Helping Your Clients with Sticky Benefits Scenarios
|
|
|
- Maud Norman
- 5 years ago
- Views:
Transcription
1 Helping Your Clients with Sticky Benefits Scenarios Passcode: Audio via headset through computer OR dial , passcode # to get via phone Improving the lives of 10 million older adults by National Council on Aging 1
2 Housekeeping Notes We have muted all lines Please type your questions in chat Slides are available from Recording and follow-up Q&A will also appear at this link Thank you for joining us! Improving the lives of 10 million older adults by National Council on Aging 2
3 Presenters Casey Schwarz, Medicare Rights Center Mike Klug, SHIP Resource Center Ann Kayrish, NCOA Brandy Bauer, NCOA Improving the lives of 10 million older adults by National Council on Aging 3
4 Agenda Scenario 1: Welcome to Medicare! Scenario 2: Part A conditional enrollment for clients applying for a Medicare Savings Program Scenario 3: The big nursing home bill Scenario 4: SNAP medical expense deduction Scenario 5: Retirement plans, the Initial Enrollment Period (IEP) and Special Enrollment Periods (SEP) Improving the lives of 10 million older adults by National Council on Aging 4
5 Scenario 1: Welcome to Medicare! (Hooray! Oh no?) Nora is 64 and will be 65 in 3 months. For the past 4 years, since she had a stroke and lost her job, she s had Medicaid thank goodness her state expanded coverage for single/childless adults. She uses a lot of health care services she gets some help at home, has a number of prescription drugs, and has been hospitalized twice. She applied for SSDI, but was denied, and she is looking forward to getting on Medicare which she believes from the news is much better than Medicaid (after all, they are talking about Medicare for all, not Medicaid for all, right?) But, then she got a notice from her state saying that once she has Medicare, her Medicaid will stop the month after her Medicare starts! Improving the lives of 10 million older adults by National Council on Aging 5
6 Poll Could the notice be correct? a. Yes b. No Improving the lives of 10 million older adults by National Council on Aging 6
7 But why? Income change as a result of collecting Social Security Retirement o Could also be deemed income based on the duty to avail one s self of potentially available income Income rules change from expansion to ABD Medicaid Asset rule change from expansion to ABD Medicaid Improving the lives of 10 million older adults by National Council on Aging 7
8 For Nora, it s because of the asset test She doesn t have a lot of savings, but she has some, about $4,000. She is understandably freaked out about losing Medicaid but knows she ll have Medicare. Her income isn t changing because she started collecting her Social Security early, at 62, and she tells you its pretty low. Improving the lives of 10 million older adults by National Council on Aging 8
9 Survey Which is a likely immediate change for Nora? a. Termination of her homecare b. Increase in Part B premium payments c. Increase in prescription premiums/ out-of-pocket costs d. Changes to her hospital costs e. a, b, & d f. b & d g. All of the above h. Not fair! We need more information Take a moment and write down a few strategies to mitigate any or all of these changes Improving the lives of 10 million older adults by National Council on Aging 9
10 Considerations Extra Help she ll have it for the next year (she will have both Medicare and Medicaid for a month after July, so will be deemed). o Screening for the MSP especially QMB is a really good place to start. States should be conducting reviews of other eligibility for anyone who loses Medicaid, but it s always a good idea to check On the homecare question... Improving the lives of 10 million older adults by National Council on Aging 10
11 What do you need to know? a. What services is she getting? i. Skilled Nursing or Therapy Services? ii. On an intermittent basis? b. Is she homebound? i. Is it very difficult for her to leave the home? c. Has her doctor/ would her doctor sign a certification of her need for these services and her homebound status? d. Could she have a face-to-face meeting with the prescribing doctor? e. Is she getting care from a Medicare Certified Home Health Agency? Improving the lives of 10 million older adults by National Council on Aging 11
12 What can she do? (Poll) a.appeal the denial of homecare b.pay for homecare out of her pocket until her savings are low enough that she qualifies for Medicaid again c. Talk to an attorney about setting up a special trust that won t count towards the Medicaid asset test Improving the lives of 10 million older adults by National Council on Aging 12
13 Scenario 1b: What if? Nelly is the same age as Nora, but her income is a bit higher, and she s had a plan on the exchange for the past few years. She s gotten a subsidy to help with the premiums, and though she s paid a bit more than she wishes for her prescriptions, she s been pretty happy with her coverage. She s Nora s twin, and Nora told her that Medicare is a terrible deal, and to avoid it if she can unlike Medicaid, I heard that the Exchange plans can t kick you off when you turn 65! Improving the lives of 10 million older adults by National Council on Aging 13
14 Poll Can (and should) Nelly decline Medicare? a. Yes, because she has creditable coverage under her exchange plan b. No, because she won t have a SEP to enroll in Part B later and will have a penalty. c. Yes, but only if she declines Part A AND Part B. d. No, but she should keep her exchange plan, with subsidies as inexpensive secondary coverage. Improving the lives of 10 million older adults by National Council on Aging 14
15 More information Issue Brief: Toward Seamless Coverage: Expansion Medicaid to Medicare Transitions FAQ: Improving the lives of 10 million older adults by National Council on Aging 15
16 Scenario 2: Part A Conditional Enrollment March 2018: Ms. Green, 66, a SC resident, seeks assistance in enrolling in Medicare A and B, which she has delayed because she can not afford the premiums Ms. Green s income is $11,500 annually with no additional resources or assets. Ms. Green has worked for 30 quarters. How do you assist Ms. Green? Improving the lives of 10 million older adults by National Council on Aging 16
17 Background: Part A Conditional Enrollment Part A enrollment is required to qualify for MSP/QMB The conditional enrollment process allows an individual to apply for Part A but only get coverage if the state approves the QMB application, whereby the state pays the Part A premium If the QMB application is denied, the individual will not be enrolled in Part A Improving the lives of 10 million older adults by National Council on Aging 17
