web02.fireside.fm Sun, 14 Jun 2026 15:58:39 -0500 Fireside (https://fireside.fm) Mastering Medicare - Episodes Tagged with “Home Care” https://www.masteringmedicare.net/tags/home%20care Mon, 12 Oct 2020 06:00:00 -0400 What's the difference between Home Health and Home Care? How do Medicare Part A and Part B work? How do you order DME for your patient? When and how should you order home oxygen? What's new in the eldercare space? For physicians, other healthcare professionals, and senior-serving professionals, interacting with Medicare can be complicated and wrought with pitfalls, which, if not understood and managed, will mire your practice in endless paperwork and frustration. We interview industry experts in every aspect of healthcare, from insurance companies, DME companies, home health agencies, medical providers, and many others, to bring you their real world expertise in the American healthcare system. Your hosts are Dr. Amy Schiffman and Dr. Alex Mohseni, two Emergency Medicine physicians who have branched off from traditional Emergency Medicine to explore and build solutions with a particular focus on eldercare and population health. Join our Facebook group: https://www.facebook.com/groups/602747270479020/ Join our Subscriber List and get exclusive access to our Mastering Medicare Cheat Sheet and other goodies: https://www.masteringmedicare.net/subscribe en-us episodic Demystifying healthcare and Medicare for senior-serving professionals and providers. Mastering Medicare What's the difference between Home Health and Home Care? How do Medicare Part A and Part B work? How do you order DME for your patient? When and how should you order home oxygen? What's new in the eldercare space? For physicians, other healthcare professionals, and senior-serving professionals, interacting with Medicare can be complicated and wrought with pitfalls, which, if not understood and managed, will mire your practice in endless paperwork and frustration. We interview industry experts in every aspect of healthcare, from insurance companies, DME companies, home health agencies, medical providers, and many others, to bring you their real world expertise in the American healthcare system. Your hosts are Dr. Amy Schiffman and Dr. Alex Mohseni, two Emergency Medicine physicians who have branched off from traditional Emergency Medicine to explore and build solutions with a particular focus on eldercare and population health. Join our Facebook group: https://www.facebook.com/groups/602747270479020/ Join our Subscriber List and get exclusive access to our Mastering Medicare Cheat Sheet and other goodies: https://www.masteringmedicare.net/subscribe no elder care, eldercare, Medicare, Medicaid, healthcare, senior care, senior, seniors, senior-serving professionals, medical care, insurance company Mastering Medicare alex@masteringmedicare.net Episode 15: Medicare Advantage (MA plans) - a deep dive with Michael Hughes https://www.masteringmedicare.net/15 141c7ce5-c8f3-4acf-a981-3ca94fc1a458 Mon, 12 Oct 2020 06:00:00 -0400 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. 1:04:51 no <p>Dr. Amy Schiffman and Dr. Alex Mohseni interview Michael Hughes, principal at Mitchell-Lowey, LLC, and do a deep dive into Medicare Advantage plans, especially as they relate to supplemental benefits like private duty home care services. We discuss:<br> What is Medicare Advantage<br> MA plans offer supplemental benefits<br> CMS is realizing that SDOH determine health and cost outcomes<br> Who costs the system the most<br> Examples of supplemental benefits include things like home care and pest control<br> How many MA plans are there<br> SSBCI - special supplemental benefits for the chronically ill<br> How does an MA plan measure effectiveness of supplemental benefits<br> How do physicians order supplemental benefits for members<br> VBID model<br> Conversion rate from MA plan to private pay<br> What are the downsides of choosing an MA plan<br> Why MA plans care about the quality of supplemental benefits<br> MA plans as a percentage of total Medicare population by state (<a href="https://www.kff.org/medicare/state-indicator/enrollees-as-a-of-total-medicare-population/?activeTab=map&amp;currentTimeframe=0&amp;selectedDistributions=overall&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D" rel="nofollow noopener">Link</a>)<br> Link to Michael Hughes: <a href="https://www.linkedin.com/in/michael-hughes-7010221/" rel="nofollow noopener">https://www.linkedin.com/in/michael-hughes-7010221/</a><br> Video version: <a href="https://www.youtube.com/watch?v=7NrtiqkkHtQ" rel="nofollow noopener">https://www.youtube.com/watch?v=7NrtiqkkHtQ</a> </p> Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors, medicare advantage, home care, private duty Dr. Amy Schiffman and Dr. Alex Mohseni interview Michael Hughes, principal at Mitchell-Lowey, LLC, and do a deep dive into Medicare Advantage plans, especially as they relate to supplemental benefits like private duty home care services. We discuss:
What is Medicare Advantage
MA plans offer supplemental benefits
CMS is realizing that SDOH determine health and cost outcomes
Who costs the system the most
Examples of supplemental benefits include things like home care and pest control
How many MA plans are there
SSBCI - special supplemental benefits for the chronically ill
How does an MA plan measure effectiveness of supplemental benefits
How do physicians order supplemental benefits for members
VBID model
Conversion rate from MA plan to private pay
What are the downsides of choosing an MA plan
Why MA plans care about the quality of supplemental benefits
MA plans as a percentage of total Medicare population by state (Link)
Link to Michael Hughes: https://www.linkedin.com/in/michael-hughes-7010221/
Video version: https://www.youtube.com/watch?v=7NrtiqkkHtQ

