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National Coverage Determination Analysis on Treatment for Alzheimer’s Disease

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CMS NEWS (released on 7/12/2021 by CMS) CMS Opens National Coverage Determination Analysis on Treatment for Alzheimer’s Disease Thorough Process Will Enable Careful Consideration of Coverage and Incorporate Public Input Today, the Centers for Medicare & Medicaid Services (CMS) is opening a National Coverage Determination (NCD) analysis, a process that will allow the agency to […]

Be Vigilant: Medicare Won’t Alert You When You Become Eligible for Part B

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Sarah celebrated her 64th birthday in October of 2020, meaning she will be 65 this year and eligible for Medicare. Luckily, she is aware that she must enroll or face the consequences of delaying enrollment. She needs to remember to do so herself because the Social Security Administration doesn’t alert people as they near age […]

Hospice and Palliative Care are Essentially the Same Thing—Why is Hospice Covered While Palliative Care Is Not?

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Q. I recently read about hospice and palliative care and now I’m thoroughly confused. They sound like exactly the same thing, but offered at different times. Why is hospice covered by Medicare and Medicaid, when palliative care is typically not? Thanks for your help! A. People often confuse palliative care with hospice care, and the […]

Special Edition: Unhappy with Your Medicare Advantage Plan? Today is the Last Day to Make Changes or Go Back to Original Medicare!

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Medicare Advantage enrollees who are dissatisfied with their plan have until today to switch into another plan or to go back to Original Medicare and, if needed, buy a prescription drug plan.   The Medicare Advantage Open Enrollment period ends today, March 31. It offers a do-over for people who might have signed up for […]

How do Medicare and Social Security Work Together?

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Dear Oakley, My husband will soon be retiring and is curious about Social Security and Medicare and how the two programs work together. Can you help explain this to him? Thanks for your help! Tu Gether — Dear Tu, Social Security and Medicare are both federal programs designed to assist older Americans and distribute benefits […]

Boo! Our Top 10 Scariest Articles of 2020 (A Very Scary Year!)

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2020 has been a scary year! Since we’re so close to Halloween, it’s a perfect time to catch up on some of the scariest elder law, estate planning, and special needs planning articles until now. Exposing everything from dementia at 30 to coronavirus patients being moved to nursing homes, our subject matter can get pretty […]

Medicare Open Enrollment: What Changed in Response to the Coronavirus?

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Q. I know that the Medicare Open Enrollment Period starts next month. Have there been any changes that I should know about in response to the coronavirus? Do you have any tips for Open Enrollment? This is my first one. Thanks for your help! A. The COVID-19 pandemic has affected the United States for six […]

CMS Launches New Compare Tool, Featuring All Eight Healthcare Tools in One Place

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Lois’ mom moved to Northern Virginia last winter. Since she has been here, she has needed new doctors, a hospital for a surgical procedure, and a new physical therapist. Lois tried to be helpful in finding her mother names of providers using The Centers for Medicare and Medicaid Services (CMS) compare tools, only to feel […]

Will Medicare Cover Alzheimer’s Brain Scans?

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In the past few months, Julia has noticed that her mother, Betsy, has become increasingly forgetful. Betsy’s memory loss started out mild, including losing her keys and forgetting the day of the week, but is beginning to disrupt her daily life. She often gets confused and sometimes loses concept of place and time. She has […]

Groundbreaking Decision Made on Observation Status Appeals

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Q. My mother, Ellen, spent a week in the hospital and ended up having surgery. She was seen by doctors and nurses, given several tests, had the surgery, and then got sent to a nursing home for two weeks of rehabilitation. She is certain that she was “inpatient” and then later switched to “observation status.” […]

Part D Donut Hole is Closed, But Does That Mean It’s Going Away?

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Rosanna (68) takes more than a dozen medications regularly to treat high blood pressure, heart disease, acid reflux, and other chronic problems. She signed up for Medicare Part D prescription drug coverage a few years ago, hoping to keep her costs down as much as possible. She knew then that there would be no avoiding […]

A Major Change to Therapy/Rehabilitation Coverage for Medicare Patients

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Q. At age 62, my father, Paul, was diagnosed with ALS (amyotrophic lateral sclerosis). He can’t walk, get out of bed, or breathe on his own (he’s on a ventilator). He can’t use the toilet, bathe, or dress himself, either. After a recent hospitalization and short-term stay in a nursing home for rehab, in-home therapists […]

Medicare Care Planning Benefit for People with Alzheimer’s

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Dear Magic, My mother, Ingrid, was diagnosed with Alzheimer’s. We know that there is no cure and that it only gets worse as time progresses. We’d like to plan in advance to make sure she gets the support services and medications she needs, and any non-medical treatments to improve her quality of life. We’d also […]

Can I Delay Enrollment of Medicare if I Have Not Yet Claimed Social Security?

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Dear Oakley, I’m turning 65 and I have not yet claimed my Social Security benefits because I thought it would make good financial sense to wait. Can I choose to wait to enroll in Medicare as well? Thanks! Juana Waite — Dear Juana, Unfortunately, if you are turning 65, you cannot wait to enroll in […]

Surprise Medical Bills May Become a Thing of the Past

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Freya (80) had chest pains, a hacking cough, and a high fever when she was visiting her son, Andy. An ambulance was called and she was rushed to a hospital in her health plan’s network. As she headed home after a week’s stay to continue her recovery, she took a measure of comfort that her […]

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