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Social Security and Medicare Answer Book, Sixth Edition by David A. Pratt Albany Law School Social Security and Medicare Answer Book, Sixth Edition by David A. Pratt Albany Law School

Social Security and Medicare Answer Book, Eighth Edition

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Social Security and Medicare Answer Book provides the specific guidance you need so you can ensure your clients receive maximum benefit under the law.

With Social Security and Medicare Answer Book, you'll receive:

  • Detailed coverage of the impact of health care reform legislation
  • More than 1,000 Medicare and Social Security issues explained in a convenient Q&A format
  • Citations to primary sources for fast, easy research
  • And more!

You'll receive answers to vital questions such as:

  • Does the health care reform legislation change the benefits under Part B?
  • How has the Social Security Administration revised the disability determination process?
  • What is the amount of an individual's Social Security benefit?
  • Does my client need insurance to supplement Medicare?
  • Does Medicare cover long-term care?
  • What level of retirement income will be needed to supplement Social Security?
  • At what point are benefits lost if an individual continues to work beyond retirement age?
  • And many more!

Social Security and Medicare Answer Book contains separate, in-depth sections devoted to:

  • Social Security: You'll find detailed explanations of the types of benefits available, who qualifies, how to apply, and what to do if you are denied benefits. You'll learn how to calculate benefits and when and how benefits may be lost.
  • Medicare Part A: You'll find detailed explanations of the coverage and rules for each of the categories covered under Part A, namely, inpatient hospital care, skilled nursing facilities, home health services, and hospice care.
  • Medicare Part B: You'll get full details on the specific services covered under Part B, including outpatient and partial hospitalization, home health services, nurse-midwife services, dental/eye care services, mental health services, and prescription drugs.
  • Medicare Advantage: Sometimes called Medicare Part C (formerly Medicare + Choice), you'll get in-depth explanations of the expanded range of choices potentially available to Medicare beneficiaries including provider-sponsored organizations, private fee-for-service plans, and medical savings accounts.
  • Medicare Part D: Learn the details of the best known feature of the sweeping Medicare reforms providing for the voluntary prescription drug program.

Note: Online subscriptions are for three-month periods.

