Medicare Explained has been prepared for Medicare beneficiaries and others who need a relatively thorough explanation of the Medicare program with particular emphasis on services covered in institutional settings and services provided by physicians and suppliers. Medicare Explained includes: Analysis of legislative, regulatory, and agency guidance issuance on available benefit. Medicare coverage and exclusions. The administration of the Medicare program. Medicare payment rules under Parts A, B, C, and D. Details on the process for submitting beneficiary claims as well as the appeals process.

Medicare For Dummies, 2nd Edition (9781119293392) was previously published as Medicare For Dummies, 2nd Edition (9781119079422). While this version features a new Dummies cover and design, the content is the same as the prior release and should not be considered a new or updated product. Make your way through the Medicare maze with help from For Dummies America's baby boomers are now turning 65 at the rate of about 10,000 a day. Yet very few have any idea about how Medicare works, when they should sign up, or how the program fits in with other health insurance they may have. Medicare For Dummies, 2nd Edition provides a detailed road map for navigating Medicare's often-baffling complexities and helps consumers avoid pitfalls that could otherwise cost them dearly. In plain language, the new edition explains: How to qualify for Medicare, according to your personal circumstances, including new information on the rights of people in same-sex marriages When to sign up at the time that’s right for you, to avoid lifelong late penalties How to weigh Medicare’s many options so you can be confident of making the decision that's best for you What Medicare covers and what you pay, with up-to-date details of the costs of premiums, deductibles, and copays—and how you may be able to reduce those expenses By conveying not only the basics but also how to troubleshoot problems and where to find assistance, Medicare For Dummies, 2nd Edition helps you to get the most out of Medicare.

This is the definitive work on Medicare’s prospective payment system (PPS), which had its origins in the 1972 Social Security Amendments, was first applied to hospitals in 1983, and came to fruition with the Balanced Budget Act of 1997. Here, Rick Mayes and Robert A. Berenson, M.D., explain how Medicare’s innovative payment system triggered shifts in power away from the providers (hospitals and doctors) to the payers (government insurers and employers) and how providers have responded to encroachments on their professional and financial autonomy. They conclude with a discussion of the problems with the Medicare Modernization Act of 2003 and offer prescriptions for how policy makers can use Medicare payment policy to drive improvements in the U.S. health care system. Mayes and Berenson draw from interviews with more than sixty-five major policy makers—including former Treasury secretary Robert Rubin, U.S. Representatives Pete Stark and Henry Waxman, former White House chief of staff Leon Panetta, and former administrators of the Health Care Financing Administration Gail Wilensky, Bruce Vladeck, Nancy-Ann DeParle, and Tom Scully—to explore how this payment system worked and its significant effects on the U.S. medical landscape in the past twenty years. They argue that, although managed care was an important agent of change in the 1990s, the private sector has not been the major health care innovator in the United States; rather, Medicare’s transition to PPS both initiated and repeatedly intensified the economic restructuring of the U.S. health care system.

A coauthor of the New York Times bestselling guide to Social Security Get What’s Yours authors an essential companion to explain Medicare, the nation’s other major benefit for older Americans. Learn how to maximize your health coverage and save money. Social Security provides the bulk of most retirees’ income and Medicare guarantees them affordable health insurance. But few people know what Medicare covers and what it doesn’t, what it costs, and when to sign up. Nor do they understand which parts of Medicare are provided by the government and how these work with private insurance plans—Medicare Advantage, drug insurance, and Medicare supplement insurance. Do you understand Medicare’s parts A, B, C, D? Which Part D drug plan is right and how do you decide? Which is better, Medigap or Medicare Advantage? What do you do if Medicare denies payment for a procedure that your doctor says you need? How do you navigate the appeals process for denied claims? If you’re still working or have a retiree health plan, how do those benefits work with Medicare? Do you know about the annual enrollment period for Medicare, or about lifetime penalties for late enrollment, or any number of other key Medicare rules? Health costs are the biggest unknown expense for older Americans, who are turning sixty-five at the rate of 10,000 a day. Understanding and navigating Medicare is the best way to save health care dollars and use them wisely. In Get What’s Yours for Medicare, retirement expert Philip Moeller explains how to understand all these important choices and make the right decisions for your health and wealth now—and for the future.

Confused by Medicare? Get your answers from a nationally-recognized Medicare and financial expert. Check out the latest quote by the author in the USA Today (January 24, 2019). Medicare is Difficult and Confusing Enrollment PeriodsPart A, Part B, Part DLate Enrollment PenaltiesExtra Help & Medicaid Consumers Can Benefit Enrollment rights in your favorChanging plans is a good ideaPlan benefits are improvingGet the best out of each dollar How to choose and what to choose will depend on a wide variety of factors. Even if people understand the rules of enrollment, there is the still why/how/when to select the proper plan to fit the situation. Location of residenceHealth situationPrivate financial situation In addition, many people face special situations, when the “normal” rules don’t apply. Working beyond 65 years oldRetiree benefits cancelledRequiring financial assistance