Click on one of the alphabetically listed links in the index below to view frequently asked questions and general information on that topic.

Acute Hospital - A Quick Screen to aide in identifying coverable cases in an acute hospital setting, coverage criteria and appeals process.

• Quick Screen For Acute Hospital Coverage

• Determinations And Appeals

• Appeals Process

• Articles And Updates

Chronic Conditions - Description of Medicare coverage for individuals deemed as chronic or suffering from long-term conditions.

• Services For Beneficiaries With Chronic Conditions

• Coverage Requirements

• Where Are Services Provided

• Who Provides Skilled Services

• Practical Tips

• How Should Medicare Decisions Be Made

• Articles And Updates

Connecticut Consumer's Guide To Medicare And Related Programs

• What Is Medicare?

• What Is Medicare Managed Care?

• What Is Medigap?

• What Is QMB?

• What Is SLMB?

• What Is ConnPACE?

• What Is ConnMAP?

• What Is Medicaid?

Coverage & Appeals - Description of basic information on Medicare Part A and Part B coverage and appeals process.

• Part A Coverage

• Part A Appeals

• Part B Coverage

• Part B Appeals

• Discharge Planning

• Articles And Updates

Disabilities - Overview of Medicare coverage for people with disabilities.
 

Home Health - Overview of Medicare Home Health's payment system, appeals process and issues.

• Quick Screen for Home Health Coverage

• Advocacy Tips For Home Health Terminations And Reductions

• Medicare Home Health Provision Enhances Homebound Definition

• Clarification to Medicare Homebound Definition

• Prospective Payment System

• Articles And Updates

Hospice - Information regarding the Medicare Hospice benefit.

• Quick Screen for Hospice Coverage

• What Is Hospice Care?

• What Kinds Of Care Does Medicare Hospice Care Include?

• When Will Medicare Cover Hospice Care?

• How Much Hospice Care Will Medicare Cover?

• Medicare vs. Hospice.

• Advocacy Tips.

• Medicaid-Covered Hospice Services.

• Coordination of Services and Dually Eligible Beneficiaries.

• Physician Education About the Hospice Benefit.

• Articles And Updates

Medicare Act of 2003 - Description of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003; Public Law 108-173 and related articles.

• Articles and Updates

Medicare Enrollment - Discusses how to enroll in Medicare Part A and Part B

Medicare Advantage - Description of the private insurance plans offered through Medicare

• Services an HMO must provide

• The Medicare Advantage program

• Medicare Advantage Plan options

• Private contracts

• Required information

• Scope of coverage

• Enrollment and "Lock In"

• Eligibility

• Guidelines for considering options

• Comparison Chart

• Articles and Updates

• Managed Care in Connecticut 2005 (CHOICES Publication)

Medicare Part B - Description of Medicare Part B benefit and services covered as well as pertinent information to Connecticut Medicare beneficiaries.

• List Of Items And Services Covered Under Part B

  • Ambulance

  • Diabetes Self Management

  • Durable Medical Equipment

  • Nutritional Therapy

  • Outpatient Services

  • Oxygen Therapy

  • Physical Therapy

  • Physician Fees

  • Preventive Benefits

• Articles And Updates

Medicare Part D - A summary of Part D, the decisions that need to be made, and issues to watch for.

• The Standard Part D Benefit

• Alternate/Enhanced Alternate Coverage

• Calculating Expenses

• Covered Part D Drugs

• Part D Formularies

• Eligibility for Part D Coverage

• Choice of Drug Plans

• Prescription Drug Plans (PDPs)

• Medicare Advantage Plans (MA-PDs)

• Consequences for People with Low Income

• Approaching Time Line Events

• SPAPs

• State Medicaid Programs

• Low Income Subsidies

• Full Subsidy

• Partial Subsidy

• Federal Poverty Levels for 2005

• Applying for the Low Income Subsidies

• A Time Line for Implementation

• Guidelines for Selecting a Plan

• Medicare Part D Articles and Updates

• Other Prescription Drug Articles

Medicare Privatization (and Occasional Reform) - Discussion of proposals to change Medicare.

• The Future Of Medicare

• A Call For Action

• Medicare Reform Proposals Are Costly To Medicare Beneficiaries

• Articles And Updates

Medicare Savings Programs - Description of the Qualified Medicare Beneficiary Program (QMB), Specified Low-Income Medicare Beneficiary program (SLMB), and Qualified Individual program (QI).

• QMB (Qualified Medicare Beneficiary Program)

• QMB Provider Certification for Title 19

• SLMB (Specified Low-Income Medicare Beneficiary Program)

• QI (Qualified Individual Program)

• Obtaining QMB, SLMB, and QI Benefits

Medicare Secondary Payer Program - Overview of rights and obligations under Medicare Secondary Payer law.

Medicare Summary - Overview of the Medicare program and components.

• 2005 Medicare Deductible, Co-Insurance, & Premium Amounts

Medigap - A discussion of Medicare Supplemental Insurance (also known as Medigap), including a chart of the ten standardized plans and a summary of rights.

• Gaps In Coverage For Part A And Part B

• Who Needs Medicare Supplement Insurance

• The Standard Medicare Supplement Policies

• Chart of the Ten Standard Policies

• Consumer Protections Under Federal Law

• Pre-Existing Conditions

• Additional Consumer Protections For Connecticut Policies

• What To Consider When Purchasing Medigap Insurance

• A Summary Of Rights

• Articles And Updates

Mental Health Services - Discussion of Medicare Coverage of mental health services.

• Hospitalization

• Partial Hospitalization

• Clinician Coverage And Outpatient Mental health Services

• Home Health Services

• Limitations On Reimbursement

• Supplemental Insurance Coverage

• Medicare Delivery Systems

• Returning to Work

Prescription Drugs (See Medicare Part D for details)
 

Quality of Care - Focuses on quality not only to raise general consumer awareness of this important topic, but to highlight the use of this growing body of knowledge by advocates to secure and expand services.

• Perception v. Reality: "The Quality Chasm"

• Failure to Deliver: the Causes of Sub-standard Care

• What Are the Standards of Care by Which Quality is Judged?

• Quality Reporting Systems: How to Choose the Best Caregivers

• The Business Case for Quality

• When Quality Works: A Case Study

• Articles and Updates

Quick Reference And Statistics - A chart of useful current Medicare statistics.
 

Rehabilitation Hospital - A Quick Screen to aide in identifying coverable cases in a rehabilitation hospital setting.

• Quick Screen For Rehabilitation Hospital Coverage

• The Inpatient Hospital Rehabilitation Benefit

• Coverage Criteria And Appeal Process

Related Topics and Medicaid - an overview of Medicaid in Connecticut (Title 19) and articles on related topics.

• What is Medicaid (Title 19)?

• What does Medicaid (Title 19) cover?

• Why do Medicare beneficiaries need Medicaid?

• What are the financial eligibility requirements for Medicaid?

• What advice or tips are there for discharge planning?

• What is a "spend down"?

• What can be done to prevent the impoverishment of a spouse when the beneficiary goes into a nursing home?

• Other Topics, Articles and Updates

Skilled Nursing Facility (SNF) - A Quick Screen to aide in identifying coverable cases in a skilled nursing facility setting, information on SNF Medicare regulations and the prospective payment system.

• Quick Screen For SNF Coverage 

• Provisions Reinstated In Medicare SNF Regulations

• Prospective Payment System

• Articles And Updates