Medicare Benefits




Weighing your Options: How to Choose a Medicare Plan


Sometimes, the more important the choice we need to make, the greater our indecision, especially when it comes to our health care.  Between Original Medicare, various Advantage Plans, or other Medicare health plans, it can sometimes seem difficult to know where to begin when choosing your plan.  By focusing on a few key areas, however, you can compare your options to your medical needs and make a confident, self-assured decision.

 The first thing you may want to think about is what, specifically, your coverage needs are.  If you use prescription medication on a fairly regular basis, or think you may in the future, make sure you sign up for a Medicare drug plan – or that your plan includes drug coverage.  If you have additional needs, like dental or vision, you may want to choose a plan that offers extra benefits. 

 Next, you will want to look at your choices in health providers.  Because most Advantage Plans require you to use certain doctors and hospitals only, it is important to find out if your doctor is on an Advantage provider network or not.  You will also want to consider how important choices in hospitals and doctors are and how convenient you need your care. It’s a good idea to look at network care provider’s hours and locations and whether or not you are confident of the quality of care offered at these sites.

 Finally, consider the costs.  Premiums, coinsurance, copayments, and deductibles all make a difference in your expenses.  Find out how much you will be required to pay in each plan, where there may be extra fees involved, and how you can best afford care that meets your medical needs.

 By considering coverage, providers, and costs, you can reflect on your needs and successfully compare plans.  Most importantly, you will be able to select a plan that offers you sense of security and peace of mind.

Medicare Part B: A Quick Overview of Medicare Part B


You may already know that Medicare is a health insurance program that is federally funded for the senior citizen above the age of 65. There may be certain individuals who might meet the specific requirements that are needed to qualify for the coverage even if they are less than 65 years, they may be suffering from permanent kidney failure, Lou Gehrig’s disease or maybe receiving Social Security benefit once for at least within 24 months. Medicare is divided into two parts, part A and part B; we will familiarize you with the Medicare part B.
 
Medicare Part B is a coverage that takes care of several outpatient services. It is a voluntary service for the individual receiving Medicare. This may include the expenses such as, outpatient hospital visits, doctor visits, medical equipment, mental health services and other diagnostic tests. The amount that you have to pay for the Medicare part B totally depends up on your income. The costs for these services are basically deducted from an individuals Social Security check every month prior to its arrival in your mailbox.

Medicare Part B pays for certain medical equipments such as oxygen tanks, wheelchairs, walkers, neck, leg, scooters, electric wheelchairs, arm and back braces, eye glasses and more. You might get confused at times, since the Medicare Part B does not cover the expenses that may not be related to medically equipment such air humidifier and safety bars. With the Medicare Part B, you will see that some of the medical equipment will be brought while there are some items that will have to be rented.

You can also receive certain coverage for preventive procedures by the Medicare Part B. the very first thing that you will receive is a physical within six months after its allotment. You will receive triglycerides and cholesterol testing once in two years. Individual who are deemed to be at high diabetic risk are also covered by Medicare Part B. The annual mammograms such as PAP, pelvic examinations are also covered every two years. Certain screening of colon cancer is also covered by it.

Medicare Part B is an affordable service that can be purchased by any individual who require them, who receive Medicare or Social Security benefits. It will cover most of your medical expenses for outpatient doctor visits, preventative screenings and medical equipment items.

If you do not get the Medicare Part B services, your medical weakmess may take a toll on your financial condition since they can be quite expensive. It is also important to enroll in Medicare Part B right away when you enroll for Medicare A because if you add it later, it can cost considerably more.

Planning Ahead: When to Sign Up for Prescription Drug Coverage


It’s surprising how many people who have Medicare decide not to sign up for the prescription drug coverage available to them when first eligible, making it necessary to, when they later change their minds, pay penalties for late enrollment.

Under normal circumstances, you can only join a Medicare drug plan during specific time frames. The logical time to sign up, even when it seems you may not need it, is when you first become eligible for Medicare; three months prior to turning 65 and three months immediately after. Personal health situations and thought processes change so quickly that planning ahead simply makes the most sense!

