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Book Categories |
Foreword | xi | |
Introduction | xiii | |
Chapter 1 | Getting Started | 1 |
What Is Medicare? | 1 | |
What Does It Cover? | 1 | |
Who Is Eligible? | 2 | |
How Much Does It Cost? | 3 | |
How Do You Enroll? | 4 | |
Where Do You Enroll? | 5 | |
When Should You Enroll? | 5 | |
Recap | 7 | |
The Medicare Card | 9 | |
Getting Help to Pay Your Health Care Costs: The Medicare Savings Programs | 9 | |
Chapter 2 | Medicare Part A | 13 |
Hospital Bills | 13 | |
The Deductible | 14 | |
Benefit Periods | 17 | |
Psychiatric Hospital Restrictions | 18 | |
Chapter 3 | What You Should Know Before You Enter the Hospital | 19 |
Medicare Myths | 19 | |
Your Rights as a Medicare patient | 19 | |
Advance Directives | 23 | |
Care in a Foreign Hospital | 24 | |
Paying Hospital Bills | 26 | |
Chapter 4 | Skilled Nursing Facilities | 31 |
When Medicare Pays | 31 | |
What Part of the Bills Does Medicare Pay? | 32 | |
Notice of Noncoverage | 35 | |
Looking for a Nursing Home | 37 | |
Chapter 5 | Home Health Care | 38 |
When Medicare Pays: The Rules | 38 | |
What Medicare Covers | 40 | |
What Medicare Does Not Cover | 40 | |
Your Rights | 41 | |
Advance Directives | 42 | |
How to Find an Approved Home Health Care Agency | 42 | |
Home Health Care Advance Beneficiary Notice | 43 | |
Chapter 6 | Hospice Care | 46 |
Who Is Eligible? | 46 | |
How the Program Works | 47 | |
What Is Covered? | 47 | |
Deductibles and Copayments | 48 | |
Chapter 7 | Doctors' Bills: The Doctors You Choose Determine How Much You Will Owe | 50 |
Private Contracts | 51 | |
The "Approved Amount" | 52 | |
Mistakes Are Made | 58 | |
How to Find Doctors Who Accept Assignment | 60 | |
Recap | 61 | |
Chapter 8 | The "I Didn't Know" Rule | 62 |
How It Works | 63 | |
Can You Get a Refund? | 65 | |
Advance Beneficiary Notice | 67 | |
Chapter 9 | Services Not Covered | 70 |
The Importance of This List | 72 | |
What Is and What Is Not "Routine" | 73 | |
Chapter 10 | Not for Diabetics Only | 75 |
Finding the Right Pharmacy or Supplier | 77 | |
Some People Do Their Jobs Better Than Others | 80 | |
For Diabetics Only | 82 | |
Chapter 11 | Diagnostic Tests | 84 |
What Is a "Diagnostic Test"? | 84 | |
What Kinds of Diagnostic Tests Are Covered? | 85 | |
What Other Diagnostic Services Are Covered? | 85 | |
Diagnostic Tests in Doctors' Offices and Laboratories | 86 | |
Prohibition on Referrals | 86 | |
Paying Diagnostic Testing Bills | 87 | |
Chapter 12 | Durable Medical Equipment and Supplies | 88 |
What Durable Medical Equipment and Supplies Are Covered? | 88 | |
When to Rent and When to Buy | 90 | |
Participating Suppliers | 92 | |
Chapter 13 | Ambulance Bills | 96 |
The Rules | 96 | |
Medicare Denial of Ambulance Bills | 98 | |
The New Changes to the Rules | 101 | |
Chapter 14 | Outpatient Hospital Bills | 105 |
Services Included | 105 | |
The "New" Outpatient Prospective Payment System | 106 | |
The Budget Reconciliation Act of 1997 | 107 | |
Chapter 15 | The Medicare Part B Deductible | 108 |
How Do You Know When You Have Met the Deductible? | 109 | |
Chapter 16 | Paying Part B Bills | 112 |
What to Do When Medicare Refuses to Pay a Bill | 112 | |
When to Pay Part B Bills | 117 | |
The "Rule of Anastasia" or, "Don't Pay Bills You Don't Have to Pay" | 121 | |
Chapter 17 | Medicare Part C | 124 |
Background | 124 | |
Who Is Eligible? | 129 | |
Traditional Medicare versus Medicare + Choice (M+C) | 129 | |
What Happens If "Harry" joins an HMO | 130 | |
What Happens When "Harry" Joins a PSO | 131 | |
What Happens When "Harry" Joins a PFFS | 131 | |
The Pros and Cons of Joining a Medicare + Choice Plan | 132 | |
Shopping for a Medicare + Choice Plan | 133 | |
You've Finished Shopping; It's Time to Make a Decision | 137 | |
The Least You Need to Know When You Join a Medicare + Choice Plan | 140 | |
Chapter 18 | Appeals | 143 |
Appealing a Decision in a Medicare + Choice Plan | 143 | |
Appealing a Decision Under Traditional Medicare | 145 | |
Chapter 19 | Medigap Insurace | 149 |
It's as Easy as A,B,C | 150 | |
The Ten Standard Medigap Policies | 152 | |
Medicare Select | 155 | |
You Have to Compare Prices | 158 | |
Prescription Drug Coverage | 159 | |
Preexisting Condition Clauses | 161 | |
Shopping for a Medigap Policy | 162 | |
Author's Note | 164 | |
Chapter 20 | Supplementary Insurance | 167 |
When You Get Your Supplementary Insurance Through a Former Employer, Does It Do the Job? | 167 | |
Buying a Supplementary Policy to Supplement a Supplementary Policy | 171 | |
Advice for the Brave | 174 | |
Who Pays First? | 174 | |
Chapter 21 | Tricare for Life | 176 |
Who Is Eligible? | 176 | |
How Much Does It Cost? | 177 | |
Who Pays First? | 177 | |
How the System--Medicare Plus Tricare--Works | 180 | |
Chapter 22 | Odds and Ends | 183 |
Medicare versus Medicaid | 183 | |
Blood Deductible | 184 | |
Prescription Drug Coverage | 184 | |
Did You Know? | 187 | |
Final Words | 190 | |
Organizations | 191 | |
Hospice Organizations | 191 | |
Long-Term Care Ombudsman | 195 | |
Peer Review Organizations | 197 | |
Durable Medical Equipment Regional Carriers | 201 | |
Index | 205 |
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Add Medicare For The Clueless, For the more than 39 million people currently on Medicare and the million plus who join each year, navigating the murky rules and regulations of health care coverage can be a full-time job. Not anymore. For ten years, Joan Harkins Conklin has guided peopl, Medicare For The Clueless to the inventory that you are selling on WonderClubX
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Add Medicare For The Clueless, For the more than 39 million people currently on Medicare and the million plus who join each year, navigating the murky rules and regulations of health care coverage can be a full-time job. Not anymore. For ten years, Joan Harkins Conklin has guided peopl, Medicare For The Clueless to your collection on WonderClub |