Extra Help is a federal program that helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage. It is also known as the Part D Low-Income Subsidy (LIS). If your monthly income is up to $1,538 in 2018 ($2,078 for couples) and your assets are
Archive for August, 2018
Items and services excluded from Medicare coverage
Medicare does not cover all health care services. Services excluded from Medicare coverage include but are not limited to: Alternative medicine, including experimental procedures and treatments, acupuncture, and chiropractic services, except when manipulation of the spine is medically necessary to fix a subluxation of the spine (when one or more
How to enroll in Medicare if you are turning 65 without Social Security or Railroad Retirement benefits
If you are eligible for Medicare but not currently receiving Social Security retirement benefits or Railroad Retirement benefits, there are three different time periods during which you can enroll in Medicare Parts A and B. Initial Enrollment Period (IEP). You can enroll in Medicare at anytime during this seven-month period,
How to enroll in Medicare if you missed your Initial Enrollment Period
If you missed your Initial Enrollment Period (IEP) and need to enroll in Medicare, you likely will have to enroll during either a Special Enrollment Period (SEP) or the General Enrollment Period (GEP). Special Enrollment Period If you are eligible for the Part B SEP, you can enroll in Medicare
The 30-month coordination period for people with ESRD
If you have job-based insurance, retiree coverage, or COBRA when you become eligible for Medicare because you have End-Stage Renal Disease (ESRD Medicare), you do not have to enroll in Medicare right away. Your group health plan (GHP) coverage–meaning job-based, retiree, or COBRA coverage–will remain primary for 30 months, beginning
Primary and secondary payers
When you have Medicare and another type of insurance, Medicare will either pay primary or secondary for your medical costs. Primary insurance pays first for your medical bills. Secondary insurance pays after your primary insurance. Usually, secondary insurance pays some or all of the costs left after the primary insurer
Good cause extensions for filing an appeal late
When initially filing an appeal and for each subsequent level, you have a limited amount of time to file. That said, after the deadline has passed, if you can show good cause for not filing on time, your late appeal may be considered. You can request a good cause extension
Getting an Advance Beneficiary Notice (ABN) from your provider
If you have Original Medicare and your provider has reason to believe that Medicare will deny coverage for a service because of Medicare’s medical necessity requirements, they should give you an Advance Beneficiary Notice (ABN) to read and sign before they provide care. You will not receive ABNs if you
Medicare Advantage costs and coverage
When choosing a Medicare Advantage Plan, be aware of the different cost-sharing you may face. Costs in MA Plans are often different from in Original Medicare, and may come with additional rules. Consider each plan carefully before enrolling. Medicare Part B premium: In an MA Plan, you generally must pay
Questions to ask before enrolling in a SNP
When you are considering a Medicare Special Needs Plan (SNP), here are some questions to keep in mind. You should also review general questions to consider before joining a Medicare Advantage Plan. Am I eligible for any of the SNPs in my area? How do the SNP’s services compare with