Level 4: Other Insurance and Assistance Programs
This level provides advanced students with in-depth information on how Medicare works with other types of insurances, and how to navigate enrollment into low-income assistance programs. Throughout advanced MI Pro Level 4 courses, you will learn about Medicare coordination of benefits and how to screen Medicare beneficiaries for low-income assistance programs.
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One-Year Subscription
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Show/hide description Course 1: Medicare and Employer Insurance Length: 50 minutes
Preview CourseCoordination of benefits is the term used to describe how Medicare works with other kinds of insurance, including employer insurance and Medicaid. In this course, you will learn about the coordination of benefits rules for current and former employer coverage, including COBRA, retiree coverage, and Federal Employee Health Benefits (FEHB). You will find out if Medicare pays primary or secondary to different employer-related insurance, depending on the number of employees and whether individuals are eligible for Medicare due to age or disability. You will also gain valuable knowledge about various enrollment-related consequences and considerations for beneficiaries who delay their Medicare enrollment.
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Show/hide description Course 2: Medicare and Other Insurance Length: 35 minutes
Preview CourseThis course explores coordination of benefits rules for military and non-employer insurance, as well as other types of insurance a beneficiary may have. We will address TRICARE, TRICARE for Life, and Veterans Affairs (VA) benefits, and see how each coordinates—or does not coordinate—with Medicare. This course also includes discussions of liability insurance, no-fault insurance, and workers’ compensation, including information about how all of these pay primary or secondary to Medicare. We will also discuss what happens when Medicare makes a conditional payment and the steps involved in the conditional payment recovery process. Finally, we will take a look at long-term care insurance, dental insurance, and Health Insurance Marketplace plans and what must happen when an individual with Marketplace coverage becomes Medicare-eligible.
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Show/hide description Course 3: Medicare and Medicaid Length: 55 minutes
Preview CourseIn this course, you will learn about the Medicaid program in more detail and how it affects lower-income Medicare beneficiaries. We will explore the basics of Medicaid, including eligibility and state-specific rules. Specifically, you will find out how individuals can qualify for Medicaid in some states by taking advantage of a Medicaid spend-down, participating in a trust program, or enrolling through the Medicaid Buy-In program. You will learn about Medicaid coverage, including mandatory and optional benefits, and go into detail about Institutional Medicaid and Medicaid waiver programs for beneficiaries who need long-term care. The course will also introduce MAGI (Modified Adjusted Gross Income) Medicaid, including Medicaid for expansion populations under the Affordable Care Act (ACA), available to individuals with higher income limits than traditional Medicaid. You will also find out how individuals transition from MAGI Medicaid to Medicare and possible outcomes.
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Show/hide description Course 4: Medicare Assistance Programs Length: 45 minutes
Preview CourseIn this course, we will address the various federal and state programs available to help beneficiaries pay for their Medicare costs: Medicare Savings Programs, including the Qualifying Individual (QI), Specified Low-Income Medicare Beneficiary (SLMB), and Qualified Medicare Beneficiary (QMB) programs; Extra Help; Medicare’s Limited Income Newly Eligible Transition program (LI NET); State Pharmaceutical Assistance Programs (SPAPs); and Patient Assistance Programs (PAPs). You will find out how each of these programs works and the Medicare costs each is designed to help cover. You will also learn more about the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, which helps ensure that beneficiaries who apply for one benefit are screened for and, where possible, enrolled in other programs for which they might be eligible.