You can also apply for coverage between November 15th and December 31st each year, your coverage then beginning on January 1st. If you are receiving Medicare because of a disability, you can sign up for drug coverage three months before to three months after your 25th month of cash disability payments. Some situations, however, allow you to join a prescription drug program at other times, like if you qualify for extra help, move out of your service area, or live in an institution.

Of course, not all plans cover all medications. It’s essential that, if you do decide to sign up for coverage with Medicare, you research the various plans in order to select the one that best meets your needs.

Evaluating Options: Choosing a Medicare Prescription Drug Plan in 2008


If you have Medicare Hospital Insurance and/or Medicare Medical Insurance, signing up for an additional Medicare prescription drug plan is always a good idea, especially if you spend a great deal of money each year on medication. These drug plans, offered to you through private companies working with Medicare, have different costs and diverse types of coverage. Consequently, finding the right plan can seem daunting when you’re faced with the many options available to you.

A good place to start when choosing a prescription drug plan is by figuring out what type of medication you most frequently purchase. In many plans, medications are organized into “tiers” of various costs. The type of drugs for which you need coverage will affect the tier, or category you fall into, impacting the cost to you. Some plans have more tiers than others. You will also want to make sure the drugs you use most are, indeed, on the plan’s coverage list.

Weigh the overall cost of the plans, considering the medications you will most need covered. Some plans will require a deductible and/or a monthly premium, and some won’t. Additionally, you want to make sure the plans you consider allow you to use pharmacies you are comfortable with. Some will limit accepted pharmacies.

Fortunately, if you’re feeling overwhelmed, there are a number of resources available to you. Online, you can find help at www.medicare.gov. You can also call 1-800-633-4227. Finally, you can call your State Health Insurance Assistance Program.

Whatever you do, don’t let uncertainty about drug plans deter you from choosing the right one for you! Once you find a Medicare prescription drug plan that best suits your needs and are able, then, to better afford the medication you need, you will be on your way to a healthier, happier you.

Medicare Scooters: Who Is Covered?


If you are one of the many disabled people in the United States who is currently covered by Medicare, you can’t help but wonder if scooters or Power Operated Vehicles (POVs) are covered by Medicare. The fact that scooters or POVs are quite expensive, you will want to know if you will be reimbursed by Medicare in case you purchase one for maximizing your mobility.

The good news is Medicare will be able to cover the expenses you incur when you purchase a scooter. However, you first need to meet certain conditions in order for you to be covered.


Free Power Wheelchairs for Medicare Patients!

The first requirement is that you should have a condition that will make it medically necessary for you to use a scooter or POV. You will need to have a certification from your physician that you do need to have a scooter in order for you to maximize mobility.

Another condition is that you should be able to properly and safely operate the scooter and that you cannot operate a regular wheelchair or manual wheelchair because of your condition.

Usually, Medicare will be able to cover about 80 percent of the total expenses you incur when you purchase the POV or scooter. The rest of the 20 percent can be shouldered by you or if you have a supplemental insurance or Medigap, you will be able to use it to cover the rest of the cost.

As you can see, Medicare will be able to cover the purchase of scooters or POVs. If you meet all the criteria or conditions set by Medicare, your scooter purchase will be able to be reimbursed by Medicare.

Medicare Part D Prescription Drug Plan: Giving You Coverage for Your Prescription Drug Needs


If you are under Medicare Part A or Part B, you will see that there is another kind of Medicare Plan which will enable you to take advantage of getting your prescription drugs covered. Commonly known as Medicare Part D, this Prescription Drug Plan from Medicare is very appealing to people under Medicare coverage, especially to those who need to fill their prescription on a constant basis.

Basically, the Medicare Part D or the Prescription Drug Plan works just like any other prescription drug insurance available in most health insurance policies today.

