9780872186637

All About Medicare 2005

by ;
  • ISBN13:

    9780872186637

  • ISBN10:

    0872186636

  • Format: Paperback
  • Copyright: 2005-03-01
  • Publisher: Natl Underwriter Co
  • Purchase Benefits
  • Free Shipping Icon Free Shipping On Orders Over $35!
    Your order must be $35 or more to qualify for free economy shipping. Bulk sales, PO's, Marketplace items, eBooks and apparel do not qualify for this offer.
  • eCampus.com Logo Get Rewarded for Ordering Your Textbooks! Enroll Now
List Price: $17.50
We're Sorry.
No Options Available at This Time.

Table of Contents

INTRODUCTION
1(14)
Medicare Defined
1(1)
Administration of Medicare
2(1)
Hospital Insurance Protection
3(1)
Medical Insurance Protection
4(1)
Providers of Services and Supplies
5(1)
Hospital Insurance
6(1)
Medical Insurance
7(1)
Home Health Coverage
8(1)
Limit on Benefits
9(1)
Availability of Benefits
10(1)
Medicare Card
11(1)
Care Not Covered by Medicare
12(1)
Quality Improvement Organizations
13(1)
Fraud and Abuse Hotline
14(1)
Fee-for-Service System Versus Medicare Advantage
15(1)
PART A: HOSPITAL INSURANCE
15(32)
Eligibility
15(9)
Who Is Eligible
1(1)
End-Stage Renal Disease
2(1)
Government Employees
3(1)
Medicare as Secondary Payer
4(1)
Persons Who Do Not Qualify for Social Security
5(1)
Special Enrollment Premium
6(18)
Administration
24(1)
Centers for Medicare & Medicaid Services
7(1)
Prospective Payment System
8(1)
Compulsory Nature of Plan
9(16)
Financing Hospital Insurance (Part A)
25(1)
Hospital Insurance Tax
10(16)
Benefits
26(1)
Generally
11(15)
Qualified Medicare Beneficiaries
26(2)
Medicare Costs Paid by State
12(1)
How to Qualify
13(1)
Income Above Poverty Level
14(1)
Applying for Assistance
15(13)
Inpatient Hospital Services
28(5)
Services Covered
16(1)
Care in Psychiatric Hospital
17(1)
Religious Nonmedical Health Care Institutions
18(1)
Selecting a Hospital
19(1)
Certification by Doctor
20(1)
Hospital Agreement with Medicare
21(12)
Hospice Care
33(3)
Hospice Care Defined
22(1)
How Hospice Care is Covered
23(1)
Hospice Benefit Period
24(1)
Cost to Patient
25(1)
Respite Care
26(10)
Skilled Nursing Facility Care
36(4)
Definition
27(1)
Services Covered
28(1)
Cost to Patient
29(1)
When Payment is Made
30(10)
Home Health Care
40(5)
When Services Are Covered
31(1)
Conditions for Coverage
32(1)
Services Covered by Medicare
33(1)
How Medicare Pays the Cost
34(11)
General Information
45(2)
Outpatient Hospital Services
35(1)
Financial Need
36(1)
Increases in Deductible and Coinsurance Amounts
37(1)
Living Will and Durable Power of Attorney
38(9)
PART B: MEDICAL INSURANCE
47(26)
Eligibility
47(3)
Who Is Eligible
1(1)
How to Enroll
2(1)
Failure to Enroll During Automatic Enrollment Period
3(1)
Federal-State Agreement
4(1)
Special Enrollment Period for Certain Disabled Workers
5(1)
Terminating Coverage
6(44)
Financing Medical Insurance
50(7)
How Program is Financed
7(1)
Qualified Medicare Beneficiary
8(1)
How Premiums are Paid
9(1)
Determining ``Approved Charges''
10(1)
How Payments are Made
11(1)
Medicare-Participating Doctors
12(1)
Medicare Supplier
13(1)
Cost Paid By Patient
14(1)
How Patient Finds Out How Much Medicare Will Pay
15(42)
Benefits
57(13)
Doctors' Services
16(1)
Outpatient Hospital Services
17(1)
Outpatient Physical Therapy and Speech Pathology Services
18(1)
Partial Hospitalization Services
19(1)
Certified Nurse-Midwife Services
20(1)
Dental Work
21(1)
Medical Equipment
22(1)
Ambulance Service
23(1)
Outpatient Treatment of Mental Illness
24(1)
Vaccines
25(1)
Antigens
26(1)
Liver Transplant
27(1)
Comprehensive Outpatient Rehabilitation Facility
28(1)
Home Health Services
29(1)
Independent Clinical Laboratory Services
30(1)
Screening Pap Smears
31(1)
Breast Cancer Screening
32(1)
Prostate Screening
33(1)
Colorectal Screening
34(1)
Diabetes Benefits
35(1)
Bone Mass Measurements
36(1)
Osteoporosis
37(1)
Eyeglasses
38(1)
Nurse Practitioners
39(1)
Lung and Heart-Lung Transplants
40(1)
Immunosuppressive Drugs
41(1)
Ambulatory Surgical Services
42(1)
Rural Health Clinic Services
43(1)
Telehealth Services
44(1)
Federally Qualified Health Center Services
45(1)
