From Health Assistance Partnership
Medicare Advantage
A SHIP Resource Guide
This manual provides an introduction to the Medicare Advantage program, including eligibility, enrollment, coverage and cost issues. It is one of three HAP Medicare training manuals in a series that also contains manuals on Medicare Basics and the Medicare Prescription Drug (Part D) program. Updated in January 2010.
Table of Contents
Overview of Medicare Advantage Program
Types of Plans
Introduction
Coordinated Care Plans (CCPs)
Private Fee-for-Service (PFFS) Plans
Medicare Medical Savings Accounts (MSAs)
Program for All-Inclusive Care for the Elderly (PACE)
Employer/Union Sponsored Group Plans for Retirees
Eligibility and Enrollment
Eligibility for Enrollment
Deciding to Enroll in an MA Plan
How to Select an MA Plan
Enrollment Periods and Effective Dates
How to Enroll in an MA Plan
Disenrollment
Post-Enrollment Actions
Coverage of Benefits and Access to Services
Basic Benefits
Supplemental Benefits and Guidelines
Value-Added Items and Services (VAIS)
Service Areas
Coordination of Benefits and Medicare as Secondary Payer (MSP)
Access to Services
Relationship to Drug Coverage
Costs and Prices
Background on MA Payment from CMS
Basics of Costs and Prices
Cost Comparison Chart
Low-Income Assistance
Marketing
Overview
Marketing Materials
Marketing Review
Special Guidelines
Promotional Activities
Employer/Union Sponsored Group Plans for Retirees
Grievances and Appeals
Background
Grievances
Organization Determinations
Appeals
Appendices
NOTE: If you have trouble accessing links in the Appendices, please copy and paste the link into your browser to navigate directly to the resource.
PDF of complete, 94-page guide
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