Medicare Preferred Provider Organizations (PPOs)
Medicare Preferred Provider Organizations (PPOs) PPO basics PPO cost and coverage Comparison: PPOs, HMOs, and Original Medicare
Part A
How Medicaid works with Medicare
All states offer a variety of Medicaid programs, several of which can help people with Medicare. If you qualify for a Medicaid program, it may help pay for costs and services that Medicare does not cover. For services covered by Medicare and Medicaid (such as doctors’ visits, hospital care, home
Small Business Health Options Program (SHOP)
Insurance plans offered through the Small Business Health Options Program (SHOP) are job-based insurance plans purchased through the Marketplace. SHOP allows businesses with fewer than 50 employees and their employees to search for and buy health coverage. SHOP plans follow the same rules as other insurance based on current work.
Making Part B enrollment decisions with QHP coverage
If you have a Qualified Health Plan (QHP), deciding what to do as you approach Medicare eligibility depends on your circumstances. In most cases, you should enroll in Medicare and disenroll from your QHP, but there are two exceptions: You have End-Stage Renal Disease (ESRD). If you have kidney disease
Medicare and observation services
Observation services are short-term outpatient services received when you are in the hospital for monitoring purposes and/or to determine whether you should be admitted as an inpatient. It is important to know that if you are receiving observation services (sometimes referred to as under observation status), you have not been
How to enroll in Medicare if you are turning 65
Most people become eligible for Medicare when they turn 65. Your Medicare enrollment steps will differ depending on whether or not you are collecting retirement benefits when you enter your Initial Enrollment Period (IEP). If you are receiving Social Security retirement benefits or Railroad Retirement benefits, you should be automatically
How Medicare enrollment works with Railroad Retirement benefits
ou are typically eligible for Medicare if you are eligible for either Social Security benefits or Railroad Retirement benefits. There are a few important differences when you enroll in Medicare if you are or were a railroad worker. Your enrollment will be processed by the Railroad Retirement Board (RRB) instead
Help understanding Medicare benefits and options
If you need help understanding your Medicare rights and how to exercise them, there is free information and assistance that you can access. Below are examples of places you can get help: State Health Insurance Assistance Program (SHIP) – Each state offers a SHIP, partly funded by the federal government,
Starting home health care
The process for starting the Medicare home health benefit changes depending on whether you are currently in a hospital or if you are already at home. Remember, in both cases you must meet the eligibility requirements and qualify for coverage under either Part A or Part B. If you are
Eligibility for home health (Part A or Part B)
You can receive home health care coverage under either Medicare Part A or Part B. Under Part B, you are eligible for home health care if you are homebound and need skilled care. There is no prior hospital stay requirement for Part B coverage of home health care. There is
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