare Advantage Enrollees Facing Difficulty Obtaining In-Network Care
Advocacy Tips
Home Health Practice Guide with Case Study (January 2020)
Medicare Home Health Coverage and CareIs Jeopardized By the New Payment Model –The Center for Medicare Advocacy May Be Able to HelpActual Recent Case StudyMrs. Green has advanced multiple sclerosis. She spends her time either in bed or in a … [Read more...] about Home Health Practice Guide with Case Study (January 2020)
Advocacy Tips: Medicare Administrative Law Judge (ALJ) Hearing Process
1. First Steps Review the Center for Medicare Advocacy’s Self-help Packets and coverage guidelines regarding the particular level of care involved in the appeal at: … [Read more...] about Advocacy Tips: Medicare Administrative Law Judge (ALJ) Hearing Process
Expedited v. Standard Medicare Appeals: Not Knowing the Difference Could Cost You Your Appeal Rights!
Here’s the Issue Expedited Medicare appeals and standard Medicare appeals are designed to address different things and there are situations where a Medicare beneficiary must pursue both types of appeals.Expedited Appeals – … [Read more...] about Expedited v. Standard Medicare Appeals: Not Knowing the Difference Could Cost You Your Appeal Rights!
Choosing Between Traditional Medicare and Medicare Advantage
If you are eligible for Medicare you can chose between getting Medicare benefits through traditional Medicare (also known as original Medicare and traditional Medicare) or a Medicare Advantage (MA) plan. Making this choice is personal and requires … [Read more...] about Choosing Between Traditional Medicare and Medicare Advantage