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Medicare Billings, Claims & Appeals

California Health Advocates > Blog > News > Medicare Billings, Claims & Appeals

Medicare Covers COVID-19 Tests & CMS Issues Guidance to Medicare Advantage & Part D Plans

March 13, 2020 By Karen Fletcher

As the coronavirus is spreading nationally and globally, the Centers for Medicare and Medicaid Services (CMS) announced early in March that Medicare will cover coronavirus testing. All COVID-19 tests ordered by your doctor or other health care provider will be covered under Medicare Part B as a diagnostic laboratory test, and therefore has no out-of-pocket costs. Coverage can … [Read more...] about Medicare Covers COVID-19 Tests & CMS Issues Guidance to Medicare Advantage & Part D Plans

Filed Under: COVID-19, Medicare Basics, Medicare Billings, Claims & Appeals

House Leaders Introduce Bills to Prevent COBRA from Biting People Eligible for Medicare

February 4, 2020 By Karen Fletcher

“Many retirees are unexpectedly exposed to out-of-pocket liability for any costs paid under COBRA benefits on or after date of Medicare eligibility and penalties for late enrollment in Medicare. Some of this risk would be eliminated if COBRA notices addressed the interaction with Medicare, and vice versa.  Unfortunately, such information is not required under either Medicare or … [Read more...] about House Leaders Introduce Bills to Prevent COBRA from Biting People Eligible for Medicare

Filed Under: Medicare & Other Health Insurance, Medicare Billings, Claims & Appeals

Alert ~ Delayed Billing for Medicare Part B Premium Payments in December 2018

January 9, 2019 By Karen Fletcher

We just received word from the Centers for Medicare and Medicaid Services (CMS) that there was a delay in the mailing of the December 2018 Medicare Premium Bills (CMS-500).  Bills are normally mailed by the 10th of each month.  Yet, last month, CMS' print contractor mailed the Medicare Premium Bills almost a week late, between December 15th and December 17th. Most beneficiaries … [Read more...] about Alert ~ Delayed Billing for Medicare Part B Premium Payments in December 2018

Filed Under: Medicare Billings, Claims & Appeals, Professionals

More Good News Regarding Equitable Relief for Part B Penalties

October 24, 2018 By Karen Fletcher

Earlier this month, we shared the good news that the Center for Medicare and Medicaid Services (CMS) extended the equitable relief for Part B penalties for one more year until September 30, 2019. We also found out that CMS is adopting our recommendation to create a permanent fix. Both of these changes will make a significant difference in the lives of many beneficiaries. For … [Read more...] about More Good News Regarding Equitable Relief for Part B Penalties

Filed Under: Health Care Reform, Medicare Basics, Medicare Billings, Claims & Appeals, News, Professionals

What Can You Do If You’re Denied Coverage for a Drug? Understanding Medicare Part D Appeals

June 5, 2018 By Karen Fletcher

What can you do if your Part D prescription drug plan will not cover a drug that you need? Below are three important points for exercising your Part D appeal rights.   Point 1: Know what an appeal is, and understand your right to file an appeal. An appeal is a formal request for review of certain decisions to limit or deny coverage made by your Original Medicare, … [Read more...] about What Can You Do If You’re Denied Coverage for a Drug? Understanding Medicare Part D Appeals

Filed Under: Fraud & Abuse, Medicare Billings, Claims & Appeals, Prescription Drugs - Blog

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Do you have comments or concerns about your Medicare coverage? Issues regarding getting your needed prescriptions from your Part D plan, or a Medicare Advantage plan representative's marketing practices? Let us know at comments@cahealthadvocates.org.

We are dedicated to making Medicare's program work well for all beneficiaries. Your feedback from your own or your client's concerns and experiences with Medicare, will guide our Medicare advocacy efforts with key policy and decision-makers in both California and nationally with the Centers for Medicare and Medicaid Services (CMS) and Congress.

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