18 Background Part A Conditional Enrollment Buy-in States are those states that include Premium-Part A in their State Buy-in agreements. In Part A Buy-in States, individuals can complete the conditional enrollment process at any time. Group Payer States are those states that did not include Premium-Part A for QMBs in their State Buy-in agreements. In Group Payer States, individuals must complete the conditional enrollment process during a prescribed enrollment period. o January 1-March 31 enrollment period for a July 1 effective date Improving the lives of 10 million older adults by National Council on Aging 18
19 List of Group Payer States Alabama Kansas New Mexico Arizona Kentucky South Carolina California Missouri Utah Colorado Nebraska Virginia Illinois New Jersey Improving the lives of 10 million older adults by National Council on Aging 19
20 Counseling Considerations Group Payer States Confirm QMB eligibility (income and assets thresholds) Explain that an application for Part B and a conditional enrollment for Premium Part A must be filed with SSA during the state s prescribed enrollment period (January 1- March 31). The effective date will be July 1. Ensure that the Remarks section of the application contains the following language o I wish to enroll in Part A. I understand that: I m not eligible for Premium-Free Part A. By enrolling, I m buying Part A coverage. I must also have Part B. I must pay monthly premiums for Part A and Part B coverage. (if Applicable) I only want Part A coverage if my State approves my application for the Qualified Medicare Beneficiary (QMB) program. I do not want Part A coverage to begin before my State starts paying my monthly premiums. I understand that if I lose my QMB status, I must pay the monthly premiums to keep my Part A coverage. Improving the lives of 10 million older adults by National Council on Aging 20
21 Counseling Considerations Group Payer States Advise client to obtain a copy of the screen shot documenting their conditional enrollment in Part A Complete/or direct the client to the State Medicaid office to complete a QMB application. Include/attach a copy of the SSA screen shot with the application Explain that a QMB is automatically eligible for LIS QMB eligibility must be recertified annually Improving the lives of 10 million older adults by National Council on Aging 21
22 Scenario 2b: Buy-In State March 2018: Ms. Green, 66, a MD resident, seeks assistance in enrolling in Medicare A, which she has delayed because she can not afford the premiums Ms. Green s income is $11,500 annually with no additional resources or assets. Ms. Green has worked for 30 quarters. How do you assist Ms. Green? Improving the lives of 10 million older adults by National Council on Aging 22
23 Counseling Considerations Buy-In States Confirm QMB eligibility (income and assets thresholds) Complete/or direct the client to the State office to complete a QMB application. She does not need to file an application for conditional Part A at SSA Explain that a QMB is automatically eligible for LIS QMB eligibility must be recertified annually Note: If the State (MD) approves the QMB application, the state will enroll her in the State Buy-In which covers both Part A and B premiums, the month after she is found eligible for QMB. Improving the lives of 10 million older adults by National Council on Aging 23
24 Buy-In vs Group-Payer State Comparison Local SSA Office Accepts Part A Conditional Enrollments Application Client Has Part B Client Does Not Have Part B Coverage Effective Date Buy-In States Any time File a QMB application with State Medicaid anytime File an application for Part B and Part A Conditional Application with SSA, then QMB application with State Medicaid anytime Varies with application date Group- Payer- States Only during prescribed enrollment periods File a Part A Conditional Application with SSA, then a QMB application with State Medicaid during prescribed enrollment period only File an application for part B and Part A Conditional Application with SSA, then a QMB application with State Medicaid during prescribed enrollment period only July 1 Improving the lives of 10 million older adults by National Council on Aging 24
25 Additional Information & Resources Conditional Part A enrollment does not change eligibility criteria for Part A Beneficiaries are allowed to complete conditional applications even if they owe Medicare premiums Part B does not have a conditional enrollment provision SSA POMS Conditional Part A Guidance: M NCOA Fact Sheet: A Closer Look: Medicare GEP and the Significance for Your Low Income Clients: Part A premium amounts: Improving the lives of 10 million older adults by National Council on Aging 25
26 Scenario 3a: The big nursing home bill Lorene s daughter, Marge, calls to ask for help with a $3,000 bill for her mother s two week nursing facility stay. Shouldn t Medicare be paying for this? she asks. Mom got a notice from Medicare that says it won t pay. Now, the nursing home is billing her and bugging me because I m her representative. Marge reports that Lorene was hospitalized for five days to treat sepsis caused by a recurrent infection in her leg tissue. Improving the lives of 10 million older adults by National Council on Aging 26
27 Poll What do you need to know before you can address Marge s question? a. Was the nursing facility owned and operated by a for-profit chain or a county government? b. Was the nursing facility a swing bed unit within the hospital? c. Was Lorene admitted as a hospital inpatient? d. Was Lorene eligible for Medicaid? Improving the lives of 10 million older adults by National Council on Aging 27
28 Scenario 3b: The big nursing home bill Marge recalls that Lorene s physician admitted her to the hospital as an inpatient. She received IV antibiotics there. Under doctor s orders, the hospital s discharge planner arranged Lorene s transfer to a Medicare-certified skilled nursing facility (SNF) directly from the hospital. Marge says that a ramp-equipped van transported her mom because she could barely stand on her own and needed a wheelchair. Improving the lives of 10 million older adults by National Council on Aging 28
29 Check-In Poll Since Lorene was hospitalized as an inpatient for 5 days and admitted to the SNF under a physician s orders, what else could explain Medicare s coverage denial? a. She didn t receive skilled nursing care on a daily basis. b. She didn t receive physical therapy on a daily basis. c. She didn t have to be in a SNF to get the care she needed. d. All of the above. Improving the lives of 10 million older adults by National Council on Aging 29
