Alice Montiel

Medicare Advantage plans provide Medicare coverage through private health insurance companies approved to participate in the Medicare program. These plans can be HMOs, PPOs, Regional PPOs or Private Fee-for-Service plans. Blue Cross Medicare Advantage plans provide all Part A and B services while generally including some additional services, such as wellness programs, hearing aids and vision services. These plans also tend to have lower cost sharing overall and a maximum that you would have to pay for out-of-pocket costs each calendar year–a feature not available through Original Medicare. Initial Enrollment Period  The Initial Enrollment Period is a limited window of time when you can enroll in Original Medicare (Part A and/or Part B) when you are first eligible. After you are enrolled in Medicare Part A and Part B, you can select other coverage options like a Medicare Advantage plan from approved private insurers. After this period has ended, you can add or change your coverage ...

Here is some important information to keep in mind: Medicare was created in 1965. The primary purpose of the program is to provide health coverage for individuals 65 years of age and older. There are four parts to Medicare, with Part C being added in 1997 and Part D in 2003. Medicare Part A (Hospital Insurance) Medicare Part A helps cover the cost of inpatient care in the hospital. It also helps cover the cost of skilled nursing care, hospice services and home health care. There is no charge for Medicare Part A if you are eligible. A person, or the spouse of a person, who has worked in Medicare-covered employment for at least 10 years (40 quarters), and is a citizen or permanent resident of the United States and at least 65 years of age is eligible. Among those who also are eligible are those who meet Social Security or Railroad Retirement disability requirements and those with end-stage renal disease. Since medicare cover inpatient care, be careful not to assume that just because ...

First, plans are required to provide the patient with benefits that are at least as generous as those required under the two-midnight rules. If that were the only factor in play here, I would say it would mean that the patient can’t be worse off than they would be if the plan used the two-midnight rule.  But there is a requirement that MA plans follow Medicare manuals. The bottom line is that if the traditional Medicare program would consider a patient an inpatient, the b lue cross medicare advantage  must as well. Let’s look at the law. There is a statutory requirement that Medicare Advantage plans offer Medicare beneficiaries benefits that are at least as generous as those in traditional Medicare.  Section 1852 of the Social Security Act says Medicare Advantage plans must offer all of the “benefits” that the original Medicare fee-for-service program offers. The law defines those benefits as “those items and services (other than hospice care or coverage for organ acquisi...

  Does Medicare Cover Acupuncture? The answer is yes, but only in very limited circumstances. Medicare Part B (Medical Insurance) covers acupuncture, but only in very limited circumstances, and for limited visits each year. The number of treatments you receive also depends on whether you’re improving. Medicare started covering acupuncture in 2020, in an effort to increase access to alternatives to prescription opioids for pain relief. What is acupuncture? Acupuncture is a traditional Chinese medical practice in which very thin needles are inserted through the skin at specific points on the body. It may be used to treat pain or for overall wellness, including stress management. By inserting needles at strategic points, practitioners believe they can help balance the flow of energy through the body. When does Medicare cover acupuncture? Medicare Part B will cover acupuncture only for chronic low back pain, which is defined by Medicare as : Lasting 12 weeks or more. Having no known c...

Medicare Advantage plans offer extra coverage, usually at no cost, but you may pay more if you get sick. About 1 in 3 people 65 and older in the U.S. enroll in blue cross Medicare Advantage , the private insurance alternative to traditional Medicare. It’s not hard to see why: Medicare Advantage plans often cover stuff that Medicare doesn’t, and most people don’t pay extra for it. But Medicare Advantage can be more expensive if you get sick because copays and other costs can be higher, says Katy Votava, president of Goodcare.com, a health care consultant for financial advisors and consumers. Unhappy customers who want to switch back to traditional Medicare may find they no longer qualify for the supplemental policies to help pay their medical bills, or that they would face prohibitively high premiums. Medicare’s alphabet soup The first hurdle many people face when deciding about Medicare coverage is simply understanding how the various parts fit together. Traditional Medicare, also kno...