Long-term care (LTC) refers to a range of services and support that help you perform everyday activities. LTC can be provided in a nursing home, assisted living facility, or other setting, and may include medical care, therapy, 24-hour care, personal care, and custodial care (homemaker services). Medicare usually does not
Home care
Medicare covers home care through its home health benefit if you meet the eligibility requirements. You must need skilled care to qualify for Medicare’s home health benefit. If you are eligible, Medicare may also cover other services, such as personal care. Remember: If you need home health care and/or personal
Medicare and dental care
Dental care is excluded from Medicare coverage. Medicare does not cover dental services that you need primarily for the health of your teeth, including but not limited to: Routine checkups Cleanings Fillings Dentures (complete or partial/bridge) Tooth extractions (having your teeth pulled) in most cases If you receive dental services,
Ending COBRA coverage
Your COBRA coverage may be terminated if: You become eligible for Medicare You reach the maximum coverage limit You do not pay your COBRA premiums on time You become eligible for another job-based insurance plan (employer group health plan) that does not have a pre-existing condition waiting period (if the
Extending COBRA coverage if you become disabled
If you develop a disability within the first 60 days of getting COBRA coverage, you and your family may be able to extend your COBRA by 11 months, to a maximum of 29 months. In this case, you must tell your COBRA insurer that you developed a disability no later
COBRA eligibility
You are eligible for COBRA if both of the following conditions apply: You are enrolled in job-based insurance (employer group health plan) where COBRA applies And, you have a “qualifying event” (such as termination of employment) that causes you to lose job-based insurance. The type of qualifying event also determines
COBRA basics
The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law passed in 1986 that lets certain employees, their spouses, and their dependents keep group health plan (GHP) coverage for 18 to 36 months after they leave their job or lose coverage for certain other reasons, as long as they
COBRA and Medicare
COBRA and Medicare COBRA basics COBRA eligibility COBRA and Medicare coordination Extending COBRA coverage if you become disabled Ending COBRA coverage
Appeal basics
An appeal is a formal request for review of a decision made by your Original Medicare, Medicare Advantage, or Part D plan. If you were denied coverage for a health service or item, you may appeal the decision. Before you start your appeal, make sure you fully read all the
PPO costs and coverage
Medicare Preferred Provider Organizations (PPOs) must provide you with the same benefits as Original Medicare but may do so with different rules, restrictions, and costs. PPOs can also offer additional benefits. Below is a list of general cost and coverage rules for Medicare PPOs. Remember to speak to a plan