30 Scenario 3c: The big nursing home bill Marge excuses herself to go look for the Medicare denial notice. When she returns to the phone, she reads a note that says Lorene didn t qualify for SNF coverage because she could have received skilled care in a less intensive setting like her home with home health care. Improving the lives of 10 million older adults by National Council on Aging 30
31 Check-In Poll What can Marge and Lorene do? a. Appeal the coverage denial. b. Sign up for Medicaid so it pays the bill retroactively. c. Stop paying the nursing home bill. d. Buy a Medigap policy to insure against something like this happening again. Improving the lives of 10 million older adults by National Council on Aging 31
32 Go to the source The practical matter test for SNF coverage (Medicare Benefit Policy Manual, Chapter 8, 30.7) As a practical matter, daily skilled services can be provided only in a SNF if they are not available on an outpatient basis in the area in which the individual resides or transportation to the closest facility would be: An excessive physical hardship; Less economical; or Less efficient or effective than an inpatient institutional setting. Improving the lives of 10 million older adults by National Council on Aging 32
33 The Practical Matter Test The availability of capable and willing family or the feasibility of obtaining other assistance for the patient at home should be considered. Even though needed daily skilled services might be available on an outpatient or home care basis, as a practical matter, the care can be furnished only in the SNF if home care would be ineffective because the patient would have insufficient assistance at home to reside there safely. (emphasis added) Improving the lives of 10 million older adults by National Council on Aging 33
34 Scenario 4: SNAP medical expense deduction Elaine, 61, lives in Arkansas with a disability. Elaine has been receiving a modest SNAP benefit amount ($40/month), but recently, she acquired a dog trained to provide her support for her disability, and she calls your office wondering if the dog s food and veterinary costs are considered medical expenses. If so, can they be counted toward the SNAP medical expense deduction, thereby possibly increasing her SNAP award? Improving the lives of 10 million older adults by National Council on Aging 34
35 Two Considerations for Counselors 1. What does the state SNAP policy manual say about qualified medical expenses that count toward the deduction? For service animals, are there any licensure qualifications? Specific animal types included/excluded? Does your state have a standard deduction? What about recurring vs. non-recurring expenses? 2. What is the mechanism to have your state agency reconsider a client s SNAP benefit amount? Are there specific timeframes? What documentation is needed? Improving the lives of 10 million older adults by National Council on Aging 35
36 Finding Your State SNAP Policy Manual Go onto the website of the agency that administers SNAP in your state and search for policy manual o Look in section on Determining Eligibility or Deductions The Center on Budget & Policy Priorities (CBPP) has a handy short-cut page linking to most state manuals at: Improving the lives of 10 million older adults by National Council on Aging 36
37 South Carolina (top) vs Arkansas (left) Improving the lives of 10 million older adults by National Council on Aging 37
38 Reconsidering SNAP Benefit Amount All states require clients to report changes in income at any time to the determining agency o Most states allow the client to report the medical expenses at any time as they would any other change in household income or expenses o Some require clients to wait until the time of interim reporting or recertification and report the medical expenses then Check your state s policy manual and client s SNAP caseworker Separate issue: If your client has already submitted documentation and been denied SNAP or a change in award, they can request a fair hearing within 90 days of benefit decision Improving the lives of 10 million older adults by National Council on Aging 38
39 Related Resources USDA Food & Nutrition Service SNAP information: NCOA Resources: o o Webinar: Maximizing SNAP Benefits Through the Medical Expense Deduction: Fact sheet: CBPP: SNAP Policy Basics: Improving the lives of 10 million older adults by National Council on Aging 39
40 Scenario 5: Retirement plans, the IEP, and SEP George turns 65 on July 27th this week. He works for a large medical equipment manufacturer and has group health coverage through his employer. He intends to retire this fall, starting in October, after 30 full years on the job. He s read about a Special Enrollment Period (SEP) for older workers and wants to know if he should plan to use the SEP in September so his Medicare Part B coverage will take effect on October 1. Improving the lives of 10 million older adults by National Council on Aging 40
41 Poll Can George use the SEP in September to enroll in Part B on October 1? a. Yes, because the SEP takes priority over his Initial Enrollment Period (IEP). b. Yes, but only if George can prove that he has creditable coverage. c. No, because George will be eligible for COBRA coverage when he retires. d. No, because the Initial Enrollment Period takes priority over the SEP. Improving the lives of 10 million older adults by National Council on Aging 41
42 Go to the Source Social Security POMS (HI ) In the case where an individual qualifies for more than one enrollment period, the order for Medicare enrollment periods is: 1. Initial Enrollment Period (IEP) 2. Special Enrollment Period (SEP) 3. General Enrollment Period (GEP) o Both the Special Enrollment Period and the General Enrollment Period are only available following the end of an individual s IEP. Improving the lives of 10 million older adults by National Council on Aging 42
43 Be in touch Reminder: Get the slides, recording and follow-up Q&A at: Ask further questions: Improving the lives of 10 million older adults by National Council on Aging 43
Medicare for Medicaid Advocates
Medicare for Medicaid Advocates July 24, 2013 Georgia Burke, National Senior Citizens Law Center Doug Goggin-Callahan, Medicare Rights Center The Medicare Rights Center is a national, not-forprofit consumer
October 21, MIPPA Reporting. Audio Portion: Web Portion: Code:
October 21, 2015 2015 MIPPA Reporting Audio Portion: 1-866-740-1260 Web Portion: www.readytalk.com Code: 4796976 Agenda 2014 MIPPA 6-month report 2015 MIPPA Reporting Requirements SHIP NPR Data Entry 2
2018 Evidence of Coverage
Los Angeles, Riverside and San Bernardino Counties 2018 Evidence of Coverage SCAN Connections (HMO SNP) Y0057_SCAN_10165_2017F File & Use Accepted DHCS Approved 08232017 08/17 18C-EOC006 January 1 December
Health Law PA News. Community HealthChoices-SW Starts January 1 st. A Publication of the Pennsylvania Health Law Project. In This Issue. Subscribe...
