Download Free Your Guide To Medicare Special Needs Plans Snps Book in PDF and EPUB Free Download. You can read online Your Guide To Medicare Special Needs Plans Snps and write the review.

Medicare Special Needs Plans (SNPs) are a type of Medicare Advantage Plan (like an HMO or PPO). Medicare SNPs limit membership to people with specific diseases or characteristics, and tailor their benefits, provider choices, and drug formularies (list of covered drugs) to best meet the specific needs of the groups they serve. This publication has important information about Medicare Special Needs Plans, including the following: How they work; Services and benefits; Joining and switching; Deciding if one is right for you. You can join a Medicare SNP if you have Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), live in the plan's service area, and meet the plan's eligibility requirements, such as one of the following: Chronic Condition SNP (C-SNP): You have one or more of the following severe or disabling chronic conditions: Chronic alcohol and other drug dependence; Autoimmune disorders; Cancer (excluding pre-cancer conditions); Cardiovascular disorders; Chronic heart failure; Dementia; Diabetes mellitus; End-stage liver disease; End-Stage Renal Disease (ESRD) requiring any mode of dialysis; Severe hematologic disorders; HIV/AIDS; Chronic lung disorders; Chronic and disabling mental health conditions; Neurologic disorders; Stroke; Institutional SNP (I-SNP): You live in an institution (like a nursing home), or you require nursing care at home; Dual Eligible SNP (D-SNP): You have both Medicare and Medicaid. Each Medicare SNP limits its membership to people in one of these groups, or a subset of one of these groups. For example, a Medicare SNP may be designed to serve only people diagnosed with congestive heart failure. The plan might include access to a network of providers who specialize in treating congestive heart failure, and it would feature clinical case management programs designed to serve the special needs of people with this condition. The plan's drug formulary would be designed to cover the drugs usually used to treat congestive heart failure. People who join this plan would get benefits specially tailored to their condition, and have all their care coordinated through the Medicare SNP. Also available in Spanish.
"About 9 million of Medicare's over 48 million beneficiaries are also eligible for Medicaid because they meet income and other criteria. These dual-eligible beneficiaries have greater health care challenges than other Medicare beneficiaries, increasing their need for care coordination across the two programs. In addition to meeting all the requirements of other MA plans, D-SNPs are required by CMS to provide specialized services targeted to the needs of dual-eligible beneficiaries as well as integrate benefits or coordinate care with Medicaid services. GAO was asked to examine D-SNPs' specialized services to dual-eligible beneficiaries. GAO (1) analyzed the characteristics of dual-eligible beneficiaries in D-SNPs and other MA plans, (2) reviewed differences in specialized services between D-SNPs and other MA plans, and (3) reviewed how D-SNPs work with state Medicaid agencies to enhance benefit integration and care coordination. GAO analyzed CMS enrollment, plan benefit package, projected revenue, and beneficiary health status data; reviewed 15 D-SNP models of care and 2012 contracts with states; and interviewed representatives from 15 D-SNPs and Medicaid agency officials in 5 states."
About 9 million of Medicare's over 48 million beneficiaries are also eligible for Medicaid because they meet income and other criteria. These dual-eligible beneficiaries have greater health care challenges than other Medicare beneficiaries, increasing their need for care coordination across the two programs. In addition to meeting all the requirements of other Medicare Advantage (MA) plans, dual-eligible special needs plans (D-SNPs) are required by the Centers for Medicare & Medicaid Services (CMS) to provide specialized services targeted to the needs of dual-eligible beneficiaries as well as integrate benefits or coordinate care with Medicaid services. This report (1) analyzed the characteristics of dual-eligible beneficiaries in D-SNPs and other MA plans; (2) reviewed differences in specialized services between D-SNPs and other MA plans; and (3) reviewed how D-SNPs work with state Medicaid agencies to enhance benefit integration and care coordination. Tables and figures. This is a print on demand report.
