The 2009 Medicare Handbook is the indispensable resource you need to clearly understand - and be able to advise on - Medicare's confusing rules and regulations. It has been prepared by an outstanding team of experts from the Center for Medicare Advocacy, Inc., a private, non-profit organization devoted to helping elders and people with disabilities obtain necessary health care. These experienced attorneys and health care professionals address - from the beneficiary's perspective - 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
• Co-insurance, premiums, penalties
• Coverage criteria for each of the programs
• Problem areas of concern for the advocate
• Grievance and appeals procedures

For each topic, you'll find an extensive selection of case citations, checklists, worksheets, and other practice tools designed to assist in obtaining coverage for clients, while minimizing research and drafting time.

The 2009 Edition has been updated to include coverage of:

• Understanding new hospital notices
• Understanding current physical, speech, and occupational therapy payment caps
• Increasing payments to, and reliance upon managed care plans (Medicare Advantage)
• Protections for individuals with low incomes, including the extension of the Qualified Individual (QI) program
• Elimination of Medicare Part D late enrollment penalties paid by subsidy eligible individuals; judicial review of decisions of the Commissioner of Social Security under the Medicare Part D Low-Income Subsidy program; and Medicare enrollment assistance
• Extension of exceptions process for therapy caps

Table of Contents 

1. An Introduction to Medicare Coverage and Appeals
2. Hospital Coverage
3. Skilled Nursing Facility Coverage
4. Home Health Coverage
5. Hospice Coverage
6. Medicare Part B: Supplemental Medical Insurance
7. Medicare Advantage: Coordinated Care Plans, Private Fee-For-Service, and Other Delivery of Services Options
8. Medigap Services
9. Medicare's Relationship with Private Insurance
10. Dual Eligibility: Issues for Medicare Beneficiaries Also Eligible for Medicaid
11. Prescription Drug Coverage