eHealth - Your Trusted Source for Insurance Products and Options
eHealth is a leading online marketplace offering a broad choice of insurance products, including Medicare Advantage, Medicare Supplement, Medicare Part D plans, individual and family health insurance, small business coverage, and ancillary health insurance products. With over 25 years of experience,
8 views • 11 slides
Understanding Medicare and Long-Term Care Coverage Options
Health Insurance Counseling and Advocacy Program (HICAP) and Legal Assistance for Seniors (LAS) offer free services to help seniors understand and navigate Medicare, long-term care, and related legal issues. LAS supports seniors' independence and dignity by providing assistance with government benef
2 views • 67 slides
Medicare Advantage Plan Payment Rate Trends Over the Past Decade
Analyzing the annual percentage changes in national per capita Medicare Advantage growth rates over the past decade reveals fluctuations in payment rates, with an average annual growth rate of 2.87%. The data reflects the evolving landscape of Medicare Advantage plan payments and policy updates. Thr
0 views • 5 slides
Medicare Advantage Enrollment Trends and Payment Mechanisms
Medicare Advantage enrollment has significantly increased in the past decade, with payments being determined by benchmarks, bids, and quality incentives. The prevalence of chronic conditions is comparable between Traditional Medicare and Medicare Advantage, excluding Special Needs Plans. Dual-eligib
2 views • 5 slides
Navigating Medicare: Your Rights and Options
Understand the ins and outs of Medicare, your entitlements, and how to cover out-of-pocket costs. Learn about the basics of Medicare, your enrollment options, and the importance of timely enrollment. Discover the four parts of Medicare and the role of Medigap insurance.
0 views • 24 slides
Seniors' Experiences with Medicare Marketing and Fraud
During Medicare open enrollment, seniors age 65 and older receive numerous solicitations about plan choices through phone calls, mailings, emails, and advertisements. The frequency of these marketing efforts varies, with some seniors reporting misleading information and fraudulent practices by marke
1 views • 10 slides
Can Medicare Beneficiaries Afford Their Health Care? Findings from Commonwealth Fund 2023
Americans with Medicare face challenges affording health care, with many struggling to pay for essential health services. The Commonwealth Fund 2023 survey reveals that a significant portion of Medicare beneficiaries find it difficult to afford health care costs, leading to delays in necessary care
1 views • 10 slides
Referrals, Advocacy and Reimbursement for DSMES
Explore the critical aspects of referrals, advocacy, and reimbursement for Diabetes Self-Management and Support (DSMES) with insights from Joan Bardsley. Gain knowledge on aligning DSMES with type 2 diabetes care standards, appealing denied Medicare claims, and understanding Medicare policy challeng
4 views • 38 slides
Massachusetts All-Payer Claims Database Technical Assistance Group Update
Updates and guidelines regarding the Massachusetts All-Payer Claims Database, including submission deadlines, reporting cycles, and versioning methods. Important information for APCD submitters and liaisons to ensure compliance and data accuracy for various reporting requirements.
0 views • 12 slides
Evolution of Medicare and the Rise of Direct Contracting Entities
Explore the historical journey of Medicare from its inception to the introduction of Medicare Advantage and Direct Contracting Entities. Understand key acronyms, models, and initiatives shaping the current healthcare landscape, and delve into strategies to address challenges posed by the shift towar
1 views • 16 slides
Medicare Prescription & Outpatient Drugs Data Analysis October 2022
Enrollment in Medicare stand-alone prescription drug plans slightly declined between 2020 and 2021. The rates of enrollment vary between rural and urban states, with higher enrollment in rural states with low Medicare Advantage rates. Across counties, enrollment in prescription drug plans ranges fro
1 views • 13 slides
Important Updates on the New Medicare Card Project
The New Medicare Card Project is nearing completion, with significant changes coming into effect from January 1, 2020. Beneficiaries are advised to use their new Medicare cards, protect their Medicare number, and take necessary steps to ensure smooth transitions. Key points reinforce the importance
0 views • 19 slides
Scott Joyce: Your Go-To Expert for Medicare 101 in St. Louis
Medicare 101 St. Louis, is a comprehensive introduction to the Medicare program, designed to educate you on the various parts of Medicare, including Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (pr
3 views • 2 slides
Organizing Strategies for Single Payer Advocacy Within Professional Organizations
Explore tips and strategies for organizing around the topic of Single Payer within professional organizations using resolutions and networking activities. Learn from past successful initiatives and the importance of advocacy within healthcare systems.
