Saturday, May 25, 2024

How Do I Find A Medicare Advocate

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Why Do Some People Delay Enrollment In A Medicare Part D Plan

My Medicare Advocate – Site Navigation

If you have prescription drug coverage , you may decide not to enroll in a Medicare Part D plan or to enroll later. For example, if you have the Veterans Affairs health care benefits or TRICARE for Life, you have creditable prescription drug coverage. To find out more about Medicare Part D and enrollment options, see Prescription Drugs .

How To Find The Right Lawyer

You can find Social Security disability lawyers in a variety of ways. The internet has plenty of lawyer referral sites. Legal aid clinics and referral services operated by state bar associations are also sources for the names of people to interview.

Be careful. Just because you find an attorney by searching one of these sources doesnt guarantee theyll be good, ethical lawyers.

A better way to put together a list of lawyers to interview is probably through word of mouth, in person, or through social media, from people who have had good experiences with a Social Security disability lawyer. And you need to ask questions before hiring someone.

How To Be A Patient Advocate For Medicare Benefits

One of the core concepts of elder law is that of advocacy for an elder who needs assistance. We have found that is especially true in the medical arena. Too often an elder does not get sufficient treatment to recover from a condition or to maintain independent living.

Advocacy is important, but how does one accomplish GOOD advocacy? In addition to the value of being persistent the advocate must be INFORMED. This can be especially difficult in the healthcare area because we rely upon doctors to make medical decisions, including the decision that treatment will no longer be beneficial.

We have written before how the healthcare system makes mistakes by not reviewing all relevant information. This is a situation where the patient advocate can be greatly beneficial in making sure the doctor has all needed information about the patient. For example, if the advocate provides a complete list of medications, supplements and botanicals that the patient takes, the doctor can review the list for conflicts with prescriptions.

But, what about Medicare? What about when a provider, say a home health agency, says Medicare will no longer pay for service? Is that the right decision? Is this a case of cost savings at the expense of patient good health? We have heard reports that some Detroit area hospitals will stop referring patients for out patient care to an agency that makes sure the patient receives the best complete treatment.

Heres to Your Health!Jim

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Medicare Agents In California

The American Association for Medicare Supplement Insurance offers a free locator tool by zip code for agents in all 50 states. This is a free service for consumers. To access the locator tool, go here.

The California Department of Insurance also maintains a consumer page to assist residents in finding an appropriate broker. It lists several trade associations and if you are not fluent in English, there is also an Agent Language Locator so that you can find a broker that speaks your desired language. To access the page,

The Health Insurance Counseling & Advocacy Program is run through the California Department on Aging and provides free and objective information and counseling about Medicare. Volunteer counselors can help you understand your specific rights and health care options. HICAP also offers free educational presentations to groups of Medicare beneficiaries, their families and/or providers on a variety of Medicare and other health insurance related topics.

To access a complete list of HICAP offices, go here, or call the California Department on Aging at 1-800-4334-0222.

California State Medicare Plans

Why Choose Seniorx Patient Advocates For Medicare Assistance

CHA Voices Concerns on the New Medicare Plan Finder Tool ...

Unlike government agencies, SENIORx Patient Advocates provides personalized service. While we do charge a fee for our services, we don’t sell insurance or other financial products. You can count on us for professional and unbiased advice about your healthcare needs. If you or a member of your family needs assistance enrolling in Medicare, filing a health insurance claim or finding coverage for prescription drugs, contact our senior patient consultants today.*We do not sell any financial products*

  • 145 South Durbin Street, Suite 104, Casper, WY 82601 472-1770

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Medicare Agents In Florida

The American Association for Medicare Supplement Insurance offers a free locator tool by zip code for agents in all 50 states. This is a free service for consumers. To access the locator tool, go here.

The Florida Office of Insurance Regulation provides a wide variety of consumer resources to assist people with several types of insurance, including Medicare. To access this information, go here.

SHINE is a free program offered by the Florida Department of Elder Affairs and local Area Agency on Aging programs. Specially trained volunteers can assist Floridians with Medicare, Medicaid, and health insurance questions by providing one-on-one counseling and information. SHINE services are free, unbiased, and confidential. The SHINE program supports the Florida Department of Elder Affairs mission by providing free and unbiased health insurance counseling through a dedicated network of volunteers, empowering Florida seniors to make informed health care choices.

Florida State Medicare Plans

Businesses And Organizations That Hire Patient Advocates To Work For Them

Patient advocates have the opportunity to work in many different settings.

Work for a hospital, rehab center, or other facilities that hire patient advocates. Many have a customer-service type position. Some of these advocates have a background in social work or other forms of customer service. While they do trouble-shoot and solve problems for patients, many of their decisions must be made in favor of the facility and not necessarily in the best interest of the patient.