Health Law PA News A Publication of the Pennsylvania Health Law Project Volume 20, Number 9 Statewide Helpline: 800-274-3258 Website: www.phlp.org In This Issue Start of Medicaid Ordering, Referring, or
Mercy Care Advantage (HMO SNP) 2018 Evidence of Coverage Evidencia de Cobertura Visit/Viste
Mercy Care Advantage (HMO SNP) 2018 Evidence of Coverage Evidencia de Cobertura 2018 Visit/Viste www.mercycareadvantage.com AZ-17-07-02 January 1 December 31, 2018 Evidence of Coverage: Your Medicare Health
EVIDENCE OF COVERAGE Molina Medicare Options Plus HMO SNP
Molina Medicare Options Plus HMO SNP Member Services CALL (800) 665-0898 Calls to this number are free. 7 days a week, 8 a.m. to 8 p.m., local time. Member Services also has free language interpreter services
Annual Notice of Changes for 2016
Health Alliance Medicare PPO 10 (PPO) offered by Health Alliance Connect, Inc. Annual Notice of Changes for 2016 You are currently enrolled as a member of Health Alliance Medicare PPO 10. Next year, there
THE IMPACT OF BBA, BIPA and MEDICARE+CHOICE ON LTC (Why Medicare/Medicare Supplement is SHORT-TERM CARE)
THE IMPACT OF BBA, BIPA and MEDICARE+CHOICE ON LTC (Why Medicare/Medicare Supplement is SHORT-TERM CARE) (For a complete description of Medicare, Medicare supplement and Medicare+Choice, see Appendix A
MEDIMASTER GUIDE. MediMaster Guide. Positively Aging /M.O.R.E The University of Texas Health Science Center at San Antonio
MEDIMASTER GUIDE MediMaster Guide 25 Appendix: MediMaster Guide MEDICARE What is Medicare? Medicare is a hospital insurance program in the U.S. that pays for inpatient hospital care, skilled nursing facility
Evidence of Coverage:
January 1 December 31, 2013 Evidence of Coverage: Your Medicare Health Benefits and Services as a Member of Health Net Aqua (PPO) This booklet gives you the details about your Medicare health care coverage
Medicare Hospice Benefits
CENTERS for MEDICARE & MEDICAID SERVICES Medicare Hospice Benefits This official government booklet includes information about Medicare hospice benefits: Who s eligible for hospice care What services are
Evidence of Coverage. Elderplan Advantage for Nursing Home Residents (HMO SNP) H3347_EP16115_SALIS_
2018 Evidence of Coverage January 1, 2018 to December 31, 2018 H3347_EP16115_SALIS_01.25.2018 January 1 December 31, 2018 Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription
Secure Blue (PPO) 2015 Evidence of Coverage. January 1 December 31, Your Medicare Health Benefits and Services Coverage as a Member of
Secure Blue (PPO) 2015 Evidence of Coverage January 1 December 31, 2015 Your Medicare Health Benefits and Services Coverage as a Member of Secure Blue (PPO) This booklet gives you the details about your
Annual Notice of Changes for 2018
SeniorHealth Basic and Plus Plans Combined Annual Notice of Change and Evidence of Coverage Contract Year 2018 Contra Costa Health Plan s SeniorHealth Plan, a Medicare Cost Plan offered by Contra Costa
Annual Notice of Coverage
CHRISTUS Health Plan Generations (HMO) Annual Notice of Coverage Finally, access to the doctor and hospital you know and trust. christushealthplan.org CHRISTUS Health Plan Generations (HMO) offered by
An Equal Opportunity Employer and Service Provider
Ted Strickland, Governor Helen E. Jones - Kelley, Director JFS 08030 (Rev. 5/2007) An Equal Opportunity Employer and Service Provider Table of Contents Page Introduction...2 General Information...3 What
Health in Handbook. a guide to Medicare rights & health in Pennsylvania #6009-8/07
Health in Handbook a guide to Medicare rights & health in Pennsylvania #6009-8/07 Tips for Staying Healthy works hard to make sure that the health care you receive is the best care possible. There are
Medicare Hospice Benefits
CENTERS for MEDICARE & MEDICAID SERVICES Medicare Hospice Benefits This official government booklet includes information about Medicare hospice benefits: Who s eligible for hospice care What services are
Table 6 Medicaid Eligibility Systems for Children, Pregnant Women, Parents, and Expansion Adults, January Share of Determinations
Table 6 Medicaid Eligibility Systems for Children, Pregnant Women, Parents, and Expansion Adults, January 2017 Able to Make Share of Determinations System determines eligibility for: 2 State Real-Time
Evidence of Coverage
January 1 December 31, 2017 Evidence of Coverage Your Medicare Health Benefits and Services as a Member of Kaiser Permanente Medicare Plus (Cost) This booklet gives you the details about your Medicare
Hospital Transitions: A Guide for Professionals.
