HDC: Insurance 101 for Social Workers

MEI’s Home Dialysis Central blog has published a post on Insurance 101 for Dialysis Social Workers.  The objective is to help assure that people with Chronic Kidney Failure avoid inaccurate advice that can be very costly.  The complexity is remarkable – even insurance experts should review the article for anything they may have overlooked.  Find the post at https://homedialysis.org/news-and-research/blog/367-insurance-101-for-dialysis-social-workers.

Just a few examples:

  • You must have paid Social Security taxes for a specific length of time to be eligible for Medicare to cover treatment for chronic kidney failure.
  • Medicare coverage starts in month 4 for in-center dialysis, but starts in month 1 for home dialysis.
  • Medicare part A is free, but it’s Part B that pays for dialysis, and it’s not free.
  • If you don’t sign up for Medicare Part B or D when you’re first eligible for part A, you’ll pay a lot more for them.
  • A few of the terms and acronyms that complicate matters: work credits, Medicare Advantage, Medigap, Medicaid, Medi-Cal, primary payer, Medicare assignment, MA, QMD, SLMB, COBRA, QHP, ACA.

6/23+ COVID-19 Weekly Webinars

A number of organizations have been hosting weekly webinars on COVID-19.  This week:

  • ESRD NCC half-hour “Quickinars” for patients and providers, 2-2:30 pm PDT.   Find the latest information, recordings of past Quickinars, and register for current presentations at https://esrdncc.org/quickinars.
      • Tuesday, June 23, 2020 Quickinar for patients on Kidney Patient Financial Help: Before, During, and After COVID-19.
      • Wednesday, June 24, 2020 Quickinar for providers on COVID-19 Dialysis Unit Strategies.
  • This week’s CMS Stakeholder Engagement Calls:

For recordings of past events, see https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts.

Medicaid Waivers for Home Patients

The Medical Education Institute has published a Home Dialysis Central blog post on Medicare Waivers: The Best Kept Secret in Dialysis Home Health Care, which describes a program that allows people who don’t normally qualify for Medicaid, but who have fragile health, to get Medicaid funding for home care anyway.  The program doesn’t cover dialysis itself, but it does cover home health care aides and other useful services.  State agencies administer waiver programs that help seniors and people with disabilities, to ensure that these vulnerable populations can live independently in their homes and communities, and/or age in place.  Thanks to these waivers, states can provide services to their residents that wouldn’t usually be covered by Medicaid.  If you are eligible for both Medicare and Medicaid, you can have and use both for the services you need.  The services they cover are not always the same.  For example, Medicaid offers coverage for things like personal care services while Medicare does not.  Find the MEI blog post at https://homedialysis.org/news-and-research/blog/346-medicare-waivers-the-best-kept-secret-in-dialysis-home-health-care.

1/1 HIC Numbers Invalid in 2020

As of today, HICNs are still being used to identify patients on 14% of Medicare claims.  Starting in four weeks, these claims will be returned, as MBIs are required after December 31, 2019.  Find all the information you need on the conversion to MBIs at https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE18006.pdf.

HDC Poster on Minimizing Cost of Dialysis

Home Dialysis Central has published a new blog post describing various insurance plans and how individuals in various situations can manage them to minimize the cost of dialysis, called Fact Sheet on Health Plans & Tips to Save Money on Dialysis Health Care.  Find the blog post at https://homedialysis.org/news-and-research/blog/334-fact-sheet-on-health-plans-tips-to-save-money-on-dialysis-health-care and a pdf poster of the table of plans/situations and tips, at https://homedialysis.org/documents/Health-Plan-Status-&-Tips-BW-10-25-2019.pdf.

NW18 11/6 CNSW-LA Fall Workshop

The CNSW Greater Los Angeles Chapter will present their Fall Semi-Annual Workshop in Burbank CA on November 6, 2019.  Topics will include workplace violence, health insurance, and relocation trauma, with 4 CEU hours offered.  For details see https://s3-us-west-2.amazonaws.com/nwrn.org/files/CNSW/CNSW.LA.FALL2019.pdf.

Transitional Care for Urgent Starts in Dialysis

Home Dialysis Central has published a blog post on Traditional Dialysis vs. Transitional Care for Urgent Starts.  Transitional Care for Urgent Starts (TCU) provides a gentler and more supportive introduction to dialysis for people whose kidneys fail with little warning, helping them get past the shock of a “sudden” change of just about everything in their life, and helping them make informed decisions about treatment modality.  Of course kidneys don’t fail suddenly, but sometimes it seems that way to the person whose kidneys have failed.  Find the post at https://homedialysis.org/news-and-research/blog/330-traditional-dialysis-vs-transitional-care-for-urgent-starts.

12/31 Old HICNs Valid for Only Six More Months

There are only six months to go on the transition to the New Medicare Card.  To help prevent identity theft, the New Card removes a patient’s Social Security Number from their Card and replaces it with a new, randomly-assigned “Medicare Beneficiary Identifier” or MBI.  MBIs must be protected as confidential PII.  All patients should have received their new card by now, barring mailing address problems.  After December 31, 2019 billing with the old “Health Insurance Claim Number” or HICN will be disallowed.  If your facility has patients that don’t have a New Card, refer to https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE18006.pdf for instructions.  Railroad Retirement Board Medicare cards are going through a parallel transition.

MEI Primer on ESRD, SSI, SSDI, and Medicare

The Medical Education Institute has written a blog post on Social Security Policies Related to Medicare: A Primer.  It’s really complicated, so it may be more appropriate for a Social Worker than a patient, but if the Primer is this complex, the Reality must be especially daunting – which makes a Primer all the more valuable.  Find the Primer at https://homedialysis.org/news-and-research/blog/307-social-security-policies-related-to-medicare-a-primer.