If you enroll in Medicare Part D, you will be signing up with a private insurance company which is appointed by Medicare to administer the plan. If you are interested to get covered under Medicare Part D, you need to remember that the private providers of this plan may vary from state to state or region to region. There are basically quite a number of providers that you can choose from and even more plans to choose from under the Medicare Part D.

Basically, all these plans may cover prescriptions in a different way and it may not cover all the prescription medications you take. This is why you need to choose which Medicare Part D plan you should enroll at in order for you to take advantage of its offers or coverage.

In order for you to know which plan you should sign up for, you may want to first list all the prescription medications you take with the brand and generic name and also take note of how often you take them. Next, you will want to contact Medicare and ask them for a list of Part D providers in the area you are currently residing in.

After receiving the list of private insurers who can cover Part D Medicare coverage, now is the time to shop around and ask what kind of prescription medications is covered under the available plans. By doing so, you will be able to know which one can cover most of the prescription medications you take and really take advantage of the benefits it provides.

Medicare Electric Wheelchair Coverage in 2008: Are You Covered?


Many people with Medicare usually ask whether they are covered by Medicare for an electric wheelchair. You have to consider the fact that electric or powered wheelchairs are quite expensive and therefore, it can be quite difficult to decide whether or not you should get one.

The great thing about Medicare is that it does indeed cover electric wheelchairs. However, you need to remember that Medicare will usually cover only 80 percent of the cost when you purchase an electric wheelchair and the rest will be up to you or it can also be covered by a secondary health insurance, such as Medigap or commonly known as Medicare supplemental insurance.

However, in order to be covered by Medicare, you need to meet the following criteria:

•    Your condition is such that it is necessary for you to have a wheelchair for mobility.

•    Electric wheelchairs should be medically necessary because of your condition and that you are not able to operate a wheelchair manually.

•    You should be capable of operating the controls of the electric wheelchair.

You should also be certified by a physician to be physically disabled and that you need an electric wheelchair for mobility.

If you meet all the criteria stated here and you are covered by Medicare, then the electric wheelchair that you need will be covered by Medicare. If all the cost are not covered, you can cover it with your own money or you can use your secondary health insurance or supplemental insurance plan to cover the rest of the cost.

These are the things that you need to know about Medicare and electric wheelchair.

Dialysis and Medicare: The Included Coverage for End-Stage Renal Disease


A lot of people have end-stage renal disease or what is commonly referred to as permanent kidney failure. This kind of disease has no other treatments but with kidney transplant and through regular dialysis treatments, an afflicted person can have great relief.

Mind you, you need to remember that dialysis can be quite costly. Some people even gave up the treatment because of the steep price.

So, if you or someone you know has end-stage renal disease, or permanent kidney failure, you may want to know about Medicare and its coverage for dialysis.

If you have permanent kidney failure and you need to get regular dialysis treatments or get a kidney transplant surgery, you will be able to get Medicare Part A no matter how old you are. However, you also need to meet the following conditions, such as:

•    You need to have worked for the required amount of time under Social Security, as a government employee, or under the Railroad Retirement Board.

•    Or, you can also qualify for Medicare Part A if you are already eligible or have been getting benefits from Social Security and the Railroad Retirement Board.

•    Also, you will be able to qualify if you are the spouse or a dependent child of a person who has worked the required amount of time to be eligible for Medicare or the person is already receiving benefits from the Railroad Retirement Board or Social Security.

If you are going through dialysis, it is a good idea to also get Part B of Medicare as you will need both Part A and Part B in order to cover most of the costs of treatments you will incur with dialysis.

As you can see, Medicare will be able to cover dialysis treatments. So, if you or someone you know has permanent kidney failure, you may want to try applying or recommend someone you know with this disease to apply for Medicare

Medicare Benefits Updates for 2008: Learning About the Benefits That You Will Get With Medicare On 2008


Medicare is considered to be one of the best health insurance providers in the United States. If you want to know what kinds of benefits that you will get from this kind of health insurance plan, then you should know about what’s new and what to expect in the year 2008.