Hospital Transitions: A Guide for Professionals 2017 www.medicarerights.org Medicare Rights Center The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure
MSG0117 Group Health Options, Inc. Medicare Supplement Plans 2017
MSG0117 Group Health Options, Inc. Medicare Supplement Plans 2017 The Group Health difference Why choose Group Health? Here are just a few of the reasons why many Medicare enrollees choose and re-enroll
2018 Medicare Advantage Dual Eligible Special Needs Plan (DSNP) & Model of Care (MOC) Overview
2018 Medicare Advantage Dual Eligible Special Needs Plan (DSNP) & Model of Care (MOC) Overview Medicare Advantage (MA) Program Part C Medicare Advantage Medicare Part A and B benefits are administered
Medicare and Medicaid
Medicare and Medicaid Medicare Medicare is a multi-part federal health insurance program managed by the federal government. A person applies for Medicare through the Social Security Administration, but
KEPRO The Beneficiary and Family Centered Care Quality Improvement Organization. Brittny Bratcher, MS, CHES
KEPRO The Beneficiary and Family Centered Care Quality Improvement Organization Brittny Bratcher, MS, CHES 1 KEPRO KEPRO is a federal contractor for the Centers for Medicare & Medicaid Services (CMS) KEPRO
CENTERS for MEDICARE & MEDICAID SERVICES. Medicare & Home Health Care
1 CENTERS for MEDICARE & MEDICAID SERVICES Medicare & Home Health Care This official government booklet tells you: Who s eligible What services are covered How to find and compare home health agencies
Medicare Basics. Part I of II
Part I of II August 2013 1 What are the Four Parts of Medicare? Part A Hospital Insurance Part B Medical Insurance Part C Medicare Advantage Plans, like HMOs and PPOs Includes Part A & B and usually Part
2
1 2 3 4 5 Types of Medicare Part A Hospital insurance (inpatient hospital care, inpatient care in a Skilled Nursing Facility, hospice care, and some home health services); Part B Medical insurance (physician
KEPRO The Beneficiary and Family Centered Care Quality Improvement Organization. Nancy Jobe
KEPRO The Beneficiary and Family Centered Care Quality Improvement Organization Nancy Jobe 1 KEPRO KEPRO is a federal contractor for the Centers for Medicare & Medicaid Services (CMS) KEPRO is the Beneficiary
Current Medicare Advantage Enrollment Penetration: State and County-Level Tabulations
Current Advantage Enrollment : State and County-Level Tabulations 5 Slide Series, Volume 40 September 2016 Summary of Tabulations and Findings As of September 2016, 17.9 million of the nation s 56.1 million
2014 ACEP URGENT CARE POLL RESULTS
2014 ACEP URGENT CARE POLL RESULTS PREPARED FOR: PREPARED BY: 2014 Marketing General Incorporated 625 North Washington Street, Suite 450 Alexandria, VA 22314 800.644.6646 toll free 703.739.1000 telephone
Academic Year Is from 12:00am on August 16 th to 11:59pm on August 15 th. This is the coverage period for CampusCare.
CampusCare A self-funded student health benefit plan for the students at the University of Illinois at Chicago including the Rockford and Peoria campuses. *Please note: The Urbana-Champaign and Springfield
Running head: NURSING SHORTAGE 1
Running head: NURSING SHORTAGE 1 Nursing Shortage: The Current Crisis Evett M. Pugh Kent State University College of Nursing Running head: NURSING SHORTAGE 2 Abstract This paper is aimed to explain the
Medicare Coverage of Ambulance Services. CENTERS for MEDICARE & MEDICAID SERVICES
CENTERS for MEDICARE & MEDICAID SERVICES Medicare Coverage of Ambulance Services This official government booklet explains: When Medicare helps cover ambulance services What you pay What Medicare pays
Annual Notice of Changes for 2017
Kaiser Permanente Senior Advantage Medicare Medi-Cal Plan South (HMO SNP) offered by Kaiser Foundation Health Plan, Inc., Southern California Region Annual Notice of Changes for 2017 You are currently
Medicare & Medicare Supplemental Insurance (Medigap)
Elder Law Basics Medicare & Medicare Supplemental Insurance (Medigap) Steven A. Kass, Esq., CELA Law Office of Steven A. Kass, PC 105 Maxess Road, Suite N116 Melville, New York 11747 What is Medicare?