0 views • 31 slides
Massachusetts All-Payer Claims Database Technical Assistance Group Update
Update on the Massachusetts All-Payer Claims Database Technical Assistance Group meeting discussing data validation projects, member eligibility elements, use of generic codes for reporting, and guidelines for reporting under different circumstances.
2 views • 22 slides
Feasibility of Care Coordination for Dual Eligibles: Characteristics and Opportunities
The Pacific Health Policy Group's report discusses the feasibility of care coordination for dual eligibles, individuals eligible for both Medicaid and Medicare with high rates of complex health conditions. Characteristics include having low incomes, chronic physical and mental health conditions, and
4 views • 52 slides
Overview of U.S. Prescription Drug Spending and Medicare Part D
U.S. prescription drug spending data from 2005 to 2025 shows trends in various payer contributions, with predictions for future years. Medicare Part D's drug spending is broken down, revealing top drugs and rebate percentages. The total Medicare spending in 2015 and average annual growth in Medicare
0 views • 10 slides
Prescription Drug Coverage in Medicare Enrollees with Chronic Kidney Disease
This report delves into the sources and parameters of prescription drug coverage in Medicare enrollees with chronic kidney disease (CKD) for the years 2010 to 2015. It explores the trends in Medicare Part D enrollment, out-of-pocket costs, and catastrophic coverage benefits. The data presented sheds
0 views • 20 slides
DePauw University Medicare Benefits Program Overview
This presentation details the DePauw University Medical & Rx Benefits Program for Medicare retirees, presented by Justin Goodwin from Amwins Group Benefits. It covers the agenda for the day, introduction to the program, information about Amwins Group Benefits, DePauw University's role in the Medicar
0 views • 39 slides
Navigating Medicare and Employer Insurance Overlap
Individuals near Medicare eligibility while working or retired often seek HR guidance. However, HR may lack expertise on Medicare interaction, leading to gaps in coverage, penalties, and limitations. To avoid these issues, it's crucial to understand the client's employment status, Medicare eligibili
0 views • 36 slides
Comprehensive Overview of CompanionCare Medicare Supplement Plan
Explore the benefits and coverage provided by the CompanionCare Medicare Supplement Plan effective January 1, 2021. Learn about the plan's offerings, enrollment criteria, and details on Medicare co-pays, coinsurance, and out-of-pocket expenses. Gain insights into who is eligible, moving to Companion
0 views • 12 slides
Understanding Medicare Coverage and Benefits for 2022
Explore key aspects of Medicare including eligibility, coverage, costs, and additional options for more coverage. Get insights on Medicare Part D, what Medicare covers, and what it doesn't. Find details on benefit decisions for individuals aged 65 and above, actively working retirees, and surviving
0 views • 10 slides
The Impact of Retiree Health Costs on Medicare and Medicaid Programs
This content discusses how retiree health costs affect individuals and government programs, specifically focusing on the rising Medicare and Medicaid spending projections. It highlights the challenges posed by out-of-pocket expenses for retirees and the gaps in Medicare coverage that contribute to h
0 views • 11 slides
Introduction to Indiana's All-Payer Claims Data Base (APCD)
Indiana's All-Payer Claims Data Base (APCD) is a comprehensive state database comprising medical claims, pharmacy claims, eligibility information, and provider files from various health plans and insurers. The initiative aims to enhance healthcare policy-making, cost comparison, consumer information
0 views • 21 slides
Insights on 2023 Medicare Fee Schedule & APTA Indiana Prior Authorization Advocacy
Review key updates from the 2023 Finalized Medicare Physician Fee Schedule impacting outpatient PT practice. Understand APTA Indiana's efforts in prior authorization advocacy and learn about tools for member participation. Explore the Payer Reporting Portal and know the process for appealing denied
0 views • 10 slides
Evolution of Payer-Provider Integration in Healthcare
Delve into the historical journey and present strategies surrounding payer-provider consolidation, vertical integration, and provider-led initiatives in healthcare, shedding light on challenges, opportunities, and the impact on care delivery models and financial landscapes.
