Part A - Home Health Care and Confinement

Medicare Part A will cover many of the costs associated with home health care if the care is both medically reasonable and necessary. If the patient is not entitled to Part A coverage, Part B may provide coverage.

Income Eligibility for Medicaid

Medicaid programs offer assistance to needy persons who cannot afford to pay for their medical care. The federal and individual state governments jointly administer Medicaid. While federal statutes and regulations provide the template, each state establishes its own methodology for administering its Medicaid program.

Insurance - Long-Term Care - Potential for Fraud

Insurance companies, perhaps more than any other type of company, depend upon written contracts to define the terms of their liability with their customers. Like other companies, their attorneys carefully modify their contracts to comply with laws governing the insurance industry.

Medicare - Limiting Charges and Assignment

Medicare limits the amount it will pay for some services, supplies, and medical equipment. This is called the Medicare limiting charge. Whether a limiting charge is available to help limit the cost of services or supplies, however, depends upon who is rendering the service, whether the provider has agreed to accept assignment, what type of item or service is at issue, and whether the physician and the patient executed a private contract. Assignment means that a provider has agreed that it will accept the Medicare-defined reasonable and customary fee for its services. A full discussion of assignment appears in a separate article.

Department of Defense Health Care Benefits

The United States Department of Defense (DOD) provides health care coverage to its members through its own facilities, military facilities, and private health care providers, although the cost of the care may vary depending upon the recipient and the location of the services provided.