Work for an insurance company, usually an HMO . Some of the managed care-type healthcare payer systems employ advocates. They may be called “patient advocates” or “case managers.” These advocates manage navigation of the system for difficult medical cases. Their primary job is to save the payer money, but they may also be helpful to patients who are having trouble figuring out where to turn.

Work for a not-for-profit disease or condition organization. Those who work within these organizations are often patient advocates at heart, although their jobs may look more like fund-raising or patient education. This work may not be the classic one-patient, one-advocate model, but it’s still a form of advocacy.

Work for a government entity. Patient advocates or case managers work for state health systems usually in nursing, or social work/human resources capacity. Most of the support is provided to patients who rely on Medicare, Medicaid, or other state-run systems to pay for their healthcare.

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Center For Medicare Advocacy: Medicare Advocacy And Medicare Appeals

  • AddressPO Box 350
  • Phone800-262-4414 Toll free in Connecticut only – Voice
  • Phone860-456-7790 Voice/TTY
  • Fees:Please contact provider for fee information.
  • Application Process:Call or visit website for additional information.
  • Eligibility Requirements:Resident of Conn.
  • Payment/Insurance Accepted:Please contact provider for accepted forms of payment.
  • ADA Access:Please contact facility for accessibility information.

What Is The Texas Health Information Counseling And Advocacy Program

Patient advocate weighs in on federal legislation aimed to address surprise medical bills

If you are eligible for Medicare, the Texas’ Health Information, Counseling and Advocacy Program can help you enroll, find information and provide counseling about your options. This partnership between the Texas Health and Human Services system, Texas Legal Services Center and the Area Agencies on Aging trains and oversees certified benefits counselors across the state.

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Durable Medical Equipment Access

Note: As a result of the coronavirus public health emergency, Medicare has waived certain DME requirements.

This Medicare Advocacy Toolkit is designed to help advocates address the needs of New Yorkers who are eligible for Medicare coverage of oxygen equipment in their home. This toolkit is intended for use with individuals who are eligible for Medicare due to age, disability, or because they have End-Stage Renal Disease .

This Medicare Advocacy Toolkit is designed to help advocates address the needs of New Yorkers who are eligible for Medicare coverage of power wheelchairs . Medicares coverage rules for PWCs are the same regardless of how someone qualifies for Medicare. Thus, this guide is intended for use with individuals who are eligible for Medicare due to age, disability, or because they have End-Stage Renal Disease .

How To Become A Patient Advocate Or Navigator

Are you a medical professional who is looking to shift your career in a different direction? Are you a social worker who would like to apply your skills to the healthcare field? Are you a parent or child or spouse who has navigated healthcare on behalf of a loved one and would like to do that kind of work for others? Are you an entrepreneur looking for a growing market niche? Are you a neighbor or friend with time on your hands which you’d like to apply to helping others, perhaps as a volunteer? Are you interested in a career in the health field and are exploring possibilities?

If you answered “yes” to any of these questions, you may have the interest, skills, even the qualifications you need to become a patient advocate or navigator. Because there are so many aspects to patient advocacy, the range of backgrounds and interests of patient advocates is broad. That’s good news if you’re considering a job, career, or volunteer position as an advocate.

“Patient advocacy” is considered an up-and-coming career. Entrepreneur Magazine and US News & World Report have both identified advocacy as a career that is coming into its own.

Here you will find some background information for those who wish to provide advocacy services in any of the following ways:

  • Medical / Navigational Assistance
  • Insurance Assistance
  • Home Health Assistance
  • Elder or Geriatric Assistance

Read Also: Does Social Security Disability Qualify You For Medicare

About The Center For Medicare Advocacy

The Center for Medicare Advocacy is a national, non-profit, law organization that works to advance access to comprehensive Medicare coverage, health equity, and quality health care for older people and people with disabilities. Founded in 1986, the Center focuses on the needs of people with longer-term and chronic conditions. The organizations work includes legal assistance, advocacy, education, analysis, policy initiatives, and litigation of importance to Medicare beneficiaries nationwide. Our systemic advocacy is based on the experiences of the real people who contact the Center every day. Headquartered in Connecticut and Washington, DC, the Center also has attorneys in CA, MA, and NJ.

A list of the Center for Medicare Advocacys publications and products is available here.

The Centers staff act as consultants and trainers for groups that are interested in learning about health care rights, Medicare coverage and appeals, or in developing Medicare advocacy projects.

Saving Money On Primary Care Doctor Visits Near You

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When a primary care doctor accepts Medicare Assignment, that means that he or she agrees to bill Medicare-approved amounts for various healthcare services. You can keep your costs as low as possibly by seeking out a primary care doctor who accepts Medicare Assignment. Medicare offers a handy search tool that you can use to find nearby doctors who agree to accept Medicare Assignment and bill Medicare for their share of the bill.

