As Medicare Advantage (MA) payers continue to be buffeted by regulatory and market changes that could dampen margins, payer leaders should not lose sight of the importance of investing now to stabilize their businesses for the long run. A critical area of focus for leaders should be the Medica...
As Medicare Advantage (MA) payers continue to be buffeted by regulatory and market changes that could dampen margins, payer leaders should not lose sight of the importance of investing now to stabilize their businesses for the long run. A critical area of focus for leaders should be the Medica...
a top executive who helped establish one of its subsidiaries as the dominant player in the Medicare Advantage market. Weeks before Thompsons killing, Biden officials at the Centers for Medicare & Medicaid Services (CMS) proposed new rules to crack down on what it described ...
in-network providers for most services. They may have different costs and rules compared to Original Medicare, but they must provide at least the same level of coverage. Medicare Advantage offers an alternative option for individuals who want additional benefits beyond what Original Medicare...
When describing prior authorization rules of Medicare Advantage plans, U.S. Health and Human Services Inspector General reports found “widespread and persistent problems related to denials of care and payment.”In 2022, 3.4 million Medicare Advantage prior authorization determinations were denied, accord...
Navigate the unspoken rules of Medicare and eliminate the fear of making the wrong decision. Learn More Take the first step Embark on a journey to clearer Medicare understanding Medicare becomes truly valuable when you understand the best choices for your needs. Take the first step by registeri...
Define medication. medication synonyms, medication pronunciation, medication translation, English dictionary definition of medication. n. 1. A drug or other substance used to treat disease or injury; a medicine. 2. The act or process of treating a patien
MEDICAREBefore discussing the 2006 changes to the Medicare enrollment rules, a brief overview of past enrollment procedures is important to understand the significance of these recently implemented changes. In 1997, the Centers for Medicare and Medicaid Services (CMS) implemented the CMS 855 application...
These rules are stricter than for other investment accounts, such as the 401(k) and403(b), which allow for a taxable but penalty-free early withdrawal to pay for sudden financial hardship. HSA Alternatives Two alternatives to the HSA are flexible spending accounts (FSAs) andhealth rei...
This knowledge will help you make informed decisions when comparing and selecting new Medicare plans during the AEP. A good practice is to identify any limitations or restrictions that exist within the plan. These are rules that determine how and when you can access certain healthcare services. ...