0 views • 15 slides
Understanding Medicare Reimbursement and Inpatient Services in Short Stay Acute Care Facilities
Short stay acute care facilities, also known as hospitals, play a critical role in delivering inpatient and outpatient services to patients. Understanding Medicare reimbursement policies, such as billing for Medicare Part A (IPPS) for inpatient services and Medicare Part B (OPPS) for outpatient serv
0 views • 35 slides
Understanding Medicare Advantage Plans - Overview & Benefits
Dive into the comprehensive overview of Medicare Advantage Plans, covering the history of Medicare, Medicare ABCDs, enrollment periods, service areas, and product details for 2022. Learn about the different parts of Medicare, including Part A which covers inpatient care, Part B for physician service
0 views • 31 slides
Medicare Beneficiary Identification Initiative Overview
The Social Security Number Removal Initiative (SSNRI) aims to enhance Medicare beneficiary protection by replacing SSN-based Health Insurance Claim Numbers with new Medicare Beneficiary Identifiers (MBIs). This initiative mandates the issuance of redesigned Medicare cards by April 2019, minimizing i
0 views • 16 slides
Massachusetts All-Payer Claims Database Technical Assistance Group Update
Stay informed about the latest updates and requirements related to the Massachusetts All-Payer Claims Database (APCD), including submission deadlines, data quality checks, and updates to submission guides for member gender and individual relationship codes. Ensure compliance and accurate reporting f
0 views • 15 slides
Understanding the Role of Medicare Beneficiary Ombudsman
Explore the vital role of the Medicare Beneficiary Ombudsman in addressing beneficiary inquiries, providing education, and recommending improvements in Medicare administration. Discover when to contact the Ombudsman for systemic issues, research topics, or feedback on Medicare experiences, including
0 views • 14 slides
Handling Medicare Set-Asides: Key Considerations and Compliance Updates
This comprehensive guide covers essential aspects of managing Medicare Set-Asides, including eligibility criteria, confirming Medicare status, compliance with the Medicare Secondary Payer Act, potential penalties for errors in reporting, and strategies to avoid violating the MSP statute. Stay inform
0 views • 59 slides
Exploring Single Payer Healthcare: Opportunities and Barriers
Understanding the concept of single-payer healthcare, its potential benefits, and challenges in implementation. Discusses the disparities in healthcare access and outcomes, highlighting the need for a reevaluation of the current system in the U.S.
0 views • 12 slides
Understanding Medicare: A Guided Tour for Beneficiaries
Explore Medicare eligibility, enrollment, benefits, and more in this comprehensive program designed for beneficiaries, advocates, and curious citizens. Get informed, engage effectively, and seek expert help to navigate the Medicare system with confidence. Join us on December 5, 2023, for a guided to
0 views • 68 slides
Insights on NH Medical Society Members' Attitudes Towards Medicare For All
NH Medical Society conducted a survey on members' opinions regarding Medicare For All. Findings reveal strong support for a simplified payer system funded by public taxes to provide basic healthcare services to all citizens. The survey also highlights consistent support for public financing of healt
0 views • 25 slides
Impact of Specialty Pharmacy Payer Changes on Hospital Operations
Specialty pharmacy payer changes, known as white bagging policy, have significant implications for hospitals and healthcare providers. These changes involve shifting from the traditional buy-and-bill method to obtaining medications through specialty pharmacies, leading to concerns about patient safe
0 views • 13 slides
Impact of Single Payer System on Mental Health Treatment in the U.S.
Mental health disorders affect a significant portion of the U.S. population, yet access to mental health services remains inadequate, leading to various negative outcomes. This presentation discusses the shortcomings of the current U.S. health system in addressing mental health and substance use dis
0 views • 26 slides
Understanding Medicare: Coverage Options and Enrollment Details
Medicare is a federal health insurance program catering to individuals aged 65 and older, those with certain disabilities, end-stage renal disease, or ALS. It offers different coverage options including Part C Medicare Advantage Plans. Enrollment details, premiums, and benefits such as hospital insu
0 views • 55 slides
Revamping Medicare Card System for Improved Security
The Medicare Access and CHIP Reauthorization Act of 2015 initiated a project to replace Social Security Number-based Health Insurance Claim Numbers with unique Medicare Beneficiary Identifiers. The primary goal is to reduce beneficiary vulnerability to identity theft. The project involves operationa
0 views • 27 slides
Updates on Massachusetts All-Payer Claims Database - September 2022
Stay informed about the latest developments regarding Massachusetts All-Payer Claims Database, including enrollment trends, data submission guidelines, and upcoming reporting cycles. Learn about the changes in submission guide for Medical, Pharmacy, and Provider files, as well as the updates on Memb
0 views • 13 slides