Europe's "Black Death" contributed to the rise of nation states, mercantile economies, and even the Reformation. Will the AIDS epidemic have similar dramatic effects on the social and political landscape of the twenty-first century? This readable volume looks at the impact of AIDS since its emergence and suggests its effects in the next decade, when a million or more Americans will likely die of the disease. The Social Impact of AIDS in the United States addresses some of the most sensitive and controversial issues in the public debate over AIDS. This landmark book explores how AIDS has affected fundamental policies and practices in our major institutions, examining: How America's major religious organizations have dealt with sometimes conflicting values: the imperative of care for the sick versus traditional views of homosexuality and drug use. Hotly debated public health measures, such as HIV antibody testing and screening, tracing of sexual contacts, and quarantine. The potential risk of HIV infection to and from health care workers. How AIDS activists have brought about major change in the way new drugs are brought to the marketplace. The impact of AIDS on community-based organizations, from volunteers caring for individuals to the highly political ACT-UP organization. Coping with HIV infection in prisons. Two case studies shed light on HIV and the family relationship. One reports on some efforts to gain legal recognition for nonmarital relationships, and the other examines foster care programs for newborns with the HIV virus. A case study of New York City details how selected institutions interact to give what may be a picture of AIDS in the future. This clear and comprehensive presentation will be of interest to anyone concerned about AIDS and its impact on the country: health professionals, sociologists, psychologists, advocates for at-risk populations, and interested individuals.
Weave your way through the tangled web of Medicare Medicare for Dummies, 3rd Edition will help you navigate the complicated, often confusing maze of the Medicare system. In simple language, with clear step-by-step instructions, the book helps you determine how and when to enroll, avoid costly mistakes, and find a plan that is right for you and your family. Written byPatricia Barry, a nationally recognized authority on Medicare and Medicare Part D prescription drug coverage, this invaluable resource offers: • Tips on reducing out-of-pocket expenses • Guidance for knowing your rights and protections • Ways to choose the best policy for you With this definitive guide, you’ll get answers to the most common and not so common questions about Medicare, to get the most out of your coverage.
Medicare For Dummies, 2nd Edition (9781119293392) was previously published as Medicare For Dummies, 2nd Edition (9781119079422). While this version features a new Dummies cover and design, the content is the same as the prior release and should not be considered a new or updated product. Make your way through the Medicare maze with help from For Dummies America's baby boomers are now turning 65 at the rate of about 10,000 a day. Yet very few have any idea about how Medicare works, when they should sign up, or how the program fits in with other health insurance they may have. Medicare For Dummies, 2nd Edition provides a detailed road map for navigating Medicare's often-baffling complexities and helps consumers avoid pitfalls that could otherwise cost them dearly. In plain language, the new edition explains: How to qualify for Medicare, according to your personal circumstances, including new information on the rights of people in same-sex marriages When to sign up at the time that’s right for you, to avoid lifelong late penalties How to weigh Medicare’s many options so you can be confident of making the decision that's best for you What Medicare covers and what you pay, with up-to-date details of the costs of premiums, deductibles, and copays—and how you may be able to reduce those expenses By conveying not only the basics but also how to troubleshoot problems and where to find assistance, Medicare For Dummies, 2nd Edition helps you to get the most out of Medicare.
Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.
To provide effective service in helping clients understand how they are going to be affected by health care reform and how to obtain coverage, pursue an appeal, or plan for long-term care or retirement, you need the most current information from a source you can trust - Medicare Handbook. This is the indispensable resource for clarifying Medicare's confusing rules and regulations. Prepared by an outstanding team of experts from the Center for Medicare Advocacy, Inc., it addresses issues you need to master to provide effective planning advice or advocacy services, including: Medicare eligibility rules and enrollment requirements; Medicare covered services, deductibles, and co-payments; coinsurance, premiums, penalties; coverage criteria for each of the programs; problem areas of concern for the advocate; grievance and appeals procedures. The 2016 Edition of Medicare Handbook offers expert guidance on: Health Care Reform Prescription Drug Coverage Enrollment and Eligibility Medigap Coverage Medicare Secondary Payer Issues Grievance and Appeals Home Health Care Managed Care Plans Hospice Care And more! In addition, Medicare Handbook will help resolve the kinds of questions that arise on a regular basis, such as: How do I appeal a denial of services? What steps do I need to take in order to receive Medicare covered home health care? What are the elements of Medicare's appeal process for the denial of coverage of an item, service, or procedure? Does my state have to help me enroll in Medicare so that I can get assistance through a Medicare Savings Program? When should I sign up for a Medigap plan? If I am on Medicare, do I have to buy health insurance in the insurance marketplace created by the Affordable Care Act? Is it true that I have to show medical improvement in order to get nursing and therapy services for my chronic condition? And more! The 2016 Medicare Handbook is the indispensable resource that provides: Extensive discussion and examples of how Medicare rules apply in the real world Case citations, checklists, worksheets, and other practice tools to help in obtaining coverage for clients, while minimizing research and drafting time Practice pointers and cautionary notes regarding coverage and eligibility questions where advocacy problems arise, and those areas in which coverage has been reduced or denied And more!