]]> Dr. Amy Schiffman and Dr. Alex Mohseni interview Michael Hughes, principal at Mitchell-Lowey, LLC, and do a deep dive into Medicare Advantage plans, especially as they relate to supplemental benefits like private duty home care services. We discuss:
What is Medicare Advantage
MA plans offer supplemental benefits
CMS is realizing that SDOH determine health and cost outcomes
Who costs the system the most
Examples of supplemental benefits include things like home care and pest control
How many MA plans are there
SSBCI - special supplemental benefits for the chronically ill
How does an MA plan measure effectiveness of supplemental benefits
How do physicians order supplemental benefits for members
VBID model
Conversion rate from MA plan to private pay
What are the downsides of choosing an MA plan
Why MA plans care about the quality of supplemental benefits
MA plans as a percentage of total Medicare population by state (Link)
Link to Michael Hughes: https://www.linkedin.com/in/michael-hughes-7010221/
Video version: https://www.youtube.com/watch?v=7NrtiqkkHtQ

]]> Episode 4: Medicare Part D https://www.masteringmedicare.net/4 16de9237-3312-4017-b302-9195abd6f851 Tue, 10 Mar 2020 14:00:00 -0400 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. 15:53 no <p>In this Mastering Medicare episode, Dr. Amy Schiffman and Dr. Alex Mohseni do a moderate dive into Medicare Part D. We discuss the following topics:</p> <p>What is Part D Medicare<br> Opt in Part D<br> Premium calculation for Medicare Part D<br> What is the Medicare Donut Hole?<br> Medicare Part D Donut Hole <br> 4 stages of Part D<br> Part D deductible stage: first $435<br> Part D initial coverage stage: first $4,020, up to 25% of cost of medication<br> Tiers of medications in Part D<br> Part D tier 1 medications<br> Part D stage 3: donut hole, 25% patient responsibility<br> Part D stage 4: catastrophic stage, copay</p> <p>Visit Mastering Medicare at <a href="https://www.masteringmedicare.net/" rel="nofollow noopener">MasteringMedicare.NET</a> </p> Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors, part d In this Mastering Medicare episode, Dr. Amy Schiffman and Dr. Alex Mohseni do a moderate dive into Medicare Part D. We discuss the following topics:

What is Part D Medicare
Opt in Part D
Premium calculation for Medicare Part D
What is the Medicare Donut Hole?
Medicare Part D Donut Hole
4 stages of Part D
Part D deductible stage: first $435
Part D initial coverage stage: first $4,020, up to 25% of cost of medication
Tiers of medications in Part D
Part D tier 1 medications
Part D stage 3: donut hole, 25% patient responsibility
Part D stage 4: catastrophic stage, copay

Visit Mastering Medicare at MasteringMedicare.NET

]]> In this Mastering Medicare episode, Dr. Amy Schiffman and Dr. Alex Mohseni do a moderate dive into Medicare Part D. We discuss the following topics:

What is Part D Medicare
Opt in Part D
Premium calculation for Medicare Part D
What is the Medicare Donut Hole?
Medicare Part D Donut Hole
4 stages of Part D
Part D deductible stage: first $435
Part D initial coverage stage: first $4,020, up to 25% of cost of medication
Tiers of medications in Part D
Part D tier 1 medications
Part D stage 3: donut hole, 25% patient responsibility
Part D stage 4: catastrophic stage, copay

Visit Mastering Medicare at MasteringMedicare.NET

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