Category Archives: Medicare
Hospice care is always an extremely difficult situation, but the financial stress of end of life care is one issue that isn’t often considered. Hospice allows terminally ill people, as well as their families, to continue to live their lives with the most possible comfort.
Hospice care is also a more flexible care option than many people realize. Some hospice care patients receive their care in designated care facilities, while others may be cared for in the comfort of their own homes. In addition to better-known medical care options, hospice can also involve counseling services for both the patient and their families.
What Portion of Hospice Care Is Covered by Medicare?
Thankfully, Medicare is available to help make sure that everything we and our loved ones need is provided should hospice become necessary. However, there are still rules and regulations involved as to how much hospice care is actually covered by Medicare.
A given Medicare recipient must be eligible for and covered by Medicare Part A. They also need to be on record of having a proposed life expectancy of half a year (6 months) or less in order to achieve eligibility. Hospice care differs from traditional medical care in that it is focused on making a given patient comfortable during their final months of life, as opposed to actually treating the disease or attempting to cure it.
The hospice benefits provided to Medicare beneficiaries generally cover four distinct levels of care.
The four levels of care are:
- Routine Home Care
- In-patient Care
- Respite Care
- Continuous Home Care
The most commonly utilized type of care is routine home care. Rates and eligibility attached to each level of care can vary, so you may want to get in touch with a Medicare insurance representative in order to obtain more information pertaining to your situation.
Some hospice care services are also covered under Medigap, Medicare’s supplemental insurance program. However, there are several Medigap plan options available, so whether or not you or your loved one will be covered will depend completely upon which of these plans they’ve subscribed to.
At the end of the day, the reality of situations that require hospice care can be hard to get through, but the process becomes infinitely easier with Medicare in your corner.
Recently, President Barack Obama made public his plans for Medicare reform over the coming fiscal year. In a nutshell, his plan involves maintaining Medicare in its current form. However, his proposal also encourages emphasis on services of high value, as opposed to high cost by focusing on two areas:
1. Reform of the currently accepted payment system
2. The reduction of waste and fraudulent activity within the system itself
Premium Support under Obama’s Proposed Plan
Those who were worried about any possibility of Medicare or Medicaid becoming a premium, voucher-supported care system can rest easy. President Obama has made clear his opposition to any such implementation.
“What I will not support are efforts to turn Medicare into a voucher or Medicaid into a block grant,” the President is quoted as saying. “Doing so would weaken both programs and break the promise that we have made to American seniors, people with disabilities, and low-income families–a promise I am committed to keeping.”
Proposed Payment Reform
President Obama has also made clear his intentions to help maintain and reinforce the stability of Medicare. To accomplish this stability, newer Medicare beneficiaries will be responsible for payment on certain services. Government payments to providers of Medicare services will also be reduced in cases of nonpayment on the part of policyholders. There are also plans in place to reduce the federal subsidy of Medicare-related costs for those in the highest income brackets.
The physician payment system is expected to undergo reforms as well. Under the currently implemented system, the payments given to physicians are being determined by SGR (short for sustainable growth rate). SGR has traditionally added up to reduced reimbursements to physicians. However, Obama and the current administration plan to streamline a brand new system that will make payment rates much more predictable in the long run.
Addressing Chronic Illness
Last but not least, Obama has announced plans to address the problem of chronic illnesses such as heart disease, diabetes, and cancer. This will be done through expanded services through the ACA (Affordable Care Act). The aim is to detect these diseases and others like them early before they rage out of control in order to reduce the associated costs and improve the patient’s likelihood of recovery.
When it comes to your health, there’s really no such thing as being too prepared. Luckily, there are options like Medigap available to help cover the cost of healthcare for people over 65.
What Is Medigap?
Medigap is a supplementary insurance option offered in tandem with traditional Medicare insurance. It’s provided to the recipient through private insurance companies, but the benefits are standardized, so beneficiaries can generally expect the same coverage for a policy of a given letter. For example, all Medigap Plan F policies have the same benefits. There are several Medigap options available for purchase, each covering its own variety of benefits. Some are basics included in all plans, like blood or standard hospital benefits that may not be covered by the primary Medicare plan. Others cover additional options like hospice care, home care options, and inpatient services. Premiums and estimated annual costs vary from plan to plan as well.
How Do I Qualify for Medigap?
There are no set time frames attached to joining or leaving supplemental Medigap plans offered by Medicare. However, in most cases it is required that you be in relatively good health at the time of application in order to qualify for benefits. Nevertheless, there are other times that people are able to enroll in a Medigap plan regardless of current health concerns.
