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Linda Collins Blogger

More on Medicare Advantage Plans

Posted by Linda Collins | October 24, 2014

​The Medicare Advantage Open Enrollment period continues until December 7, 2014 so it is important for patients and clinicians to understand this program.

Medicare Advantage programs must follow the established Medicare coverage criteria as outlined in the LCDs and Policy Articles. You may be subject to payer processes such as pre-authorization, but the actual coverage criteria must be the same as traditional Medicare. If you experience denials that do not match the LCDs, then you can immediately appeal to the payer. You and your patient may also contact the Medicare Ombudsman’s Office for assistance in these situations. (MedicareComplaintForm)
Medicare Advantage plans are becoming increasingly attractive to Medicare beneficiaries. Some experts predict that Medicare Advantage enrollees will represent 30 percent or more of all Medicare beneficiaries by 2016.
For more information about the Medicare Advantage program for you or your patient, visit


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