A "plain English" approach to Medicare and Medicaid

Provide your clients, customers, or employees concise, easy to read descriptions of the Medicare and Medicaid federal health insurance program for the aged, disabled and certain low-income individuals with the 2006 Medicare and Medicaid Benefits booklet. This annual edition offers an overview of the Medicare and Medicaid Programs, including the latest legislative developments impacting Medicare and Medicaid, while covering the basics of Medicare Part A, Part B, Medicare Advantage (Part C), and Prescription Drug Plans (Part D).

This plain language approach includes practical examples to explain:

• Exclusions from Medicare
• Payment Rules, Claims, and Appeals
• Covered Services
• Eligibility and Enrollment
• Prescription Drug Coverage
• Eligibility Groups and Coverage Rules
• And More!

Table of Contents

Introduction

THE MEDICARE PROGRAM

• Medicare: In General
• Services Covered—Part A
• Services Covered—Part B
• Exclusions from Coverage
• Rules for Payment of Benefits
• Beneficiary Cost and Appeals
• Medigap Supplemental Plans

MEDICARE ADVANTAGE

• Medicare Part C
• Choosing a Plan in 2006
• Eligibility
• Enrollment
• Medicare Advantage Plan Costs
• Beneficiary Protections
• Access to Services
• Grievances and Appeals
• Medigap Policies
• Other Program Rules
• Prescription Drug Plans

PRESCRIPTION DRUG PLANS

• Prescription Drug Coverage
• Transitional Drug Discount Cards
• Prescription Drug Benefit
• Prescription Drug Coverage Defined
• Premiums and Late Enrollment Penalties
• Subsidies for Low-Income Individuals

THE MEDICAID PROGRAM

• Medicaid: In General
• Eligibility Groups
• Covered Services
• Allowable Income and Resources
• Nursing Facility Care
• Spousal Impoverishment
• Transfer of Assets
• Trusts
• Programs Related to Medicaid
• Liens and Recoveries
• Prescription Drug Benefit