Guaranteed issue periods of qualification for Medigap usually are when a given patient is a new recipient of either Medicare Part A or Medicare Part B and is at an age of 65 years of age or older. Furthermore, these guaranteed periods last from 3 months to 6 months before you actually begin Medicare, as well as half a year after the month you are recorded as meeting all of the criteria attached to the guarantee.
There are sometimes special circumstances involved that can also result in guaranteed coverage under Medigap. These include your plan provider stopping coverage in the area in which you live, or moving out of an area where you’re covered.
However, it’s important to note that eligibility for these are can vary from situation to situation and individual to individual. Get in touch with your Medicare agent for the current Medigap plan you’re considering, in order to determine whether or not you qualify.
These days, we’re seeing more and more people exploring the world of electric wheelchairs from manufacturers like Hoveround and The Scooter Store, and with good reason. Electric scooters can drastically reduce the number of injuries elderly and disabled people sustain because of the superior degree of mobility they offer. In many cases, electric scooters are covered by Medicare.
If you suffer from decreased mobility and think you may be able to benefit from a power wheelchair, then it may really pay off to speak to your doctor or your insurance company about the potential benefits sooner rather than later. Medicare will typically pay for up to 80% of the costs of your new power wheelchair. If you have supplemental insurance, the entire cost could be covered.
However, deciding which of the two biggest power wheelchair suppliers to choose can present something of a challenge until you know the details. Let’s take a closer look at the benefits of each.
Hoveround
Hoveround has been in business for over 20 years helping people with limited mobility get around, so they definitely know their stuff when it comes to mobility. They provide a variety of different power chairs, electric scooters, and accessories in order to help each person find the option that will best fit their needs and their living space.. Hoveround has a proprietary design called Round for a Reason, which they say makes it easier to get around in than the competition. Most people cite this design as Hoveround’s major advantage. The product is guaranteed and delivered for free as well!
Scooter Store
Scooter Store customers also cite the breadth of the product line and the superior degree of coverage provided by Medicare as selling points attached to the brand. Portable versions are even available to help people get around when they’re on the go. The Scooter Store is also well known for the high degree of customer service offered to potential owners. Often, reps will happily travel to your home and even offer to fill out all the paperwork for you for your convenience.
Which Is the Right Pick for You?
Ultimately, Hoveround and Scooter Store both offer high quality products, so the best option is to speak with a representative of each company and choose the product that best fits your needs.
Almost all Americans turning 65 become eligible to collect Medicare benefits. Medicare is important because this aging population typically requires more care and is at risk for the development of more health issues.
Traditional Medicare
Most Medicare beneficiaries are eligible for both Medicare Part A and Medicare Part B. Part A generally covers hospital-related insurance and is offered to the beneficiary of the plan for free. Part B, on the other hand, usually requires the payment of a premium and encompasses other forms of medical insurance. Often times, Medicare beneficiaries use their part of their Social Security penefits to cover that cost.
Other Forms of Medicare
In addition to the traditional forms of Medicare discussed above, there are also supplemental forms of Medicare to consider. For instance, there is what is known as Medigap. Medigap is Medicare’s supplemental insurance system and it comes in a number of forms, designated plans A through N, each of which covers its own collection of services. Premiums attached will vary from plan to plan.
There are also Medicare Advantage options available, which is delivered by private insurance companies. These are actually different from Medigap, although it’s easy to confuse the two. Advantage is typically put in place instead of Medigap coverage, as opposed to in addition to it. Some Advantage plans don’t call for the payment of additional premiums and a few options even call for a refund of some of the Plan B premium.
Choosing Your Coverage
Which of the many Medicare options out there represents the best choice for you depends largely on your answer to a number of questions. To begin with, you will want to look into which plans are available in your area, as well as which plans are likely to include your existing hospital and doctor under coverage. (Most people prefer to stay with the health care provider and facility they know.)
Budgetary concerns are also something to consider. Some Medicare options are a lot more expensive than others and many offer much greater degrees of coverage. If you have certain medical conditions that will require special treatment or consideration, definitely keep those in mind when selecting your plan. Often, choosing the right coverage option for you involves weighing the benefits against the out of pocket costs and coming up with a happy medium that best covers all the bases.
While most people are aware of Medicare, not many people fully understand the different eligibility requirements, or in fact, what Medicare is. We hear phrases like “entitlement programs” and “welfare” tossed about, often in conjunction with Medicare. Those phrases can be mischaracterizations, though, and it is important to fully understand what you are dealing with before you start receiving benefits under this program.
What Is Medicare?
