Introduction to Part D appeals

…formal appeal. Once you know why you drug was not covered at the pharmacy, speak to your prescribing physician or other provider about your options. For example, you may be…

Filing a grievance

…it is best to send your complaints in writing. Be sure to send your grievance to your plan within 60 days of the event that led to the grievance. You…

Making Part B enrollment decisions with QHP coverage

…you have the choice to enroll in or stay enrolled in a QHP with cost assistance (tax credits). Be sure to consider how the QHP’s coverage and costs compare to…

Creating documents to plan future care

…future care documents with family members, health care providers, and anyone else you feel should know. You should give your providers a copy and may want to provide copies to…

How to enroll in prescription drug coverage

To enroll in Medicare Part D prescription drug coverage, you must choose from private plans available in your service area. Make sure to look at all the costs, including the…

Six things to know about Fall Open Enrollment

…are satisfied with your current Medicare coverage, look at other Medicare options in your area that may better suit your individual needs in the upcoming year. For example, check to…

PFFS basics

…higher cost. If you plan to receive care from an out-of-network provider, you or your provider can request an advance organization determination (also called an advance coverage determination) from your…

Welcome to Medicare preventive visit

…your Part B enrollment. Covered services During the course of your Welcome to Medicare preventive visit, your provider should: Check your height, weight, blood pressure, body mass index (BMI), and…

Cardiovascular disease risk reduction visits

…disease risk reduction visits at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance). Medicare Advantage…

Heart disease screenings

…at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance). Medicare Advantage Plans are required to…