Pages 942
Last Updated 05/14/2020
Update Frequency Annually
Product Line Wolters Kluwer Legal & Regulatory U.S.
ISBN 9781543819397
SKU 10081532-7777
Publish Frequency Annually
Product Line Wolters Kluwer Legal & Regulatory U.S.
SKU 000000000010048359
Table of Contents
  • Introduction
    • Social Security
    • Medicare
    • The Financial Condition of Social Security
    • The Financial Condition of Medicare
    • The Outlook for the Future
    • Reform Proposals
    • How Big Is the Social Security Financing Problem?
    • Conclusion
  • 1. Overview of the Social Security System
    • Function and Operation of the Social Security System
    • Social Security Benefits
  • 2. Coverage Under the Social Security Act
    • Overview of Coverage
    • Defining Employer and Employee
    • Self-Employment Coverage
    • Officers, Directors, Partners, and Stockholders
    • Direct Sellers, Traveling Salespeople, and Commission Drivers
    • Manufacturers’ Representatives
    • Life Insurance Agents
    • Crews on Fishing Boats
    • Railroad Employees
    • Foreign Students and Other Nonimmigrant Aliens
    • Members of the U.S. Uniformed Armed Forces
    • Federal Government Employees
    • Family Employment
    • State and Local Government Employees
    • Religious Denominations
    • Employees of Nonprofit Organizations
    • Hospital Interns
    • Student Nurses
    • Domestic Workers
    • Nonbusiness or Casual Employment
    • Farmers and Agricultural Labor
    • Students Working for a College or College Club
    • Distributors and Vendors of Newspapers or Magazines
    • Employees of the District of Columbia
    • Government Volunteer Programs
  • 3. Social Security Taxes and Earnings
    • Tax and Income Apportionment
    • Employers and Employees
    • Wages
    • Cash-Pay Test
    • Domestic Workers
    • Agricultural Workers
    • Nonprofit Organizations
    • Tips
    • Self-Employment Income
  • 4. Benefits Programs
    • Retirement Benefits
    • Disability Benefits
    • Benefits for Dependents
    • Survivor’s Benefits
    • The American Recovery and Reinvestment Act of 2009
  • 5. Application for Benefits and Proof of Entitlement
    • Application for Benefits
    • Calculating Benefit Payment Amounts
    • Evidence for Benefits
    • Proof of Entitlement
  • 6. Entitlement for Disability
    • Determining Disability
    • Earnings Records
    • Evidentiary Requirements
    • Resumed Employment and Benefit Termination
    • Ticket to Work Act
  • 7. Payment of Benefits
    • Calculation of Benefits
    • Maximum Family Benefit
    • Procedures for Payment of Benefits
    • Persons Who Can Receive Payments
    • Benefits Under Foreign Social Security Systems
    • Procedures for Payment of Benefits
    • The American Recovery and Reinvestment Act of 2009
  • 8. Administrative Review Process
    • Initial Determination
    • Reconsideration
    • Hearing Before an Administrative Law Judge
    • Representatives’ Fees
    • Review by the Appeals Council
    • Applicable Law
    • Reopening a Decision
    • Reimbursement of Travel Expenses
    • Review by Federal District Court
  • 9. Loss of Benefits
    • Retirement Test
    • Excess Earnings
    • Death of a Beneficiary
    • Recipients of Dependent’s or Survivor’s Benefits
    • Types of Earnings Under the Retirement Test
    • Substantial Services Test
    • Earnings of Insurance Agents
  • 10. Introduction to Medicare
    • How Medicare Works
    • The Four Parts of Medicare
    • Coverage and Claims
    • Obtaining Information
  • 11. Eligibility for Medicare
    • Part A
    • Part B
  • 12. Medicare Secondary Payer Rules
    • Other Insurance
    • Group Health Plans
  • 13. Medicare Claims and Appeals
    • General Rules
    • Rules Relating to Part A Claims
    • Rules Relating to Part B Claims
    • Rules Relating to Medicare HMOs
    • Rules Relating to Medicare Advantage Organizations
    • Health Privacy
    • Additional Requirements Under ERISA
    • Rules Under the 2003 Medicare Legislation
    • Revised Rules Under the 2005 and 2009 CMS Regulations
    • General Rules Under the 2005 and 2009 CMS Regulations
    • Initial Determinations
    • Redeterminations
    • Reconsiderations
    • Reopenings
    • Expedited Access to Judicial Review
    • ALJ Hearings
    • Applicability of Medicare Coverage Policies
    • Medicare Appeals Council Review
    • The Recovery Audit Contractor (RAC) Program
    • Claims and Appeals Under the Medicare Advantage Program (Part C of Medicare)
    • Claims and Appeals Under the Medicare Prescription Drug Program (Part D of Medicare)
  • 14. Medicare Financing
    • Financing of Medicare Part A
    • Financing of Medicare Part B
  • 15. Benefits Under Medicare Part A
    • Inpatient Hospital Care
    • Skilled Nursing Facility Care
    • Home Health Services
    • Hospice Care
  • 16. Benefits Under Medicare Part B
    • Specific Services Covered
    • Other Services
    • Paying for Services
  • 17. Medicare Advantage Plans
    • Medicare Advantage Plans
    • Types of Plans and Procedures
    • Election of Plans and Termination of Enrollment
    • Benefits and Services
    • Premiums
    • Information About Medicare Advantage
    • 2010 Health Care Reform Legislation
  • 18. The Medicare Part D Prescription Drug Program
    • The Part D Prescription Drug Benefit
    • Prescription Drug Discount Cards and Transitional Assistance
    • Prescription Drug Coverage Under Part B
  • 19. Medicare Exclusions
    • General Exclusions
    • Services Provided to Specific Groups
    • Specific Services
    • Additional Covered Items and Services
    • Exclusion of Program Abusers
    • Medical Errors
  • 20. Medicare Supplemental (Medigap) Insurance
    • Benefit Plans
    • Choosing a Medigap or Other Policy
    • Cost of Medigap
    • Medicare SELECT
    • Open Enrollment
    • Regulating the Sale of Medigap Insurance
    • Filing and Payment of Claims
    • Protections for Consumers/Beneficiaries
    • Protections Against Loss of Medigap Coverage
    • Medigap Coverage and the Medicare Part D Drug Benefit
    • Private Contract
  • 21. Other Recent Medicare Changes
    • 2008 and 2009Medicare Legislation
    • 2010 Legislation
    • Medicare Part A
    • Early Retirees
    • Health Care Quality Improvement
    • Medicare Advantage
    • Medicare Supplement (Medigap) Policies
    • Medicare Part D
    • Medicare Part B Premiums
    • The Independent Medicare Advisory Board
    • Protection of Benefits
    • Preventive Services
    • Dual Eligible Beneficiaries
    • Accountable Care Organizations
  • Table of Cases
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