First and foremost, Medicare is a federal program that is run nationally, although some differences in the details vary from state to state. The program is run under the auspices of the Social Security Administration, which means that the benefits administered through the program are often connected with Social Security payments.
Medicare for Medicare Beneficiaries
The typical coverage for Medicare begins after an adult turns sixty-five. It is available as part of a retirement benefit of sorts that the Federal government makes available automatically to most adults.
Medicare for The Disabled
Certain disabled persons are eligible before they turn sixty-five. In order to qualify as disabled, you must go through a strict process of proof. In most cases, there is a requirement that you qualify for social security disability insurance in order to also receive Medicare as a disabled person. If you are applying for disability Medicare, there are several things you should know. For instance, there is a twenty-four month waiting period after qualification before Medicare benefits accrue.
Special Qualifications
There are other situations where an individual may qualify for Medicare. Two of these scenarios include individuals with Lou Gehrig’s disease and with End State Renal Failure. The delay in Medicare benefit accrual does not apply to those individuals with Lou Gehrig’s disease. People with End State Renal Failure may begin receiving benefits three months after the first dialysis treatment.
Still Have Questions?
When it comes to Medicare, there is a lot of information to take in, so don’t be discouraged if you are confused to start out. There are changes to the policies that affect Medicare every year, so it is important to make sure that you keep track of any changes that will make your coverage change. Stay informed, stay on top of things, and keep educating yourself. You can find out more about Medicare and the various policies you can choose from at www.medicare.gov.
Hearing loss is very common among aging adults. Your hearing loss may stem from several causes, though the most common is sensorineural. That means that the tiny hairs inside your ears have been damaged and are deteriorating, usually because of aging. You losing your hearing if you notice that straining to hear thing clearly makes you tired, or if you watch the mouths of people around you to understand what they are saying. Other troubling signs of hearing loss include having difficulty hearing people in public places where there is a lot of ambient sound, or if you often find yourself asking people to repeat themselves.
Hearing Aid Exams
The signs of hearing loss can be troubling, but you can do something about it. The first step is a hearing exam. You can ask your family doctor to administer this hearing exam, and if your doctor does not do these tests, you can ask for a referral to a hearing aid professional. There are two different kinds of hearing exams, but only one is covered by Medicare. The typical hearing exam, often similar to regular health checkups, is not covered.
If you want your hearing exam to be covered by Medicare, you should opt for a diagnostic hearing aid exam. It is based on medical need, which is often related to illness or surgery. These exams must be prescribed by your doctor.
Hearing Aid Specialists
There are many different healthcare professionals who qualify as hearing aid specialists. You may be able to get a Medicare-covered hearing exam from an audiologist, otolaryngologist, or a certified hearing aid specialist. These professionals can help assess your hearing loss and also if your loss is a good fit for hearing aids. Make sure that your specialist is trained and certified, and is using up-to-date testing equipment in a sound controlled room for accuracy.
Your Hearing Exam
Remember that your hearing exam should be ordered by a doctor in order to get coverage under Medicare Part B. You may also be able to get Medicare coverage for hearing exams following a loss of hearing due to accident, injury.
During a hearing exam, you should expect to have an ordinary conversation with your hearing aid specialist, at least to start. Make sure you have specific details to share about when your hearing loss began and when you have the hardest time hearing. You will also be tested using specialized hearing technology.
When you are deciding which Medicare Supplemental Insurance plan, or Medigap plan, to choose, you may wonder if there is any real difference between the plans. After all, these plans must be substantially the same, and they all must comply with State and Federal laws. Despite substantial similarities, there are differences that you should pay attention to when making your selection.
An Overview of Medigap
The Medigap program is not run by Medicare, but it is Medicare-approved and run by companies that have been approved to sell Medigap policies. When individuals decide to use Original Medicare, they may seek a way to get their policies filled in through the Medigap system. These policies allow you to pay coinsurance, co-pays, and deductibles for Medicare-covered services. Some other policies allow you to get coverage for conditions and treatments that are not covered by Original Medicare.
A Standardized Policy
Every Medigap policy must be clearly defined as Medicare Supplemental Insurance, and from state to state, those policies must be standardized, so that no matter what company you buy them from, you get substantially similar policies. The same basic benefits are available, and cost of the only really difference between the same lettered policy from different companies. For example, a Medicare Supplemental Part F policy from any company provides the same benfits. The only real difference is cost.
Buying Medigap Policies
There are certain times when you are guaranteed the right to buy a Medigap policy. For instance, if you are in a Medigap open enrollment period, you have the absolute right to buy such a policy. You also may buy Medigap at any time you have a guaranteed issue right.
