Category Archives: Medicare News

Medicare and the Cost of Cancer Treatment

Share This:

This article is for both the person facing cancer today, wanting to know what to expect from their Medicare insurance as well as for the person turning 65 and weighing the pros and cons of staying with Original Medicare or moving to Medicare Advantage. Medicare and the cost of cancer treatment is written to help everyone on Medicare.  If you find this article helpful, please share.  We have also included a link to a printer friendly version so that you may save this article for your files.

For those who prefer video:  Medicare & the Cost of Cancer Treatment

I realise the article is a bit long, but the subject matter is critically important.  When first diagnosed with cancer, there is a lot going through your mind. One small part is the question of “What is this going to cost me?”  The battle with cancer can be emotionally draining without worrying or wondering about your health insurance and how it works.  This information on how Medicare handles the cost of cancer treatment is much more difficult to find and piece together than it should be.  I believe the information in this article can be a great relief, benefit, and resource for anyone about to embark on a very tough personal battle.  The information has been compiled from numerous sources including Medicare.gov and the National Cancer Society.

For those new to Medicare, this information will help you decide if you are more comfortable with Original Medicare or Medicare Advantage.  For the person who has cancer or a history of cancer, we hope the information will ease any financial uncertainty of not knowing what part of your treatment may or may not be covered by your current Medicare plan and how much out-of-pocket expense can be expected from you.

Click here for Printer Friendly version

Read more… →

Medicare Part A

Share This:

With over 70% of seniors in the United States participating, original Medicare remains the top healthcareMedicare Part A Part B program in the country.  Because seniors can choose any doctor that takes Medicare without having to consider networks or referrals, Original Medicare offers seniors more freedom of choice than any alternative Advantage program. In addition, because virtually every medically necessary medical procedure is covered by either Medicare Part A or Medicare Part B, seniors using Original Medicare do not have to worry about their insurance program denying coverage.  As long as you and your doctor believe it is necessary, the odds are your Original Medicare will cover it. In this article, we answer the question; what is Medicare Part A?

Original Medicare has three basic parts; Part A, Part B and Part D.  In general, Part A covers inpatient hospital care, Part B covers outpatient care and Part D covers prescription drugs.  This article focuses on Medicare Part A which seems the simplest, but is in fact the most misunderstood part of Original Medicare.

Medicare Part A covers:

  • inpatient hospital care,
  • skilled nursing,
  • nursing home care,
  • hospice and home health services.

Part A MedicareMost insurance agents simply explain that Medicare Part A is your inpatient hospital coverage and Medicare Part B is outpatient coverage.  While that is technically true, it ignores the potential pitfalls and surprises are in the details of the plans.   Part A operates very differently that Part B.  It’s in these details that Part A is misunderstood and can lead to surprises and significant unexpected health costs for the Medicare beneficiary.

Medicare Part A offers health insurance coverage in time units called “Benefit Periods”.  A benefit period begins the day you are admitted as an inpatient in a hospital.  The benefit period ends when you have not been an inpatient in either a hospital or skilled nursing facility for 60 consecutive days. You can have an unlimited number of benefits periods.  Note: your skilled nursing benefits only take effect after you have a qualifying hospital stay (i.e. an admitted inpatient for 3-days)

Read more… →

Using Medicare.gov To Enroll In Part D Medicare

Share This:

Best Part D Plan

Unless you are new to Medicare or have a Special Enrollment period, Open Season (October 15th through December 07th) is the only time of year that seniors with Medicare Advantage plans can enroll, renew or change their plans. Seniors on Original Medicare have the ability to change Plan D prescription drug plans each year at the same time. You can have a Part D drug plan no matter if you are on original Medicare or Medicare Advantage, However, with a Medicare Advantage plan you do not get to choose your Plan D coverage.  You must accept the one packaged with your Medicare Advantage plan.  With Original Medicare you can choose from among the 25 or so plans available to you in your area.   In this Blog post we are going to illustrate how to use the Medicare.gov website to find the best, most cost effective Part D drug plan for you.

Read more… →

Medicare Fraud Strike Force Protects Seniors

Share This:

Source:  www.hhs.gov

FOR IMMEDIATE RELEASE
May 13, 2014

Contact: HHS Press Office
202-690-6343

Medicare Fraud Strike Force charges 90 individuals for approximately $260 million in false billing

27 Medical Professionals, Including 16 Doctors, Charged with Health Care Fraud

WASHINGTON – Attorney General Eric Holder and Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that a nationwide takedown by Medicare Fraud Strike Force operations in six cities has resulted in charges against 90 individuals, including 27 doctors, nurses and other medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $260 million in false billings.

Attorney General Holder and Secretary Sebelius were joined in the announcement by Acting Assistant Attorney General David A. O’Neil of the Justice Department’s Criminal Division, FBI Assistant Director Joseph Campbell, U.S. Department of Health and Human Services (HHS) Inspector General Daniel R. Levinson and Deputy Administrator and Director of the Centers for Medicare & Medicaid Services (CMS) Center for Program Integrity Shantanu Agrawal.

This coordinated takedown is the seventh national Medicare fraud takedown in Strike Force history.  The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.

Read more… →

%d bloggers like this: