Also called a “Spend-down” program, one spends their “excess” income on medical bills, such as health insurance premiums, medical supplies, and hospital bills. Once their income is “spent down” to the medically needy income limit (MNIL), they qualify for Medicaid for the remainder of the month. How do I meet […]
Medicaid Spend Down is what you must do when you have too many resources. In other words, you have too much money and you have to “spend down” assets before you will be eligible for Medicaid coverage. Those excess assets are called the “spenddown” amount. How do I meet my […]
The MultiPlan PHCS network. The MultiPlan PHCS network is the nation’s largest and most comprehensive independent PPO network. This network offers access in all states and includes more than 700,000 healthcare professionals, 4,500 hospitals and 70,000 ancillary care facilities. What is the largest PPO insurance? MultiPlanMultiPlan is the nation’s oldest […]
PPOs are one of the most popular types of health insurance plans because of their flexibility. With a PPO, you can visit any healthcare provider you’d like, including specialists, without having to get a referral from a primary care physician (PCP) first. Why is a PPO better? PPOs Usually Win […]
“Not Medically Necessary” is the term applied to health care services that a physician, exercising prudent. clinical judgment, would provide to a patient for the purpose of preventing, evaluating, diagnosing or. What should not be considered medically necessary? Most health plans will not pay for healthcare services that they deem […]
A non-covered service in medical billing means one that is not covered by government and private payers. Medicare Non-covered Services. The four categories of items and services that Medicare does not cover are: Medically unreasonable and unnecessary services and supplies. Noncovered items and services. What are non-covered services? A service […]
Which of the following is true of an exclusive provider organization (EPO)? Premiums are higher than with a preferred provider organization (PPO). What is an EPO health insurance plan? A managed care plan where services are covered only if you go to doctors, specialists, or hospitals in the plan’s network […]
Laws require that all states’ Medicaid programs cover outpatient hospital services, including emergency room visits. Some states may exclude certain services performed in an ER from coverage and require you to pay for them out of pocket. Does Medicaid cover ER visits Texas? Medicaid and Texas CHIP. In these programs, […]
The PPO plan is available to clients through the Blue ChoiceSM Network, one of the largest networks in Texas. Blue ChoiceSM provides: Access to the national BlueCard® network when members are outside of Texas. Is there PPO in Texas? PPOs are the familiar letters normally associated with meeting typical health […]
Most insurances will pay for an MRI or MRA examination. Michigan Resonance Imaging participates with Blue Cross Blue Shield of Michigan, Medicare, Medicaid, Capp Care, PPOM, HAP and Preferred Choices, to name a few. We will provide scans for commercial and auto workers’ compensation insurances. What does Medicaid cover in […]
A service can be considered a non-covered service for many different reasons. Services that are not considered to be medically reasonable to the patient’s condition and reported diagnosis will not be covered. What is a non-covered benefit? A non-covered benefit is anything that a plan does not cover and never […]
MRIs are classified by Medicaid and Medicare as diagnostic non-laboratory tests. What does Medicaid in New York cover? New York Medicaid Benefits. New York Medicaid benefits include regular exams, immunizations, doctor and clinic visits, relevant medical supplies and equipment, lab tests and x-rays, vision, dental, nursing home services, hospital stays, […]
Pros and Cons of an EPO Low monthly premiums: EPOs tend to have lower premiums than Preferred Provider Organizations (PPOs), though they’re higher than Health Maintenance Organization (HMO) premiums. Large networks: They generally offer a wider selection of care providers than HMOs. What are the pros and cons of PPO? […]
Our Personal Choice EPO Reserve plan works like other EPO health plans, in that you can see any in-network doctor or specialist without a referral. But with the HSA-qualified plan, you can set aside money in a tax-advantaged health savings account (HSA) for any qualified medical expenses you may have. […]
2015 is the first tax year that Oregon Health Plan (OHP) members are required to report OHP coverage on their income tax return. People who file a 2015 federal income tax return, and who had OHP coverage in 2015, must report which months of the year they had OHP. This […]