Abstract

Many Medicare recipients and social work advocates assume this program of federal health care insurance for the elderly and disabled to be relatively trouble free and, therefore, not relevant for advocacy efforts. Only when confronted with a reimbursement denial do the internal complexities and contradictions of the Medicare program, and the resultant need for advocacy, become apparent to recipient and worker alike. This paper presents a conceptual framework and advocacy perspective on Medicare's structure, benefits, and appeals procedures in order to aid a social work advocate in deciding whether to deal with recurrent Medicare problems through techniques to maximize benefits, appeals procedures, or legislative advocacy.

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