From Health Assistance Partnership
Medicare Basics
A SHIP Resource Guide
This manual provides an introduction to the Original Medicare program, eligibility, Medicare coverage issues, and related health insurance programs, such as supplemental coverage. It is one of three HAP Medicare training manuals in a series that also contains manuals on the Medicare Advantage and Medicare Prescription Drug (Part D) programs. Updated in January 2010.
Table of Contents
Overview of the Medicare Program
Medicare in a Nutshell
Who Runs Medicare?
Highlights in Medicare History: A Timeline
Sources of Medicare Eligibility, Coverage, and Payment Rules
Where to Learn More
Eligibility and Enrollment
Eligibility in General
Enrollment in General
Eligibility and Enrollment for Medicare Part A
Eligibility and Enrollment for Medicare Part B
Where to Learn More
Hospital Insurance under Medicare Part A
Medicare Part A Overview
Inpatient Hospital Coverage
Payments to Hospitals and the Right to Needed Care
Skilled Nursing Facility (SNF) Coverage
Home Health Care
Hospice Care
Where to Learn More
Medical Insurance under Medicare Part B
Medicare Part B Introduction
Part B Covered Services, Items, and Coverage Rules
Excluded Services and Items
Part B Costs and Claims
Where to Learn More
Medicare as a Secondary Payer and Coordination of Benefits
The Medicare Secondary Payer (MSP) Rule
The Coordination of Benefits (COB) Program
Where to Learn More
Medigap Insurance and Other Supplemental Insurance
Medicare Supplement Insurance — Medigap
Employer and Union Group Plans for Retirees
COBRA Continuation Plans
TRICARE for Life
Indemnity Insurance Policies
Veterans Administration (VA) Benefits
Where to Learn More
Long-Term Care Insurance (LTCI)
What is Long-Term Care Insurance (LTCI)?
Who Needs Long-Term Care Insurance (LTCI)?
What is Long-Term Care (LTC)?
What Does Medicare Cover?
How Does Long-Term Care Insurance (LTCI) Work?
What Else Do I Need to Consider When Purchasing a Policy?
What are Partnerships for Long-Term Care (PLTC)?
Resources for Long-Term Care Insurance (LTCI) Counseling
Where to Learn More
Medicaid
Medicaid Overview
Medicaid Eligibility
Medicaid Programs
Medicare Savings Programs (MSPs)
Home and Community-Based Services Program
Medicaid and MSP Problem-Solving
Where to Learn More
Medicare Appeal Rights and Procedures
Medicare Appeals Generally
Original Medicare Coverage Decisions and Appeal Procedures
Expedited Determinations and Reconsideration in Original Medicare
Where to Learn More
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, 112-page guide
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