Medicare benefits updates for 2008 include updates of the original Medicare, Medicare Health Plans, such as HMOs and PPOs, Medicare Prescription Drug Plans, and Medigap or the Medicare Supplemental Insurance policies.

In the original Medicare plan, you will see that this is a fee for service plan that is currently managed by the Federal Government. Here, you will need to use your red, white, and blue Medicare card if you are going to get health care from physicians and other health care providers.

The great thing about this plan is that you will be able to go to any doctor or supplier that accepts Medicare and is accepting new patients who are also under the original Medicare plan.

You will also need to pay a certain amount for your health care that is not considered to be covered by Medicare before Medicare pays for what’s covered. Or, you might also want to use the Medigap policy to cover the things that Medicare does not cover.

With the original Medicare, you will be able to get a Medigap Policy if you choose to do so. This particular policy will pay for the deductibles or the part which Medicare does not cover.

With the Medicare Advantage Plans, you will see that the plans here are run by private companies but are approved by Medicare. The plans here will sometimes require referrals to see specialists. Also, you will be able to benefit from the plans here as the cost of services can be lower than the original Medicare plan. The Medicare Advantage will also provide all your Part A and Part B coverage and will cover services that are considered to be medically necessary.

These are just some of the updates available for the Medicare benefits in 2008. If you wish to know more about the other updates, you may want to visit Medicare or the Medicare website. Here, you will be able to find out more about the other updates in 2008 regarding the benefits.

Will Medicare Package Be Added?


The legislation that could thwart middle-class U.S. citizens from paying the alternative minimum tax was moved to the House floor recently and did not contain any of the Medicare provisions that would hold up the scheduled 10% fee cut for physicians. Senate Finance Committee Chair Max Baucus had said that, “Medicare probably has to go with AMT” as the measure is “very bipartisan”. However, the House made the conclusion to move along with the AMT measure derailing one of the best options for a Medicare package and increases the possibility that the Medicare physician fee cut will take effect Jan. 1, 2008. Read more…

Funding Increased For Hospitals In Orange And Dutchess Counti


Seven hospitals across Dutchess and Orange counties are a few steps closer towards hiring more nurses and improving the quality of patient care, thanks to the approval of $12 million dollars from the Senate. U.S. Senator Charles E. Schumer announced the Senate Medicare package qualifying the aforementioned hospitals for funding thanks to their status as New York Section 508 hospitals.

He fought for these hospitals to obtain this funding since the Section 508 program funding had expired last fall. The seven hospitals will now receive additional funding: Northern Dutchess Hospital receives $543,240, Bon Secours Community Hospital receives $1,271,500, Orange Regional Medical Center receives $525,090, St. Anthony Community Hospital receives $791,700, St. Francis Hospital receives $1,187,200, St. Luke’s Cornwall Hospital receives $3,905,600 and Vassar Brothers Medical Center receives $3,960,600. Read more…

Different Cost And Benefit Options In The Medicare Drug Plans


A Part D plan does not have a limit on income, prescription or state of health. To receive Medicare the person only needs to be over 65 or disabled. If one has traditional Medicare, then a Medicare Part D can be opted for through a private drug plan.

There is an open election period that commences 15th November and goes on till 31 Dec and the coverage comes into effect from January 1. Here you select a Medicare Part D prescription plan and get a card for plan members which you use to get prescriptions filled at the pharmacy. To lower costs there are some plans which can be availed by low-income patients. This is called a “formulary”. Here there is a list of specific drugs for selected diseases. These do restrict the choice of drugs but can save money. Read more…

A Rational Health Care Prescription


There is an urgent need to address health care issues in the US. Unchecked health care spending is on the rise. The citizens of the US are given information which indicates that it is the problem of the uninsured people that is of paramount importance as there are about 47 million uninsured today. But it is the ramifications of uncontrolled spending, which are either lost on the politicians or they choose to turn the other way, which sparks the most debate as an increase in spending on health care generates politically rewarding benefit. Read more…

Colonoscopy? What’s The Need?


