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Centers for Medicare and Medicaid Services logo. Medicare Part D, also called the Medicare prescription drug benefit, is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs. [ 1] Part D was enacted as part of the Medicare Modernization Act of 2003 and went into effect ...
For millions of retirees, Medicare coverage that takes effect for most people at age 65 is the key to being able to afford health care costs that would otherwise quickly sap their retirement savings.
Major Diagnostic Category. The Major Diagnostic Categories (MDC) are formed by dividing all possible principal diagnoses (from ICD-9-CM) into 25 mutually exclusive diagnosis areas. MDC codes, like diagnosis-related group (DRG) codes, are primarily a claims and administrative data element unique to the United States medical care reimbursement ...
The Medicare Part D coverage gap (informally known as the Medicare donut hole) was a period of consumer payments for prescription medication costs that lay between the initial coverage limit and the catastrophic coverage threshold when the consumer was a member of a Medicare Part D prescription-drug program administered by the United States federal government.
What you need to know. Officially, Medicare drug plans no longer have a donut hole—the gap between covered drugs and catastrophic coverage. This hole was gradually closed thanks to provisions in ...
In many instances, people needed prior authorization: their doctors had to prove to their Part D plan that the drug was medically necessary for them to get it covered. Health insurers want to ...
The acronym HCPCS originally stood for HCFA Common Procedure Coding System, a medical billing process used by the Centers for Medicare and Medicaid Services (CMS). Prior to 2001, CMS was known as the Health Care Financing Administration (HCFA). HCPCS was established in 1978 to provide a standardized coding system for describing the specific ...
Medicare has several parts that provide different types of coverage. Part A covers hospitals, skilled nursing facilities, and hospice; Part B covers doctor visits, lab tests, and medical equipment ...
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