Hey Medicare Nation! www.TheMedicareNation.com Today, I'm finishing up my series on the Medicare Plan Sponsors that CMS has issued Sanctions and/or Civil Money Penalties for in 2020! THREE more plan sponsors to discuss! CMS sent notice to Ms. Aparna Abburi, President of Health Care Service Corporation (HCSC), on February 28, 2020, that CMS was imposing a Civil Money Penalty in the amount of $381,272.00! HUGE Penalty people! According to CMS Summary of Non-Compliance, HCSC disclosed to CMS that it "discovered" a backlog of unprocessed Part C (Medical) Appeals. The ..read more

Hey Medicare Nation! Medicare Nation CMS Imposes a Civil Money Penalty against HUMANA! CMS conducted an "Audit" of Humana's Medicare Operations from June 3, 2019 through June 21, 2019. Humana failed to comply with Medicare requirements related to Part D formulary and benefit administration and coverage derterminations, appeals, and grievances in violation of 42 C.F.R. Part 423, Subparts C and M. Humana's failures in these areas were systemic and adversely affected, or had the substantial likelihood of adversely affecting, enrollees. CMS provided notice to Humana's CEO, Mr. Bruce Broussard, on ..read more

Hey Medicare Nation! Medicare Nation Today, I'm informing you about The Centers For Medicare & Medicaid Services Notice, given to Mr. Art Carlos, CEO of Delaware Life Insurance Company. In a notice dated January 31, 2020, CMS notified Mr. Carlos that they were immediately imposing Intermediate "Sanctions" against Delaware Life Insurance Company. CMS determined that Delaware Life Insurance Company is "in substantial violation of Medicare Advantage and Prescription Drug Plan requirements." SIX specific violations were listed in the notice to Carlos. LISTEN to the episode to learn about ..read more

Hey Medicare Nation! www.TheMedicareNation.com Medicare has taken many steps to assist you during the COVID-19 crisis. Coronavirus tests Medicare Part B (Medical Insurance) covers a test to see if you have coronavirus (officially called COVID-19). This test is covered when your doctor or other health care provider orders the test. I spoke about testing for COVID-19 in the previous episode, dated April 1, 2020. Listen to episode 101 to learn more about COVID-19 Testing. Your costs in Original Medicare for COVID-19 Testing. You pay nothing for this test. NADA! This includes the ..read more

Hey Medicare Nation! www.TheMedicareNation.com It’s April 1st and over One Million People have been diagnosed with the COVID-19 Virus Worldwide! On this week’s episode….. I provide a time-line of the events of the Pandemic as well as updates on COVID-19 testing and Important phone numbers should you have symptoms or questions about COVID-19. I also have a “list” of phone numbers, for EACH Health Department in All 50 States! You can email me at  Support@TheMedicareNation.com for the list or check the show notes for an attachment. Here is an important phone number for the CDC HOTLINE on COVID-19 ..read more

Hey Medicare Nation! We're smack in the middle of a Corona Virus Pandemic! The Medicare Nation I wanted to give you an episode that is full of USEFULL information. I know you've been hammered by the news, internet and newspapers about the Corona Virus. Let's start with a very important fact: Human coronaviruses were first identified in the mid-1960s. The 1960's people! the coronavirus gets its name from a distinctive corona or in a scientists world…a “Crown of Sugary Proteins,” that projects from the surface of the virus. There are four main types of Human Corona Viruses Alphacoronavirus,  B ..read more

Hey Medicare Nation! www.TheMedicareNation.com It's still January,,,, but February is right around the corner. Spring WILL come. I promise! Let me give you some good news! Medicare is now covering Acupuncture! As of January 21, 2020, The Center for Medicare & Medicaid Services (CMS), will cover acupuncture for "Chronic Low Back Pain." Let's look at the coverage in the Medicare National Coverage Determination Manual. Section 1862(a)(1)(A) of the Social Security Act  Up to "12" visits in 90 days are covered for Medicare Beneficiaries under the following circumstances: a. Chronic Low Back Pai ..read more

Hey Medicare Nation! www.TheMedicareNation.com It's 2020!  Love the sound of that! Right now...... the Medicare Advantage Open Enrollment Period is in full swing. If you are on a "Medicare Advantage Plan," you have the opportunity to make a ONE TIME change, between January 1st through March 31st. You can change from one Medicare Advantage Plan to another Medicare Advantage Plan. You can "disenroll" from the Medicare Advantage Plan you're on and go back onto "Original Medicare." With Original Medicare, you can add a stand-alone-prescription drug plan and ..... you can enroll into a Medicare Sup ..read more

Hey Medicare Nation! CMS just announced the 2020 Medicare Part B Premium increase! CMS also announced 2020 Part A Deductible and co-pays, as well as the Part B annual deductible. Here's a look at what's changing in 2020: Medicare premiums, deductibles, and co-payment amounts are adjusted each year in accordance with the Soc Sec Act.      SOCIAL SECURITY   Increase:    1.6%  (Avg $24 more a month)   Average Monthly SS Check $1,503.00       2020 - PART A DEDUCTIBLE AND COINSURANCE   Inpatient Hospital Deductible:                       $1408.00 Daily Coinsurance Days 61-90 ..read more

Hey Medicare Nation! www.TheMedicareNation.com It's October! That means it's Medicare Time! The Annual Enrollment Period is just around the corner. Did you receive your "Annual Notice of Changes (ANOC)" for your Medicare Advantage Plan or Prescription Drug Plan? If not....contact your plan and request the ANOC. Today......I want to talk with you about Part D Prescription Drug Coverage for 2020! Medicare has set the maximum Part D Deductible for 2020 at $435.00. Medicare Advantage Plans and Stand-Alone Prescription Drug Plans have the option to charge the maximum deductible amount of $435.00 ..read more