Medicare Minutes

Even as Medicare has been strengthened during the past few years, dangerous schemes to weaken and dismantle the program threaten the health and economic security of millions of American families.

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Welcome!  This month on Medicare Minutes we will look at some of the preventive services covered by Medicare Part B.  Please note that Medicare may cover some services and tests more often than the timeframes we mention if they are needed to diagnose a condition. Also, to find out if Medicare covers a service that we do not mention, visit www.medicare.gov/coverage, or call 1-800-MEDICARE.

This month on Medicare Minutes we will look at some of the preventive services covered by Medicare Part B. We will talk in detail about the services alphabetically from A to G, and next month we will examine the rest.

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On the December 2011 edition of Medicare Minutes, we will discuss some options for those who may have missed this year's Medicare annual enrollment period. Don't fear... you may still be able to enroll or change plans.

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One condition for Medicare payment for skilled nursing facility care is that a beneficiary be a hospital inpatient for at least three days before admission to the skilled nursing facility.  A primary concern among advocates has been that time in observation status and in the emergency room was not counted by the Medicare program as part of an inpatient hospital stay, even when that time was followed by a beneficiary's formal admission to the hospital as an inpatient.  Recently, however, a new and greater concern has arisen.  Beneficiaries throughout the country report that their entire stays in a hospital, including stays as long as 14 days, are classified by the hospital as "outpatient observation".

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As we have discussed previously  previous Podcasts, people with chronic conditions and long-term illnesses are often denied Medicare coverage because they supposedly:

• Will not improve, or
• Need "maintenance services only," or
• Have "plateaued", or
• Are "chronic and stable".

These reasons are referred to as the Medicare "Improvement Standard." Medicare is often the only insurance for this population, so, unfortunately, Medicare coverage denials can result in the loss of necessary health care.  And we are trying to end it.

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Congress continues to propose Medicare changes that will have bad consequences for beneficiaries and their families. Policymakers and pundits are feeding the media and the public false information about Medicare. The simple truth is that Medicare works… and it costs LESS than private insurance.

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Obviously here at Medicare Minutes we talk a lot about Medicare and its importance to so many of our country's older and disabled people.  Something people might overlook, though, is that the MediCAID program is equally important.  And Medicaid matters to Medicare beneficiaries, too.

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It seems like Congress has a lot of trouble understanding that there are some solid, manageable solutions that would actually protect Medicare coverage while still reducing costs to taxpayers.  And this month on Medicare Minutes, we're going to highlight a half dozen of them for you.

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In this episode of Medicare Minutes we take a look at some issues surrounding the Medicare Secondary Payer (MSP) Program, which seeks to that Medicare doesn not pay for services resulting form injury that should be paid for by another source.

For more information on the MSP program, see our topic page, http://www.medicareadvocacy.org/medicare-info/medicare-secondary-payer-program.

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