Medicare & Medicaid
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Medicare pays for most of the cost of hospitalization, rehabilitation, doctors' visits, labratory expenses, prescription drugs, and much other medical care for older and disabled Americans, but it still leaves almost half of all medical costs unpaid. Most people need a medigap insurance policy or managed care plan to cover the gaps in Medicare. For those with low income and assets, Medicaid can pay for medical expenses instead, for who don't qualify for Medicare, or can cover the gaps in Medicare for those who do. This section covers the basics of Medicare and Medicaid, including information on Medicare managed care plans, medigap insurance, and Medicare Part D prescription drug coverage.
Medicaid
If you receive a notice of action that you are being denied Medicaid, appeal.
Here's an introduction to Medicaid's complicated rules on eligibility for nursing homes and home health care.
Medicare Overview
What is Medicare?
Medicare and Medicaid coverage explained.
Medigap insurance helps fill the gaps in Medicare coverage.
Medicare Appeals
If your Medicare Advantage plan has denied you services or withheld reimbursement for medical expenses, you can appeal the decision to the Office of Medicare Hearings and Appeals.
ALJ hearings for Medicare appeals are often held by video conference.
Medicare Part A: Hospital Insurance
When you need part-time skilled nursing care or therapy, Medicare will pay for home health care visits.
If you are denied Medicare coverage or payment for a hospital stay, here's how to appeal.
Medicare Part B: Medical Insurance
Medicare's Part B Medical Insurance pays for doctors' bills, but you have to pay premiums, deductibles, and co-pays for most services.
If you are denied Medicare coverage or payment for a doctor's visit or outpatient services, here's how to appeal.
Medicare Advantage: Medicare Part C
A Medicare managed care plan can supplement your Medicare coverage.
If your Medicare Advantage plan has denied you services or withheld reimbursement for medical expenses, you can appeal the decision to the Office of Medicare Hearings and Appeals.
Medicare Part D: Prescription Drug Coverage
Medicare Part D covers some of the costs of prescription drugs you take at home.
If Your Medicare Part D Plan denied drug coverage or reimbursement, here's how to appeal.
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