Medicare News Center: All About Medicare Benefits & Eligibility News » Medicare Eligibility http://medicarenewsline.com Medicare Benefits, News & Application Information Tue, 15 May 2012 03:19:52 +0000 en hourly 1 http://wordpress.org/?v=3.0 Long-Term Care is NOT Covered by Medicare in All Situations http://medicarenewsline.com/long-term-care-is-not-covered-by-medicare-in-all-situations/medicare-eligibility/ http://medicarenewsline.com/long-term-care-is-not-covered-by-medicare-in-all-situations/medicare-eligibility/#comments Sun, 15 Apr 2012 02:44:28 +0000 staffwriter http://medicarenewsline.com/?p=561 Long-term care is important in your life when it comes to being elderly or sick and this makes having the right insurance coverage vitally important.  The problem with this is that Medicare doesn’t necessarily cover this type of care when you might really need it.  Here is the definition by Medicare of what type of long-term care is covered and what type is not.

“Long-term care encompasses a variety of services that help people with health, personal needs, and activities of daily living over a period of time. This care can be provided at home, in the community, or in various types of facilities, including nursing homes and assisted living facilities. Most long-term care is custodial care. Medicare doesn’t cover this type of care if this is the only kind of care a person needs.”

Reading this care the right way is important because the last line defines what Medicare is trying to avoid doing.  They do not want to pay for long-term care if that is the only type of coverage that is needed.  This is typically how the insurance will work, it will cover the unforeseen events, not those that are predictable.

]]> http://medicarenewsline.com/long-term-care-is-not-covered-by-medicare-in-all-situations/medicare-eligibility/feed/ 0 Stopping Medicare Supplier Fraud: Doctor Requirements are a Red Flag http://medicarenewsline.com/stopping-medicare-supplier-fraud-doctor-requirements-are-a-red-flag/medicare-eligibility/ http://medicarenewsline.com/stopping-medicare-supplier-fraud-doctor-requirements-are-a-red-flag/medicare-eligibility/#comments Sun, 11 Dec 2011 03:57:32 +0000 staffwriter http://medicarenewsline.com/?p=550 Any insurance company in any field of insurance should know better than to require you to see anyone to fix whatever your need for insurance is. Car insurance companies cannot require that you go to one particular body shop and health insurance companies cannot require you to go to any one particular doctor. This is another form of Medicare supplier fraud that is becoming an issue, when suppliers are requiring participants to see specific doctors before receiving any further materials.

What insurance companies can do is recommend someone to you that can help you with an issue, but requiring any one person or place is a conflict of interest. You have the ultimate right to decide who will help you with your issue and if you choose that person to be different than the insurance company so be it. Your right as an American is to treat yourself the way you wish to be treated so you can do the same with your insurance.

Any supplier that tries to force you to see one particular person should be reported to the Medicare authorities to be handled immediately. This is not a practice that Medicare makes regular habit so you should not expect that you will have to go to anyone to get supplies. Direct your questions about care to your healthcare provider to guarantee you are getting the care that you need.

]]> http://medicarenewsline.com/stopping-medicare-supplier-fraud-doctor-requirements-are-a-red-flag/medicare-eligibility/feed/ 0 Medicare Long Term Care Options for 2012 http://medicarenewsline.com/medicare-long-term-care-options-for-2012/medicare-eligibility/ http://medicarenewsline.com/medicare-long-term-care-options-for-2012/medicare-eligibility/#comments Mon, 07 Nov 2011 15:49:16 +0000 staffwriter http://medicarenewsline.com/?p=538 A few options are available for long term care and how to pay for it in Medicare for 2012. You would have total control over how to pay for your long term care if you used your savings, but that is a risky chance to take. You could go through a local or community group to have long term care covered or you could purchase coverage outside of Medicare.

If you are one of the unfortunate people that doesn’t have the other options, there are a few things for you to think about.

1. Medicaid: You have the option of more coverage through Medicaid as they are a combination of state and federal aid groups.

2. VA: You can often get the long term benefits that you need through the Veterans assistance programs.

3. PACE (Programs of All-inclusive Care for the Elderly): You can stay in the community and get the nursing home level care that you need with this Medicaid and Medicare program.

4. The Community Living Assistance Services and Supports (CLASS) Program: Living as independently as possible is the goal here and this national voluntary program will do everything to make it possible. CLASS isn’t available yet. Eligible working adults will be able to enroll in the CLASS program when it begins. Enrollees who meet certain eligibility requirements (including at least a 5-year vesting period and the need for assistance with activities of daily living) will have access to the benefit.