Evidence of Coverage
January 1 December 31, 2018 Evidence of Coverage Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of Kaiser Permanente Senior Advantage Medicare Medi-Cal Plan North
MMW Webinar Medicare & Medicaid Updates. August 30, 2017
MMW Webinar Medicare & Medicaid Updates Webinar Logistics: Audio: Listen through your computer speakers or call in using a telephone. To get call-in information, click telephone under audio. Because there
REQUEST FOR PROPOSALS (RFP)
REQUEST FOR PROPOSALS (RFP) GRANT INVITATION AND APPLICATION INSTRUCTIONS ISSUED BY: The National Council on Aging s Center for Benefits Access Released September 25, 2017 Funding Opportunity Title: Benefits
Evidence of Coverage January 1 December 31, 2014
L.A. Care Health Plan Medicare Advantage (HMO SNP) Evidence of Coverage January 1 December 31, 2014 Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of L.A. Care Health
TABLE 3c: Congressional Districts with Number and Percent of Hispanics* Living in Hard-to-Count (HTC) Census Tracts**
living Alaska 00 47,808 21,213 44.4 Alabama 01 20,661 3,288 15.9 Alabama 02 23,949 6,614 27.6 Alabama 03 20,225 3,247 16.1 Alabama 04 41,412 7,933 19.2 Alabama 05 34,388 11,863 34.5 Alabama 06 34,849 4,074
November 24, First Street NE, Suite 510 Washington, DC 20002
820 First Street NE, Suite 510 Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org November 24, 2008 TANF BENEFITS ARE LOW AND HAVE NOT KEPT PACE WITH INFLATION But Most
HOME HEALTH AIDE TRAINING REQUIREMENTS, DECEMBER 2016
BACKGROUND HOME HEALTH AIDE TRAINING REQUIREMENTS, DECEMBER 2016 Federal legislation (42 CFR 484.36) requires that Medicare-certified home health agencies employ home health aides who are trained and evaluated
State Options Report. Supplemental Nutrition Assistance Program. Program Development Division Twelfth Edition Options as of October 1, 2015
United States Department of Agriculture Food and Nutrition Service State Options Report Supplemental Nutrition Assistance Program Program Development Division Twelfth Edition Options as of October 1, 2015
TABLE 3b: Congressional Districts Ranked by Percent of Hispanics* Living in Hard-to- Count (HTC) Census Tracts**
Rank State District Count (HTC) 1 New York 05 150,499 141,567 94.1 2 New York 08 133,453 109,629 82.1 3 Massachusetts 07 158,518 120,827 76.2 4 Michigan 13 47,921 36,145 75.4 5 Illinois 04 508,677 379,527
Medicare Hospice Benefits
CENTERS FOR MEDICARE & MEDICAID SERVICES Medicare Hospice Benefits This official government booklet includes information about Medicare hospice benefits: Who is eligible for hospice care What services
We can never insure one-hundred percent of the population against one-hundred percent of the hazards and vicissitudes of life. Franklin D.
Medicare Explained We can never insure one-hundred percent of the population against one-hundred percent of the hazards and vicissitudes of life. Franklin D. Roosevelt comments on signing The Social Security
Medicare Supplement Plans
KPShealth plans P R O V I D E R N E T W O R K If you have questions about any of our Medicare Supplement plans or about the application process, please feel free to contact us at 360-478-6786, or toll
Medicare Coverage of Ambulance Services. CENTERS for MEDICARE & MEDICAID SERVICES
CENTERS for MEDICARE & MEDICAID SERVICES Medicare Coverage of Ambulance Services This official government booklet explains: When Medicare helps cover ambulance services What you pay What Medicare pays
Table 8 Online and Telephone Medicaid Applications for Children, Pregnant Women, Parents, and Expansion Adults, January 2017
Table 8 Online and Telephone Medicaid Applications for Children, Pregnant Women, Parents, and Expansion Adults, January 2017 State Applications Can be Submitted Online at the State Level 1 < 25% 25% -
2009 Evidence of Coverage BlueMedicare SM Polk County HMO. A Medicare Advantage HMO Plan
2009 Evidence of Coverage BlueMedicare SM Polk County HMO A Medicare Advantage HMO Plan Member Services phone number: 1-800-926-6565 TTY/TDD users call: 711 8:00 a.m. - 9:00 p.m. ET, seven days a week
2015 State Hospice Report 2013 Medicare Information 1/1/15
2015 State Hospice Report 2013 Medicare Information 1/1/15 www.hospiceanalytics.com 2 2013 Demographics & Hospice Utilization National Population 316,022,508 Total Deaths 2,529,792 Medicare Beneficiaries
Use of Medicaid MCO Capitation by State Projections for 2016
Use of Medicaid MCO Capitation by State Projections for 5 Slide Series September, 2015 Summary of Findings This edition projects Medicaid spending in each state and the percentage of spending paid via
Annual Notice of Changes for 2017
Network PlatinumPlus (PPO) offered by Network Health Insurance Corporation Annual Notice of Changes for 2017 You are currently enrolled as a member of Network PlatinumPlus. Next year, there will be some
Caring for Your Aging Parents
Caring for Your Aging Parents The first step you need to take is talking to your parents. Find out what their needs and wishes are. Don't try to care for your parents alone. Many local and national caregiver
Critical Access Hospitals and HCAHPS
Critical Access Hospitals and HCAHPS Michelle Casey, MS Senior Research Fellow and Deputy Director University of Minnesota Rural Health Research Center June 12, 2012 Overview of Presentation Why is HCAHPS
Our service area includes these counties in: Arizona: Apache, Coconino, Maricopa, Mohave, Navajo, Pinal, Yavapai.
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete ONE (HMO SNP) H0321-004 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
Benefits Counseling Providing counseling, advice and representation on public benefi ts and legal issues.
