1. If you have to have any work done that is a qualified clinical laboratory service you owe nothing for the service.  This could be many different procedures or testing that has to do with your blood or general well being.
2. When home health services come in to play you pay nothing for Medicare approved services and only 20% of the amount for durable medical equipment.  This will help with anyone who is struggling with the decision of assisted living or staying home.
3. Mental health services are available to you and Medicare will pay 55% of approved services, meaning you are left with 45% to pay on your own.  This can be sometimes worked out with your therapist if you are not able to make timely payments.

There are some things that you should know about this payment, that will arrive in June if you have hit the coverage gap, so you don’t get scammed.  There is nothing due by you to anyone to have this payment initiated or sent to you, instead this is something that Medicare will automatically send out.  If anyone calls you asking for your personal information to get the payment, do not give it to them, it is a scam.

Everyone’s coverage gap will depend on the coverage they have and how much money they have paid out for prescription drugs.  When you receive your explanation of benefits it should tell you where you stand and if the payment is coming.  If you are at the coverage gap already your check will arrive in late June, if you reach the gap after the program has begun you will receive your check within 45 days after your gap is reached.

If you are not familiar with Diabetes Self-Management Training it is an amazing training experience that will help you deal with your lifestyle.  The course includes education about self-monitoring of your blood glucose as well as your diet and exercise.  On top of that you have the opportunity to learn a little more about the insulin that becomes so important to your life.

If you have been diagnosed with diabetes Medicare may also cover up to ten hours of initial diabetes self-management training and possibly two hours each year.  You qualify for the extra two hours if your training is provided in a group of 2-20 people, it lasts for at least 30 minutes and it takes place in a calendar year following the year you got your initial training.  Also, your doctor or a qualified non-physician practitioner must be ordered as it is a part of your plan of care.

In most cases, hospitals will be supplied by local blood banks that will not charge for the use of the blood.  These places have only the goal that the blood is put to good use and are not for profit.  However, in the event that you do need to get blood for any reason you may have to cover the first bit of blood that enters your body. 

The first three units of blood that you are given in a calendar year, if not from a blood bank, will be on your dime.  After this the Medicare Part A coverage will kick in to help you with the expenses that you incur.  There is one last solution to the Medicare Part A blood issue, you could have someone donate blood to the hospital specifically for use by you.  How does that sound for a birthday present?

One of the biggest and possibly soonest changes under the new healthcare plan to Medicare benefits is the free checkups and screenings.  This is part of Obama’s changes that he wants in force next year and it would entitle all beneficiaries, even if they do not change insurance plans, to get a free annual checkup and free screening.  These changes would benefit thousands or possibly millions of Medicare beneficiaries across the country.

The free screenings could include preventative measures such as colonoscopies and mammograms, which would be a relief to many.  These changes to Medicare benefits have not been made or put in force yet, but the final steps are being walked in Washington right now.  Be sure to check back for other possible changes to Medicare benefits with the new healthcare plan.

• Fecal Occult Blood Test—Once every 12 months if age 50 or older. No cost for the test, but you generally have to pay 20% of the Medicare-approved amount for the doctor’s visit.
• Flexible Sigmoidoscopy—Generally, once every 48 months if age 50 or older, or 120 months after a previous screening colonoscopy for those not at high risk. You pay 20% of the Medicare-approved amount.
• Colonoscopy—Generally once every 120 months (high risk every 24 months) or 48 months after a previous flexible sigmoidoscopy. No minimum age. You pay 20% of the Medicare-approved amount.
• Barium Enema—Once every 48 months if age 50 or older (high risk every 24 months) when used instead of a sigmoidoscopy or colonoscopy. You pay 20% of the Medicare-approved amount.

Again, if you think you are going to have to use Medicare Part B for any of the above you should always consult your doctor first.

Here are three ways that you may qualify for Medicare Part D Extra Help.  You only have to be able to answer yes to one of these questions.

• You have full Medicaid coverage.
• You get help from your state Medicaid program paying your Part B premiums (belong to a Medicare Savings Program).
• You get Supplemental Security Income (SSI) benefits

If you qualify based on one or more of the preceding points then you could get Medicare Part D Extra Help to give you a little more assistance.  Understand that there are other possible income requirements, but being a part of one of the above groups will likely include you in those requirements as well.

Medicare Part A does not cover the following:

•Private duty nursing is not covered and should not be considered a part Medicare Part A.  This will likely have to be covered by personal funding.

•A television or telephone in your room or personal care items like razors or slipper socks will not be covered by Medicare Part A.  Make sure you have someone that can bring you these things while you are in the hospital.

•A private room unless medically necessary will not be covered by Medicare Part A.  This is viewed as being an extra benefit not a necessity.

•The first three pints of blood unless the blood deductible has been met will not be covered by Medicare Part A.  This is good to know if you have already paid your deductible for the year.

The doctor services you get while you are in a hospital may be filed under Part B.  Don’t forget that some of the above may also be covered under other parts of Medicare, but not under Medicare Part A.

How to decide if you will pay out-of-pocket with Medicare benefits:

• Your out-of-pocket costs could be greatly reduced if you inform your doctors that you want to sign a Medicare benefits private contract.
• Be very honest when explaining the type of health care and why you need it when trying to get enrolled.  You’ve got to know that this will affect your pocketbook if you enroll in Medicare benefits that don’t suit you.
• If you choose to get Medicare services or supplies that are not covered by your Medicare benefits they will be charged at full cost to you.  In other words, be careful that the Medicare benefits you enroll in are the benefits that you need to survive.

In short, the message is this, the more research you do during enrollment the more of a chance you have to pay lower out-of-pocket costs.  Medicare benefits can only take you as far as you allow them to.

This new addition to Medicare benefits will assist you financially in taking care of the tab when you visit a doctor, psychiatrist or social worker to treat your mental health condition.  If you are diagnosed and being treated for your mental health condition then this Medicare benefit will cover more than if you are not.

When you are going to a doctor to be diagnosed for a mental health condition then this Medicare benefit will pay 20% of the amount that is approved by Medicare.  This same 20% applies to the Medicare benefit when you monitor or change your prescription that treats your mental health condition.

If you are receiving treatment for your mental health condition, such as trips to see a therapist or going through therapy then you will pay 45% of the Medicare approved amount under this Medicare benefit.  This amount will decrease over a 4 year period as part of your Medicare Part B deductible.