At other times, you may still be able to buy a Medigap policy, but you are subject to denial by the insurance company for health reasons.
You Need To Know
In order to qualify for Medigap, you must have Medicare Parts A and B. If you have a Medicare Advantage Plan, but you want to return to Original Medicare soon, then you may still apply for a Medigap policy before your coverage ends. As long as you are leaving Medicare Advantage, it is legal for an insurance company to sell you Medigap coverage. You will pay a premium every month, and your policy will only cover you, not any other family members. As long as you continue to pay your premiums, your insurance company can’t cancel your policy.
The bottom line is,besides cost and the practioners who may be covered under your Medigap plan, there are no major differences from company to company for a given plan.
Medicare is available to adults ages 65 years old and older in most cases. You may also qualify for Medicare if you have certain disabilities, or if you suffer from Lou Gehrig’s disease or End Stage Renal Failure. Medicare is a nation-wide program that offers healthcare coverage to Medicare beneficiaries and the disabled for certain guaranteed prices. You are automatically enrolled in Medicare Part A and B. If you choose to supplement your Original Medicare coverage with a Medicare Supplemental Insurance plan, you may find that you have a lot to choose from.
Know Your Plans
Medicare Supplemental Insurance, or Medigap, is designed to fill in the gaps in Medicare Parts A and B coverage. These Medigap plans are controlled by federal and state law. They must offer certain standard benefits, and they must be labeled A through N. When you are choosing between the various plans, you must consider what you are being offered.
Plans A and B
In most cases, you will be required to take plans A and B. These plans relate to your Medicare Part A and B coverage. That means you will need to remember the premium payments and deductible for your Part B coverage. Parts A and B cover hospital and medical care.
Plans C through N
The differences between other plans offered to you will vary from state to state, and to some extent from insurance company to insurance company. You should pay particular attention to the deductibles and premium costs from plan to plan. While some coverage options are standard, there will also be some differences between the various plans over what is covered and what is not. For instance, you will see some differences in prescription drug coverage and treatments.
Make a List
The best way to make sure that you get the kind of coverage you need is to first determine what it is you need. Sounds simple, right? Just make a list of the various medications, treatments, and services that you require. Make sure you determine which are already covered by Medicare, and which you will need additional coverage for. You can eliminate the plans that do not provide coverage for the services and medication you require, and then narrow your options based on premium payments and deductibles. Choosing an insurance plan is difficult no matter what, and the best way you can insure you pick the right one is through careful preparation and research.
The Medicare Open Enrollment period is one of the most important times of the year for those who receive benefits under the Medicare program, and it is vital that you don’t let it go by without taking stock of where you are currently. If you are thinking about making changes to your Medicare coverage, or getting additional coverage, the time to do it is during open enrollment.
The Open Enrollment period for 2013 is October 15 through December 7.
Open Enrollment Defined
During the open enrollment period, all individuals who are enrolled in Medicare policies are allowed to make changes and update prescription drug and health plans for the New Year. Open enrollment is also the time for individuals who have not previously elected coverage have the option to do so. This period is usually over the holidays through late fall and early winter, but you should always make sure you know the precise dates for this period because it changes virtually every year. Missing it means that you will have to wait another full year until the next open enrollment period, unless certain qualifying events, which allow an individual to enroll outside of open enrollment, occur. Coverage for the new, adjusted plan would begin on January 1. Remember that your Medicare plan is an insurance plan, and that means that it can be adjusted yearly.
Adjusting Medicare Part D
One thing that many medicare beneficiaries examine when the open enrollment period arrives is their prescription drug coverage. With Medicare Part D, a phenomenon that regularly occurs is called the “donut hole.” This is a gap in coverage between the limit in coverage policy and the next year on the policy where the enrollee must pay all out of pocket costs. Thanks to the Affordable Care Gap, Medicare beneficiaries will be receiving some help on their donut hole spending in the future, including certain discounts and a boost in coverage limits.
Selecting Your Plan Adjustments
There may be many different Medicare options available to you during open enrollment, so don’t feel like you must be committed to the one you are using right now. This is particularly true when it comes to re-examining your Medicare prescription drug coverage. If your costs are too high, then it may be time to invest in a new policy. There are online tools that can help you determine the right plan for you, including a Medicare Plan Finder tool on the Medicare website at www.medicare.gov.
If you are happy with your coverage, that is great. You won’t have to worry about re-enrolling or doing anything at all during the open enrollment period. It is only for those who seek an adjustment to their coverage that the open enrollment period really matters.