Benefits Counseling Providing counseling, advice and representation on public benefi ts and legal issues. How a benefits counselor can help you A benefits counselor answers questions regarding the application
The Medicare Admissions Process and Strategies for Success. Your Speakers
The Medicare Admissions Process and Strategies for Success Leading Age Michigan 2014 Annual Leadership Institute Thursday, August 14, 2014 10:45 am 11:45 am 1 Your Speakers Betsy Anderson, President FR&R
Medicare Rights & Protections
CENTERS for MEDICARE & MEDICAID SERVICES Medicare Rights & Protections This official government booklet has important information about: Your rights & protections in: Original Medicare Medicare Advantage
2018 Medicare Advantage Dual Eligible Special Needs Plan (DSNP), Chronic Special Needs Plan ESRD (CSNP ESRD) & Model of Care (MOC) Overview
2018 Medicare Advantage Dual Eligible Special Needs Plan (DSNP), Chronic Special Needs Plan ESRD (CSNP ESRD) & Model of Care (MOC) Overview Medicare Advantage (MA) Program Part C Medicare Advantage Medicare
42 CFR 438 MMC Service Authorization and Appeals MMC/HIV SNP/HARP/MLTC/Medicaid Advantage/Medicaid Advantage Plus
of Health Office of Health Insurance Programs 42 CFR 438 MMC Service Authorization and Appeals MMC/HIV SNP/HARP/MLTC/Medicaid Advantage/Medicaid Advantage Plus Hope Goldhaber, Division of Health Plan Contracting
Medicare & Your Mental Health Benefits
CENTERS for MEDICARE & MEDICAID SERVICES Medicare & Your Mental Health Benefits This official government booklet has information about mental health benefits for people with Original Medicare, including:
Topics. Overview of the Medicare Recovery Audit Contractor (RAC) Understanding Medicaid Integrity Contractor
RACS, ZPICS & MICS John Falcetano, CHC-F, CCEP-F, CHPC, CHRC, CIA Chief Audit and Compliance Officer University Health Systems of Eastern Carolina jfalceta@uhseast.com Topics Overview of the Medicare Recovery
Agenda. Agenda 03/22/ th Annual Spring Payer Panel March 29, Program News and Announcements. Clinical News and Reviews
6 th Annual Spring Payer Panel March 29, 2018 wpsgha.litmos.com Agenda Program News and Announcements New Medicare Cards WPS GHA Portal Enhancements Medicare Day of Learning CMS Electronic Cost Report
THIS INFORMATION IS NOT LEGAL ADVICE
Medicaid Medicaid is a federal/state program that gives certain groups of people a card that can be used to get free medical care, nursing home care, and prescription drugs at reduced prices. In general,
FACT SHEET Low Income Assistance: Cal MediConnect (E-004) p. 1 of 6
FACT SHEET Low Income Assistance: Cal MediConnect (E-004) p. 1 of 6 Low Income Assistance: Cal MediConnect What is Cal MediConnect? California is one of 12 states that has signed a Memorandum of Understanding
Introduction. Introduction 9/14/2010. ALABAMA NURSING HOME ASSOCIATION ANNUAL CONVENTION & TRADE SHOW Birmingham, Alabama September 20 23, 2010
ALABAMA NURSING HOME ASSOCIATION ANNUAL CONVENTION & TRADE SHOW Birmingham, Alabama September 20 23, 2010 1 Introduction CMS defines state long term care rebalancing as achieving a more equitable balance
Heart of Hope Asian America Hospice Care 希望之 心安寧醫護關懷中 心
Heart of Hope Asian America Hospice Care 希望之 心安寧醫護關懷中 心 Teleconference 2017.01.19 Prepared by: Che-Fai Au (fai@mac.com) Hospice Care through Medicare, Medi-Cal, and Private Insurance Hospice care is a
What is Medi-Cal?...2. What is Medi-Cal Recovery?...2. Covered California and Medi-Cal Expansion...3. What is Managed Care?...3
What is Medi-Cal?...2 What is Medi-Cal Recovery?...2 Covered California and Medi-Cal Expansion...3 What is Managed Care?...3 What If I Choose Not to Enroll in a Health Care Plan?...4 How Does Managed Care
MBQIP Quality Measure Trends, Data Summary Report #20 November 2016
MBQIP Quality Measure Trends, 2011-2016 Data Summary Report #20 November 2016 Tami Swenson, PhD Michelle Casey, MS University of Minnesota Rural Health Research Center ABOUT This project was supported
Medicare Preventive Services
Medicare Preventive Services Presented by Part B Provider Outreach & Education December 16, 2015 Event Instructions Today s event is a teleconference Slides will not be advanced during the presentation
EVIDENCE OF COVERAGE. January 1 December 31, Your Medicare Health Benefits and Services as a Member of Cigna HealthSpring Advantage (PPO)
January 1 December 31, 2018 EVIDENCE OF COVERAGE Your Medicare Health Benefits and Services as a Member of Cigna HealthSpring Advantage (PPO) This booklet gives you the details about your Medicare health
Complex Challenges/Financial Impact Medical Necessity Compliance Role of the Physician Advisor. NJHFMA Finance for Clinicians Session March 24, 2016
1 Complex Challenges/Financial Impact Medical Necessity Compliance Role of the Physician Advisor NJHFMA Finance for Clinicians Session March 24, 2016 Complex Challenges 2 Declining Inpatient Admissions
2015 Summary of Benefits
2015 Summary of Benefits Health Net Cal MediConnect Plan (Medicare-Medicaid Plan) Los Angeles County, CA H3237_2015_0291 CMS Accepted 09082014 Health Net Cal MediConnect Summary of Benefits! This is a
Palmetto GBA Hospice Coalition Questions August 7, 2001
Palmetto GBA Hospice Coalition Questions August 7, 2001 1. How should billing be handled when the initial certification is provided outside of the 2 weeks before and 2 days after time frame? For example,
2013 Summary of Benefits Humana Medicare Employer RPPO
2013 Summary of Benefits Employer RPPO RPPO 079/631 Loudoun County Public Schools Y0040_GHA0B4IHH13 PPO 079/631 Thank you for your interest in the Employer Regional PPO Plan. This plan is offered by Humana
INSURANCE TRAINING SUPPORT FOR USE WITH KAREN FESSEL TRAIN THE TRAINER MATERIALS 2016
INSURANCE TRAINING SUPPORT FOR USE WITH KAREN FESSEL TRAIN THE TRAINER MATERIALS 2016 WITH MEDI-CAL WHAT IS COVERED????? Outpatient Services/Emergency Services Hospitalization Newborn Care Mental Health
Division of Assets and Medicaid Planning...