]]> http://medicarenewsline.com/medicare-long-term-care-options-for-2012/medicare-eligibility/feed/ 0 Medicare and Therapeutic Shoes or Inserts for Diabetes http://medicarenewsline.com/medicare-and-therapeutic-shoes-or-inserts-for-diabetes/medicare-eligibility/ http://medicarenewsline.com/medicare-and-therapeutic-shoes-or-inserts-for-diabetes/medicare-eligibility/#comments Mon, 05 Sep 2011 02:51:03 +0000 staffwriter http://medicarenewsline.com/?p=518 Diabetes can wreck havoc on a person’s body and one of the places where this is most apparent is when you look at the feet of a diabetic.  If this person has diabetic foot disease you will notice that great help and support is needed for the feet of the patient.  Medicare can help in the way of diabetic foot wear and inserts to protect the feet.

Medicare Part B covers therapeutic shoes or inserts for people with diabetes who have severe diabetic foot disease.  This is good news for you but there is something that you must do to ensure that this will occur in your situation.  The doctor who treats your diabetes must certify your need for therapeutic shoes or inserts.

The shoes and inserts must be prescribed by a podiatrist or other qualified doctor and provided by a podiatrist, orthotist, prosthetist, or pedorthist.  

Medicare helps pay for one pair of therapeutic shoes and inserts per calendar year. Shoe modifications may be substituted for inserts. Medicare covers the fitting of the shoes or inserts for the shoes.  In 2011, it is your obligation to pay 20% of the Medicare-approved amount.

]]> http://medicarenewsline.com/medicare-and-therapeutic-shoes-or-inserts-for-diabetes/medicare-eligibility/feed/ 0 Medicare and Cancer Screening http://medicarenewsline.com/medicare-and-cancer-screening/medicare-eligibility/ http://medicarenewsline.com/medicare-and-cancer-screening/medicare-eligibility/#comments Wed, 11 May 2011 03:22:39 +0000 staffwriter http://medicarenewsline.com/?p=469 Everyone has encountered someone in their lives that is struggling with or has passed away due to cancer. The widespread nature of the condition has made it to where people are aware of the need for research to cure cancer. Preventative screening is always a good idea regardless of whether or not the doctors have found a cure yet.

Multiple different kinds of cancer screening are available if you are in a situation in which you need something to be tested. Annual mammograms are available to women over 40 and colorectal tests are performed as well. Every 24 months it is recommended that you get a pap test and/or pelvic exam to stay up-to-date.

Annual prostate exams are also open to men that are already over the age of 50. There is no doubt that cancer screening is very important to stopping the onset of the condition from the beginning. Don’t stop unless your question is answered as this information is constantly changing.

]]> http://medicarenewsline.com/medicare-and-cancer-screening/medicare-eligibility/feed/ 0 Is a Hospital Comparison Necessary with Medicare? http://medicarenewsline.com/is-a-hospital-comparison-necessary-with-medicare/medicare-eligibility/ http://medicarenewsline.com/is-a-hospital-comparison-necessary-with-medicare/medicare-eligibility/#comments Fri, 29 Apr 2011 03:17:03 +0000 staffwriter http://medicarenewsline.com/?p=465 Having Medicare shouldn’t be different than any other insurance coverage when it comes to the hospital, your nervous energy won’t change. The vague nature of what is and is not covered can be confusing and frustrating when you are trying to get treatment. The type of care provided by the hospital is what you should concern yourself with when making a decision.

Two hospital types should be considered with reference to medical care:

1. The ability to care by looking in to certain ailments is one way that you can look in to a hospital’s ability to provide care. Process measures are very important as they show the hospital’s general reaction to struggles.

2. The outcome of the care that is provided is another way that you can judge a hospital’s ability to provide care. If you were to think of this another way, it would be how do the people in their care recover?

At this point many people start to drift off as their attention is drawn to the complexity of the situation. What you may find as good news is that the government has a “Hospital Compare” section that makes all of this easy for you.

]]> http://medicarenewsline.com/is-a-hospital-comparison-necessary-with-medicare/medicare-eligibility/feed/ 0 Do you need a prescription to get a supply on Medicare? http://medicarenewsline.com/do-you-need-a-prescription-to-get-a-supply-on-medicare/medicare-eligibility/ http://medicarenewsline.com/do-you-need-a-prescription-to-get-a-supply-on-medicare/medicare-eligibility/#comments Fri, 08 Apr 2011 21:34:14 +0000 staffwriter http://medicarenewsline.com/?p=452 Medicare is not unlike any other health insurance plan when it comes to getting things approved for your use every day. Protecting the public from fraud and unnecessary payments there is a process that has to be followed. One such thing that can be referenced is the need for certain items that could make your life better or more enjoyable.

Medicare does require that your doctor give a written prescription to the supplier before the item is delivered for it to be covered. When you happen to order the prescription and then approach the doctor your claim will likely be denied. This is not without merit as you can’t expect insurance to pay for someone that you haven’t proven to need yet.

