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IT'S THAT TIME OF THE YEAR!!!

Medicare Open Enrollment Period

October 15 - December 7

November 3, 2021

Selecting a benefit plan for 2022 can leave you overwhelmed and confused. With so many options to choose from and to select the best option for your medical needs. With that being said, we want to give a few tips to help you during this process.

  • If you are turning 65 soon, you will need to enroll into Medicare to apply for Part A & B Medicare Enrollment. Medicare will all you to enroll 3 months before your birthday, your birthday month and 3 months after . Now, if you do not enroll into Medicare when you are eligible, you will be penalized for the duration of you not enrolled when eligible.

IT'S THAT TIME OF THE YEAR!!!-continue


  • Understand Medicare Parts- A, B, C, D

    • Part A = If you have been employed full or part-time for 10 years +, you will automatically receive Part A for Free (YOU WILL NOT HAVE TO PAY A MONTHLY PREMIUM). This part only covers Inpatient settings ( hospital, residents of nursing facilities and /or partial hospital settings). Medicare does not cover LONG TERM CARE.

    • Part B = Only covers Outpatient settings (doctor office, specialists, ambulatory). All Medicare recipients must pay a monthly premium (expected to be $158.50 for 2022). Medicare only covers 80% of visits that are not preventative. You will be responsible for the 20%.

    • Part C= Medicare Advantage Plans, these plans are approved by Medicare. Many health insurance carriers you may be familiar with have Medicare plan such as Aetna, UHC or Cigna (so many options). You may be offered some additional benefits and may have to pay more.

    • Part D= Prescription Plan, this plan helps with paying for medication you need. Now, if you do not enroll when you are eligible and you do not have a creditable drug plan. You will be penalize for the duration of you not enrolled when eligible.

  • Ensure your health care professional(s) accepts the plan you select.

  • Reviewing plan benefits options, see what preventative services are covered at 100% (no cost to you).

  • Understand key health insurance terms such as deductible, co-payment, and co-insurance.

If you need further assistance please click the link to schedule an session with us Patient Advocacy

Let's Talk DPP

Medicare Diabetes Prevention Program

September 11, 2021

Many of you may not be aware of the Medicare Diabetes Prevention Program (DPP). This program was created to reduce the cost ($104 Billion as of 2019) Medicare spends each year for diabetes care. Medicare is seeking the public, facilities, employers and community organizations to become a Diabetes Prevention Coach. To learn more about Medicare Proposed Policies for 2022 click the link below. www.cms.gov/newsroom/fact-sheets/proposed-policies-medicare-diabetes-prevention-program-mdpp-expanded-model-calendar-year-2022 .


Let's Talk DPP- continue

The program target market:

  • Individuals diagnosed with pre-diabetes (lab work required as proof)

  • Individuals with gestational diabetes (diagnose during pregnancy (proof of lab work required)

  • Individuals overweight at risk of becoming pre-diabetic (preventative measures)

So many individuals are at risk of being diagnosed with Type 2 diabetes, which affects many organ systems in the body. Participants have the advantage of reaching many individuals to prevent Diabetes Type 2.

P&C spreads the word about this program for several reasons:

  • To bring awareness to communities (undeserved)

  • Participants are able to receive reimbursement from health insurance carriers, Commercial ,Medicare, and Medicaid payors for services rendered.

  • Many health/wellness coaches and fitness instructors are already performing the work. Our healthcare system allows participants the opportunity to receive reimbursement for the services, by submitting claims to health insurance carriers.

With that being said, when Medicare rolled out the program there was little medical billing guidance. In order for participants to receive reimbursement from health insurance carriers. Participants must know how to document properly and select the proper codes for payment . P&C is here to do just that. Let's join forces to help save lives. Click the link to register for a medical billing session to Become a Diabetes Prevention Coach.