Division of Assets and Medicaid Planning... How to Pay for the Nursing Home Without Going Broke One of the things that concerns people most about nursing home care is how to pay for that care. There are
3+ 3+ N = 155, 442 3+ R 2 =.32 < < < 3+ N = 149, 685 3+ R 2 =.27 < < < 3+ N = 99, 752 3+ R 2 =.4 < < < 3+ N = 98, 887 3+ R 2 =.6 < < < 3+ N = 52, 624 3+ R 2 =.28 < < < 3+ N = 36, 281 3+ R 2 =.5 < < < 7+
Commonly Asked Medicaid Questions. 1. What is the difference between Medicaid and Medicare?
Commonly Asked Medicaid Questions 1. What is the difference between Medicaid and Medicare? Medicaid is a federal health program available to disabled individuals and seniors who are 65 or over. Eligibility
Our service area includes these counties in:
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete (HMO SNP) H0432-009 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
Holding the Line: How Massachusetts Physicians Are Containing Costs
Holding the Line: How Massachusetts Physicians Are Containing Costs 2017 Massachusetts Medical Society. All rights reserved. INTRODUCTION Massachusetts is a high-cost state for health care, and costs continue
Our service area includes the following county in: Delaware: New Castle.
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete (HMO SNP) H3113-011 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
NURSING FACILITY SERVICES
CHAPTER 17 17.9 INCOME WV INCOME MAINTENANCE MANUAL 17.9 There is a two-step income process for providing Medicaid coverage for nursing facility services to individuals in nursing facilities. The client
1965-1969 1970-1974 1975-1979 1980-1984 1985-1989 1990-1994 1995-1999 2000-2004 2005-2009 Intro Entire Timeline Displaying: 1965-2009 1965-2009 1965: President Johnson signed H.R. 6675 to establish Medicare
CMS -1599F. The 2 Midnight Rule Effective October 1, 2013
Joseph Nitti, M.D. Medical Director/Physician Advisor Continuum of Care Dept. Morristown Medical Center 973-971-4004 CMS -1599F The 2 Midnight Rule Effective October 1, 2013 Determination of Inpatient
Fiscal Year 1999 Comparisons. State by State Rankings of Revenues and Spending. Includes Fiscal Year 2000 Rankings for State Taxes Only
Fiscal Year 1999 Comparisons State by State Rankings of Revenues and Spending Includes Fiscal Year 2000 Rankings for State Taxes Only January 2002 1 2 published annually by: The Minnesota Taxpayers Association
Our service area includes these counties in: Texas: Aransas, Kleberg, Nueces, San Patricio.
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete Focus (HMO SNP) H4527-004 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
MEDICARE. 32 nd Annual Open Season Seminar
MEDICARE 32 nd Annual Open Season Seminar What is Medicare and who is eligible? Federal Health Insurance Program for aged and disabled o Over age 65 o Disabled workers o Patients with End Stage Renal Disease
EARLY CHILDHOOD BULLETIN
EARLY CHILDHOOD BULLETIN News by and for Parents and Parent Members of State Interagency Coordinating Councils Prepared by the Federation for Children with Special Needs Fall Parent Component Staff of
NeedyMeds
NeedyMeds www.needymeds.org Find help with the cost of medicine Thank you for downloading this patient assistance document from NeedyMeds. We hope this program will help you get the medicine you need.
Supplemental Nutrition Assistance Program. STATE ACTIVITY REPORT Fiscal Year 2016
Supplemental Nutrition Assistance Program ACTIVITY REPORT Fiscal Year 2016 Food and Nutrition Service Supplemental Nutrition Assistance Program Program Accountability and Administration Division September
Illinois Medicaid. updated August 2016 AgeOptions All rights reserved.
Illinois Medicaid updated August 2016 AgeOptions 2016. All rights reserved. 1 What We Will Cover Today What is Medicaid? Medicaid Eligibility Categories of Medicaid Coverage Medicaid Waiver Programs Medicare
Enrolling Older Adults in SNAP Best Practices from the Field. September 2015
Enrolling Older Adults in SNAP Best Practices from the Field September 2015 Follow Along with Us Online Please join us online at www.readytalk.com 2 Lines are Muted We ve muted all the lines to help eliminate
Health plans for Maine small businesses Available through the Health Insurance Marketplace
Health plans for Maine small businesses Available through the Health Insurance Marketplace Effective January 1, 2016 We can help you navigate the health care road We re here to help. In fact, for more
Caring for Your Aging Parents
Emilio Vazquez SVP/CNB Wealth Management & Investment Executive INFINEX INVESTMENTS, INC. 1801 SouthWest 1st Street Miami, FL 33131 305-631-6410 emilio.vazquez@infinexgroup.com Caring for Your Aging Parents
WikiLeaks Document Release
WikiLeaks Document Release February 2, 2009 Congressional Research Service Report 98-968 The Hill-Burton Uncompensated Services Program Barbara English, Knowledge Services Group May 9, 2006 Abstract. The
Improving Care for Dual Eligibles through Health IT
Los Angeles, October 31, 2012 Presentation Improving Care for Dual Eligibles through Health IT The National Dual Eligibles Summit Duals Market is sizable Medicare and Medicaid Populations Medicaid Total
Summary Of Benefits. WASHINGTON Pierce and Snohomish
Summary Of Benefits WASHINGTON Pierce and Snohomish 2018 Molina Medicare Choice (HMO SNP) (800) 665-1029, TTY/TDD 711 7 days a week, 8 a.m. 8 p.m. local time H5823_18_1099_0007_WAChoSB Accepted 9/26/2017