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ALJ/MAC Decision Database



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.

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

Connecticut Consumer's Guide To Medicare And Related Programs

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

Disabilities - Overview of Medicare coverage for people with disabilities.

Discharge Planning - Overview of Discharge planning rights and requirements, and tip sheets for beneficiaries and advocates.

Health Care Disparities - assorted facts about inequities in our health care system.

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

Hospice - Information regarding the Medicare Hospice benefit.

The Improvement Standard - A discussion of the illegal standard of denying Medicare coverage to beneficiaries whose conditions are not actively improving.


Lesbian, Gay, Bisexual, and Transgender (LBGT) Seniors - useful articles and resources for this growing population.


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

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


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

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

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

Medicare and Health Care Reform - Discussion of proposals to change Medicare.

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

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

Medicare Summary - Overview of the Medicare program and components.

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

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

Observation Status - When is a hospital NOT considered a hospital stay?  When the patient is on "Observation Status"


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.

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.

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

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.


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