Medicare & Medicaid

Determining Hospice Eligibility for Dementia

April 16th, 2008 by Audrey

How do you know if your loved one is eligible to receive hospice services? How does a physician make a prognosis of six months or less for a patient? Let’s take a look at the criteria that hospice and medical professionals utilize when determining whether a patient is appropriate for hospice services. A life-limiting dementia such as Alzheimer’s disease will progress over time. Patients can live with this dementia for several years; many are even able to remain at...Read the rest of this article »

Medicare Explained

February 11th, 2008 by Gilbert Guide

Medicare is the federally administered health insurance program for people sixty-five years of age and older, certain disabled people under sixty-five years of age, and people with end-stage renal disease. Medicare is divided into four parts, known simply as Part A, Part B, Part C and Part D. The benefits associated with Part A are free and automatic once an individual turns sixty-five. Part B is an add-on that requires a monthly premium. Below are the benefits associated with each...Read the rest of this article »

Centers for Medicare & Medicaid Services: Nursing Home Deficiencies Explained

February 11th, 2008 by Gilbert Guide

Centers for Medicare and Medicaid Services (CMS) is part of the federal government's Department of Health and Human Services. Because many Medicare and Medicaid recipients are elderly, much of the funding goes to nursing homes or eldercare services. Nursing homes that receive certifications from Medicare undergo an inspection every fifteen months (at a minimum). CMS visits nursing homes and publishes information on any deficiencies found during inspection. CMS Deficiencies & Citations Medicare and Medicaid-certified nursing homes are inspected every twelve...Read the rest of this article »

Managed Care (HMO) Explained

February 11th, 2008 by Gilbert Guide

Managed care policies fall under Medicare Part C. These policies were originally designed to provide all of the medical services and supplies offered by Medicare, plus additional benefits such as prescription drug, vision and hearing coverage, as well as enhanced coverage within a skilled nursing facility. Most policies require individuals to sign over their Medicare benefits and pay a monthly premium in return for full coverage by the HMO's doctors, hospitals and services. There is a yearly out-of-pocket limit with...Read the rest of this article »

Centers for Medicare and Medicaid Services: Home Health Quality Measures Explained

January 22nd, 2008 by Gilbert Guide

The Centers for Medicare & Medicaid Services (CMS) is part of the federal government's Department of Health and Human Services. Because many Medicare and Medicaid recipients are elderly, much of the funding goes to nursing homes or eldercare services. Home health agencies that receive certifications from Medicare undergo an assessment every three years. CMS assesses these home health agencies via quality measures and publishes each agency's results. CMS & Home Health CMS provides scoring for all Medicare-certified home health...Read the rest of this article »