Medicare In-Depth

Medicare is broad in scale and complex in nature. It comprises an alphabet soup of parts and plans.

Then there are the many policy combinations, eligibility guidelines, and enrollment periods.

We understand Medicare.

Here, we take on common questions and answer them in detail. Our goal is to remove any confusion or doubts you have about Medicare, so you can move forward with making your decision.

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Medicare In-Depth FAQ’s

What Is Medicare’s Hospice Benefit?

Hospice is a program of end-of-life pain management and comfort care for those with a terminal illness. Medicare’s hospice benefit offers end-of-life palliative treatment, including support for your physical, emotional, and other needs. It is important to...

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What Services are Covered Under The Hospice Benefit?

If you qualify for the hospice benefit, Medicare covers the following: Skilled nursing services, which are services performed by or under the supervision of a licensed or certified nurse to treat your injury or illness. Services you may receive include...

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How are Drugs Covered Under Hospice?

Medicare’s hospice benefit should cover any prescription drugs you need for pain and symptom management related to your terminal condition. You pay a $5 copayment for outpatient pain and symptom management drugs. You pay nothing for drugs you receive as an...

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How Can I Continue Hospice Past My Initial Prognosis?

Medicare covers hospice care for two initial 90-day benefit periods, or a total of six months. After this, it will cover an unlimited amount of 60-day (two-month) benefit periods. At the start of each benefit period, your hospice doctor or a related...

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How Can I End The Hospice Benefit?

If you decide you want curative treatment (instead of just palliative treatment), you have the right to stop hospice at any time. Speak with your hospice doctor if you are interested in stopping. If you end your hospice care, you will be asked to sign a...

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What are Medicare Appeals?

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 any appeal, make sure you...

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How Can I File a Standard Appeal with Original Medicare?

If you have Original Medicare and your health service or item was denied, you have the right to appeal. Check your Medicare Summary Notice (MSN) to see if Medicare has paid for your services and how much you may owe your provider.A Medicare Summary Notice is a summary...

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What are Some Tips for Making a Strong Appeal?

Below are some general rules to follow when appealing the denial of a health service or item:Try to understand the reason that your plan is denying coverage for your health service or item.Address any relevant coverage rules in your appeal letter, and...

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When and How Should I Request a Good Cause Extension?

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...

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When and How Should I File a Grievance?

If you are dissatisfied with your Medicare Advantage or Part D prescription drug plan for any reason, you can choose to file a grievance. A grievance is a formal complaint that you file with your plan. It is not an appeal. Times when you may wish to file a...

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What Services Does Medicare Part A Cover?

Medicare Part A covers the following services: Inpatient hospital care (see Does Medicare Cover Inpatient Hospital Care?): This is care received after you are formally admitted into a hospital by a physician.You are covered for up to 90 days each benefit...

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What is the Cost of Part A?

In Original Medicare, these are the costs related to Part A covered services: If you have a Medicare Advantage Plan, you should contact your plan to learn about their costs for these services. Read More: Does Medicare Cover...

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Does Medicare Cover Inpatient Hospital Care?

Part A covers medically necessary inpatient hospital care, which is care that you receive as a formally admitted hospital inpatient. You must be formally admitted into the hospital by a physician in order for your care to be considered inpatient hospital...

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What Would be Considered 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...

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