Other Benefits
46(1)
Services Covered With No Cost Sharing
47(23)
Medicare Coverage of Blood
70(1)
How Medicare Helps Pay Cost of Blood
48(23)
Private Contracts
71(2)
Private Contracts with Physicians
49(24)
PART C: MEDICARE ADVANTAGE
73(10)
Definition
73(2)
Medicare Advantage Defined
1(1)
Health Maintenance Organization
2(1)
Private Fee-For-Service Plan
3(1)
Provider-Sponsored Organization
4(1)
Religious Fraternal Benefit Society Plan
5(70)
Eligibility, Election, and Enrollment
75(1)
Enrollment Process
6(1)
Enrollment Periods
7(1)
Beneficiary Information
8(68)
Benefits and Beneficiary Protections
76(3)
Basic Benefits
9(1)
Standards of Protection
10(1)
Antidiscrimination Rules
11(1)
Disclosure to Enrollees
12(1)
Access to Services
13(1)
Quality Assurance Program
14(1)
Grievances
15(1)
Provider Participation Rules
16(1)
Billing Limits
17(62)
Premiums
79(1)
Proposed Premiums
18(1)
Other Premium Rules
19(61)
Contracts with Medicare Advantage Organizations
80(1)
Contracts with Health Care Financing Administration
20(61)
Medigap Insurance Program
81(2)
Medigap Insurance Rules
21(1)
Special Protections
22(61)
PART D: PRESCRIPTION DRUG INSURANCE
83(4)
Prescription Drug Insurance Defined
1(1)
Effective Date
2(1)
Who Is Eligible
3(1)
Benefits of Medicare Drug Discount Card
4(1)
Cost of Medicare Drug Discount Card
5(1)
Benefits of Prescription Drug Insurance
6(1)
Cost of Prescription Drug Insurance
7(80)
MEDIGAP INSURANCE
87(12)
Defined
1(1)
Open Enrollment Period
2(1)
Medigap Insurance for Medicaid Recipients
3(1)
Federal Standards for Medigap Insurance
4(1)
Additional Benefits
5(1)
Twelve Standard Policies
6(1)
Medicare Select Policies
7(1)
Choosing the Right Policy
8(1)
Medicare Advantage Program
9(1)
Rules for Selling Medigap Insurance
10(1)
Shopping for Medigap Insurance
11(88)
HOW TO SUBMIT CLAIMS AND APPEALS
99(8)
Claims Procedure
99(2)
Hospital Insurance Services
1(1)
How to Submit Medical Insurance Claims
2(1)
Itemized Bills
3(1)
Death of Person Filing Claim
4(1)
Time Limit for Filing Claim
5(1)
Where to Send Claims
6(1)
Prompt Payment
7(94)
Appeals Procedure
101(6)
Right to Appeal Decision on Claim
8(1)
How to Appeal Medical Insurance Claim Decision
9(1)
Review by Medicare Carrier
10(1)
Hearing with Medicare Carrier
11(1)
How to Appeal Hospital Insurance Claim Decision
12(1)
How to Appeal All Other Hospital Insurance Claims
13(1)
How to Appeal HMO Decisions
14(1)
Protection if Organization Ceases To Provide Benefits
15(92)
MEDICAID
107(18)
Overview
107(1)
Medicaid Defined
1(1)
Expenses Paid by Federal Government
2(106)
Medicaid Eligibility
108(3)
Groups Covered by States
3(1)
SSI States
4(1)
Optional Coverage
5(106)
Medicaid Services
111(2)
Basic Services
6(1)
AIDS
7(1)
Optional Services
8(105)
Payment Under Medicaid
113(2)
How Providers are Paid
9(1)
Amount and Duration of Services
10(1)
Medicare Coverage
11(104)
Long-Term Care
115(1)
Medicaid Coverage
12(104)
Exempt Income and Resources
116(1)
Income and Resources Recipient Can Keep
13(104)
Spousal Impoverishment
117(2)
Income
14(1)
Resources
15(1)
Income Eligibility Requirements
16(1)
Post-eligibility Treatment of Income
17(102)
Medicaid Transfer Rules
119(1)
Transfer of Property to Meet Eligibility Requirements
18(102)
Trusts
120(2)
Use of Trusts
19(1)
Exceptions to Trust Rule
20(102)
Estate Recoveries
122(1)
State Recovery of Medicaid Expenses
21(102)
Discrimination
123(1)
Nursing Homes
22(102)
Managed Care
124(1)
Changes to Medicaid Program
23(102)
APPENDICES
125(24)
Appendix A - Table of Medicare Benefits
125(2)
Appendix B - What Medicare Does Not Cover
127(2)
Appendix C - Example of Medicare Benefits
129(2)
Appendix D - Fiscal Intermediaries
131(2)
Appendix E - Medicare Carriers
133(2)
Appendix F - Medicare Quality Improvement Organizations (QIOs)
135(2)
Appendix G - Durable Medical Equipment Regional Carriers
137(2)
Appendix H - Insurance Counseling - General Information
139(2)
Appendix I - State Agencies on Aging
141(6)
Appendix J - Centers for Medicare & Medicaid Services
147(2)
Appendix K - Medicare Advantage PPO Regions
149

Rewards Program

Reviews for All About Medicare 2005 (9780872186637)