If youd rather not have to limit your choice of doctors to those who will agree to charge only what Medicare allows, you can consider buying Medicare Plan F or Plan G to supplement Original Medicare. These two supplements will typically cover excess charges, or bills in excess of Medicares limits. This benefit can help broaden your choice of caregivers. It doesnt just apply to first-line primary care doctors but also to specialists.

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What Is An Elder Care Advocate

A senior advocate, or elder care advocate, educates senior citizens about resources and services that are available and helps them apply for those benefits. Job duties include researching health care and social services, helping clients review bills or insurance claims, and offering support after hospital visits.

Do I Need A Medicare Agent To Sign Up For Medicare Advantage

No. You do not need to use a Medicare agent to sign up for a Medicare Advantage plan, but unless you do a lot of homework and become extremely familiar with all the possible choices that are in the marketplace, you could be making a regrettable mistake.

An agent who works in the industry every day has added insights and first-hand knowledge that no amount of online digging will uncover. Doing the research on your own might produce a good result, but you are also gambling with your health care coverage this way and it is just as likely that you could end up with the wrong coverage, lesser coverage or a plan that forces you to pay more than you would have done so otherwise.

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What Medicare Advantage Pays For Primary Care Doctor Visits Near You

You will mostly find managed care Medicare Advantage plans, like HMOs and PPOs. Other kinds of managed care plans work slightly different but still rely upon provider networks to reduce costs. Less commonly, you may also find Medicare Advantage plans that dont use networks.

Finding a nearby primary care doctor who accepts your Medicare Advantage plan coverage could depend upon the type of plan that you have. For instance:

  • HMO : With an HMO, you will need to choose a primary care doctor or have the insurer assign one. You may need to get referrals from this doctor to visit specialists. Except for emergencies and other unique situations, you need to stay within the network to get your care covered.
  • PPO : You can look at your provider directory to choose a primary care doctor. While a PPO may cover a non-network doctor, you will probably get the best coverage by sticking to your plans network. You also dont need referrals to see specialists however, you will want to find a primary care doctor to handle routine medical needs and help manage all of your healthcare.

Examples Of Medicare Agents And Plans By State

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We picked four of the larger states in the United States and have given you some specific contact information on how to find Medicare agents for these areas.

Weve also listed all of the Medicare plan providers for each of the four states so that if you are a resident, you can begin researching individual companies if that is your preference.

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How Much Will It Cost

Most cases will cost you little or nothing up front. Lawyers take their fees from any retroactive benefits youre awarded from Social Security. The fee is limited to 25% of your past-due benefits, up to a maximum of $6,000.

The attorney will have you sign a document that allows Social Security to pay the law firm directly. Most lawyers will only get paid if they win your claim for you. If you get nothing, you owe the lawyer nothing.

Because the lawyer will likely have to request medical, school, work, and psychological records that come with a cost, they might pass on that fee to you. This should be a couple of hundred dollars at most. There may also be small fees related to postage and copying expenses.

Before hiring a lawyer, ask about the fee structure. If they tell you that its all paid by the Social Security Administration, ask about any extra fees that might come out of your pocket.

Since it costs you nothing unless and until you win, consider talking to somebody if you file a claim and get turned down initially.

How Much Does Non

Non-MAGI Medicaid provides free health insurance to individuals who qualify based on income, resources, and family size. If your income is above the income limit, you may still qualify. Some of your income may not count or you may qualify for other non-MAGI Medicaid programs. Other non-MAGI Medicaid programs include: Spend-down, Medicaid Buy-In for Working People with Disabilities , or Medicare Savings Program.

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Benefits Of Using A Local Medicare Agent To Pick Your Plan

There are three critical reasons why you should consider enlisting a local agents help.

  • Expertise. If you are new to Medicare, the choices you face may feel a bit overwhelming and youre sure to have questions about whats best for you. People who have been covered by an employers group insurance plan need to understand that Medicare is different in terms of benefits, costs and the providers you can access, so overall general knowledge about Medicare is critical which is perhaps the biggest benefit an agent can offer. In addition, because providers vary by market, having someone who works in your local service area is especially important when comparing the pros and cons of each plan. Agents who sell Medicare plans are also required to go through many hours of additional training and get special certification to sell Medicare products, providing you a greater sense of reassurance when you engage them to assist you.
  • Full range of options. Independent agents are often your best bet when shopping for Medicare, primarily because they represent a wide range of companies. Agents who represent only a few companieswe call them captive agentsmay have limited options. An independent agent can give you a more complete rundown of your options than can a captive agent.
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