Who Is Eligible for Both Medicare and Medicaid in 2025 | Forbes Health Who Is Eligible for Both Medicare and Medicaid? The Complete 2025 Guide for Dual Eligibility and Smarter Healthcare Coverage Quick Summary If you’re a low-income senior, disabled individual, or caregiver helping someone manage medical costs, dual eligibility for Medicare and Medicaid could … Read more
You can find out if you’re eligible for Medicaid by checking your income, household size, age, disability status, and state of residence. The fastest way is to visit your state’s Medicaid website or the federal marketplace (HealthCare.gov), where you can fill out a short eligibility form. Generally, adults earning up to 138% of the federal … Read more
To qualify for Medicaid long-term care in 2026, applicants must meet both medical and financial requirements. They must demonstrate a medical need for daily assistance with at least two Activities of Daily Living (ADLs), such as bathing, dressing, or eating. Financially, most individuals must have income below about $2,829 per month and countable assets under … Read more
2026 is shaping up to be a landmark year for American healthcare. Major shifts in Medicare and Medicaid policy will impact coverage options, drug pricing, eligibility, and the way federal funds are distributed to states. Whether you’re a senior, healthcare professional, or policy watcher, understanding these updates is essential not just to stay informed, but … Read more
In the world of medical billing, the tiniest details can make the biggest difference—especially when it comes to modifiers. Two of the most commonly misunderstood are modifier 25 and modifier 59. To the untrained eye, they may seem interchangeable. But in reality, using the wrong one could trigger denials, audits, or even compliance issues. If … Read more
Modifier 23 means “Unusual Anesthesia.” It’s appended to a surgical procedure code to indicate that anesthesia services were more extensive than typically expected due to unusual circumstances. CPT Definition: Modifier 23 – Unusual Anesthesia: “When a procedure which usually requires either no anesthesia or local anesthesia must be done under general anesthesia due to unusual … Read more
While medical coders and billers both contribute to the healthcare revenue cycle, their roles serve different but complementary purposes. Medical coders translate doctors’ notes, test results, and procedures into standardized codes like ICD-10 and CPT. These codes are essential for insurance documentation and accurate patient records. In contrast, medical billers take those codes and prepare … Read more
Whether you’re a student learning medical billing, a healthcare provider, or a patient reviewing your surgical charges, understanding the difference between global periods and postoperative care billing can help you avoid confusion and billing errors. Where to Learn About Global and Postoperative Periods If you want reliable, up-to-date information on surgical billing rules, start with … Read more
In medical billing, the terms “clean claim” and “dirty claim” are more than just jargon, they directly affect how quickly healthcare providers get paid. A clean claim is one that is accurately completed, properly coded, and submitted in compliance with the payer’s guidelines. It processes smoothly and typically results in timely payment. A dirty claim, … Read more
In medical billing, authorization and referral serve different purposes, though both are crucial for insurance coverage and patient care. Simply put, authorization is permission from the insurance company for a service, while a referral is a recommendation from a primary care provider (PCP) to see a specialist. Let’s break down the details to help you … Read more
