Prior Authorizations Will My Procedure Be Denied?

Prior Authorizations Will My Procedure Be Denied?

When deciding whether to use Original Medicare with a Supplement Plan as primary coverage versus enrolling in an Advantage Plan, the growing concern many have is with Prior Authorizations.  There has been a lot of chatter and negative attention in the media about Medicare beneficiaries being denied medical care by insurance companies.  So, is this true?  Should you be concerned?  I think it is helpful to first understand what a Prior Authorization is for and how it came about.  Then, I’ll share how to navigate that process to get what you need out of your plan.  Let’s go…..

What’s Coming in 2024…..

What’s Coming in 2024…..

Each year as we head toward the last quarter of the year, the Center for Medicare/Medicaid Services or ‘CMS’ begins to announce changes to Medicare for the coming year.  Sometimes the changes are new regulations put in place by CMS, and sometimes there are changes written and signed into law by the acting government.  So, what is coming up for 2024?  Here is a sneak peak at the exciting and maybe not so exciting changes.

What is Post Acute Care

What is Post Acute Care

Most of us understand how Medicare works and pays for a hospitalization and going to the Doctor’s office for visits.  We even have a pretty good understanding of how to use our insurance to get labs drawn, x-rays, MRIs or go to the ER.  What can sometimes be confusing is how Medicare works in areas of Post Acute Care.  As we age and/or have multiple complicated conditions, we may need ongoing care after a serious illness, surgery or hospital stay.  Post Acute Care encompasses home health care, home or outpatient therapy, hospice care or skilled rehabilitation.  Let’s take a deeper dive into those services and what to expect in terms of Medicare coverage.  

SSA Medicare Tips and Tricks

SSA Medicare Tips and Tricks

HOW TO AVOID STANDING IN LINE
When the pandemic hit, all government offices shut down to anyone in person needing assistance.  This left Seniors at a major disadvantage.  Seniors are the largest group of people that rely on the Social Security Administration for enrolling in retirement benefits and their medical benefits.  Everything had to be done over the phone with long hold times or online.  No one enjoys these processes, let alone the generation who did not grow up in the high-tech world we see today.  This is when I took a deep dive and learned all the tips and tricks on how to navigate the Medicare world without walking into an SSA office.  Here are some valuable tips I picked up….

Medicare Alphabet Soup–The Difference Between Plan G and N

Medicare Alphabet Soup–The Difference Between Plan G and N

The first distinction to make here is that Plan G and Plan N are types of Medicare Supplement or Medigap Plans.  In other words, these are not Advantage Plans (Part C) or Prescription Drug Plans (PDP).  Medicare loves using letters to name benefit options and plans, which often makes the whole thing more confusing.  Acronyms are another favorite as in MA Only, MAPD, DSNP, HMO, PPO, etc.  We can address that another day!  But not to worry, CDI is here for you!  In this blog, I want to help highlight the difference in these two supplement plans which are currently the most popular and beneficial among the supplement offerings [as of 2023]. 

Optional Supplemental Benefits – Dental, Vision and Hearing

Optional Supplemental Benefits – Dental, Vision and Hearing

What many Medicare Beneficiaries need most in their ‘Golden Years’ is Dental, Vision and Hearing coverage.  This can sometimes be the largest expense as we age.  Ironically, Medicare does not cover Dental, Vision or Hearing at all; at least not yet as of 2023.  This has been a topic of discussion in many recent legislative sessions.  However, nothing has officially been done by the federal government to care for our Seniors’ teeth, eyes, and ears.  But all is not lost!  There are optional supplemental benefit plans offered by many insurance carriers.  In addition, Medicare Beneficiaries can get D/V/H coverage through Part C or Advantage Plans.  And finally, there are some providers that offer their own discount program for services.  Let’s take a closer look at your options.

Medicare and Travel – Am I Covered?

Medicare and Travel – Am I Covered?

You did it!  You have been working towards this your whole life.  You get to travel the country and even the world in some cases!  Now that you are finally here, you want to be sure you can enjoy traveling with the security of knowing should a health emergency arise, you are covered with your Medicare benefits. 

Whether you are celebrating your new retirement status with a trip, living your retired life in two different states, or still tied down but taking well-earned trips throughout the year, we have you covered. 

How Many Advantage Plans Are Out There?  Which One is Best?

How Many Advantage Plans Are Out There?  Which One is Best?

Let’s start with the fact that most people don’t realize that Advantage Plans are the same things as ‘Part C’, which is what Medicare calls them.  So if you see an advertisement on TV saying you may be eligible for Part C, and you should call so you don’t miss out, they are usually intentionally misleading you.  The fact is, you probably already have Part C, but you know it as an ‘Advantage Plan’.  The terms are interchangeable.  However, there are many different types of Advantage Plans through many different carriers.  Here is a bit of help on deciphering what is available and what you may or may NOT be eligible for……

We do not offer every plan available in your area. Currently we represent 10 organizations which offer 62 products in your area.  Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all your options.  CDI is not affiliated with the U.S. government or federal Medicare program.