Colon cancer is the second major cause of cancer deaths. According to the latest reports from the Agency for Healthcare Research and Quality, less than 50% of Americans who are over the age of 50 have had a screening of the colon done.

Now when this is broken up, the picture that emerges is even clearer. Among the whites, there was no screening done for over 47%, while for the blacks it was over 55%. Among the Hispanics though, the figure goes to a little under 70% and this rises even further when it comes to older people who are not insured. Read more…

Medicare Reimbursement for Diabetic Shoes


As a diabetic, you know that you need to be careful on every move you make and every step you take. A simple wound will be quite hard to treat and it takes a long time to heal. In most diabetics, most of them suffer injuries on their feet because of improper footwear. This is why you, as a diabetic, will need special diabetic shoes in order to prevent blisters and also to let you do your daily activities without worrying about injuries on your feet.

Wearing regular footwear can be harsh on diabetics. You have to consider the fact that it may cause the soles of the feet to develop blisters. If you are active and that you are diabetic, you will need to get therapeutic shoes. With statistics showing that there are about 54,000 diabetic amputations done in the United States each year, you too should be concerned about it. Read more…

More Generic Drugs Rather Than Branded Ones Under Medicare?


The announcement last year by the Centers for Medicare and Medicaid Services was that only US FDA approved drugs would be covered under these schemes when it came to any particular health problem. So if you want a particular drug for a particular ailment, it has to be in the Medicare formularies list.

However, many of the drug plans under Medicare are not too clear about which drugs they cover so it means that seniors could very well be in a quandary about what to buy and what not to when it comes to prescription drugs for their ailments. Read more…

Long-term Care: Should Private Players Remain In The Fray?


Medicare is significantly conspicuous by its absence in the long-term care arena. With Medicare coverage, it is expected that you fall ill and recover. However, with a population that includes so many older people, this isn’t always the case. Then where do they go for their medical coverage?

It was therefore to fill the gap that private insurance companies entered this vacuum and offered policies that promised long-term care. These policies provided a wide-spectrum coverage of long term care – both in the home or in a nursing home. However, the premiums were high and there were instances of fraud which resulted in these plans not being really feasible. Considering that over 40% of senior U.S. citizens can afford to pay for long-term coverage and less than 10% are actually covered speaks volumes for the faith people have in these instruments. Read more…

What Is Hospice Care and Is it Covered?


Health care is something that people needs in order to stay healthy and also to regain their health. However, time comes where the different kinds of treatments will become futile and will have no effect anymore. If a person reaches this kind of condition, they may choose to spend their last months on hospice care.

Hospice understands that dying is the last stage of life and that the patient receiving hospice care should die with dignity. Hospice care will provide terminally ill people help on easing the thought of death. Here, life of the patient will not be prolonged but will be improved even when facing death. Read more…

Medicare and Nursing Home Coverage


If you or someone you know needs skilled nursing facility care services, it is important that you should know about Medicare and its current view on nursing homes. Basically, Medicare will be able to cover treatments on this facility as it will also be able to provide you or someone you know with skilled nursing care or rehabilitation services.

However, Medicare will not cover custodial care. You have to remember that getting skilled nursing facility care and custodial care are different.

Medicare will be able to cover the expenses you or someone you know incurs in a skilled nursing facility for up to one hundred days. However, it is important that the patient should be able to continue and meet the requirements set by Medicare. Read more…

Medicare Approved Diabetic Supplies: What is Covered?


As a diabetic, you know that properly maintaining your blood sugar or glucose level is one of the most important factors in order for you to live a life that is as normal as possible. You will also need different kinds of equipments in order for you to measure your glucose levels everyday.

However, you need to consider the fact that medical supplies for diabetics can be quite expensive, especially the glucose testing supplies. This is why you may want to use your Medicare in order for you to make it easier on your pocket when it comes to spending for the supplies you need. Read more…