Understanding Medicare Advantage Plans: A Comprehensive Overview
Medicare Advantage plans have emerged as a popular option for individuals seeking healthcare coverage beyond what traditional Medicare offers.
Tag: Medicare Advantage Plans
Is the PAID Act the Solution for Locating Hidden Medicare Advantage Liens?
The PAID Act has the potential to make it easier to locate these hidden liens. The risk of not finding them is a private action by the Medicare Advantage plan for double damages.
Exploring Options for Conditional Payment Resolution
July 8, 2021 Rasa Fumagalli JD, MSCC, CMSP-F Most attorneys are well aware of the need to resolve Medicare’s conditional payments in connection with a client’s settlement. This obligation stems from the Medicare Secondary Payer (MSP) Act, 42 U.S.C. § 1395y(b)(2)(A)(ii), which prohibits Medicare from making payment for medical services when “payment has been made […]
Confused by Medicare? Here’s a Helpful Overview
The Medicare program—and the related Social Security Disability Income/Retirement benefit (SSDI)—is one of the primary benefit programs available to those who are injured and disabled. Understanding the basics of this program is imperative to protecting the client’s eligibility for their benefits.
Medicare and SSDI benefits are an entitlement and are not income or asset sensitive. Clients who meet Social Security’s definition of disability and have paid enough quarters into the system can receive disability benefits regardless of their financial situation.
Medicare Advantage Plans and Workers Compensation Medicare Set-Asides
March 25, 2020 B. Josh Pettingill We are oftentimes asked about injured workers who have a Medicare Advantage Plan (MAP) and if they still need to use their Workers’ Compensation Medicare Set-Aside (WCMSA) funds if the MAP will cover all their medical care. This brief post will explain Medicare’s position on this issue and then […]
No Time Limits on Medicare Advantage Plans Private Cause of Action for Double Damages
March 2, 2020 The 11th Circuit Court of Appeals weighed in on the question of whether the Medicare statute, which provides a three-year timeline to the government to request repayment, applies to a private entity providing Medicare benefits (Medicare Advantage plans). The Court’s answer is that the claims filing provision does not bar a claim […]