Some of the items that require a prescription are: Decubitus care cushions/mattresses, Power Operated Vehicles (POVs), or scooters, Seat lift mechanisms, and Transcutaneous electronic nerve stimulators (TENS). Remember that it is very important that your doctor prescribes these things prior to your ordering or purchasing them. Paying that bill on your own is not a good idea and you shouldn’t put yourself in that position.

]]> http://medicarenewsline.com/do-you-need-a-prescription-to-get-a-supply-on-medicare/medicare-eligibility/feed/ 0 Prostate Cancer Screenings for Medicare Patients http://medicarenewsline.com/prostate-cancer-screenings-for-medicare-patients/medicare-eligibility/ http://medicarenewsline.com/prostate-cancer-screenings-for-medicare-patients/medicare-eligibility/#comments Tue, 01 Feb 2011 05:31:32 +0000 staffwriter http://medicarenewsline.com/?p=432 Prostate Cancer for men is the breast cancer that women deal with on the scale of how it affects the population as a whole.  Men generally don’t like to have the procedure done because it is invasive and this doesn’t help to convince men, who generally don’t like medical procedures, to keep up with the screenings.  If you are trying to prevent any issues from popping up with your health it is definitely recommended, however, that you have this screening.

Prostate cancer screenings will help to detect prostate cancer before it completely sets in to your body and life. Medicare covers a digital rectal exam and Prostate Specific Antigen (PSA) test once every 12 months for all men with Medicare over age 50.  This is a good sign to you that you should have the test done regularly if it is covered or recommended for such an extended period of time in your life.

When it comes to paying for the exam there are some things that you should be aware of before you open up your wallet.  You pay 20% of the Medicare-approved amount, and the Part B deductible applies for the doctor’s visit. You pay nothing for the PSA test that is needed to diagnose you if you are possibly afflicted with the disease.  This is something that you shouldn’t debate, get tested to protect yourself.

]]> http://medicarenewsline.com/prostate-cancer-screenings-for-medicare-patients/medicare-eligibility/feed/ 0 HIV Screening and Medicare http://medicarenewsline.com/hiv-screening-and-medicare/medicare-eligibility/ http://medicarenewsline.com/hiv-screening-and-medicare/medicare-eligibility/#comments Tue, 14 Dec 2010 05:25:45 +0000 staffwriter http://medicarenewsline.com/?p=420 Few things have captured the attention of the world over the last 30 years like the onset of HIV and AIDS across the world.  Because of all of the attention there are a lot of rumors and disinformation that spread about what causes AIDS and how the spread of the condition occurs.  While there is much out there that you can ignore about AIDS and HIV, there are many reasons to pay attention if it could happen to you.

When it comes to Medicare’s approach to HIV the approach is very liberal for insurance and is so to encourage people to get tested.  Medicare takes the general approach off the bat of saying that they will cover anyone who is at risk for the infection as well as anyone who is pregnant.  However, their website actually covers who will be covered for the screening for HIV with the following line:

“Medicare covers HIV screening for people with Medicare who are pregnant and people at increased risk for the infection, including anyone who asks for the test.”  This is a very general statement but you can see how you may fit in to the last category regardless of who you are.  If you ask to have the test be taken and see if you are at risk for HIV or have HIV and you have Medicare, you are covered.

]]> http://medicarenewsline.com/hiv-screening-and-medicare/medicare-eligibility/feed/ 0 Skilled Nursing Care and Your Medicare Benefits http://medicarenewsline.com/skilled-nursing-care-and-your-medicare-benefits/medicare-eligibility/ http://medicarenewsline.com/skilled-nursing-care-and-your-medicare-benefits/medicare-eligibility/#comments Fri, 13 Aug 2010 03:28:08 +0000 staffwriter http://medicarenewsline.com/?p=382 There are times in a person’s life when survival or just good quality of life depends on the expertise of medical professionals.  When you are in this case and have Medicare coverage it is possible that your care will be completely covered.  You must still qualify for home health benefits by meeting the four standards of home health coverage, but once you do the following skilled nursing benefits will apply.
 
Medicare’s website states the following about skilled nursing services allowed covered by policies: “…Skilled nursing care on a part-time or intermittent basis. Skilled nursing care includes services and care that can only be performed safely and correctly by a licensed nurse (either a registered nurse or a licensed practical nurse)…”  This is a relatively liberal interpretation of the coverage, which is a good thing for you, the policy holder.
 
What you must do now is find someone that qualifies to provide this service and will do work through Medicare policies.  If your doctor is the one that is recommending that the services be done he or she will likely be able to recommend someone to you that can care for you.  If not, contact your local Medicare or Social Security office and ask for a referral to a skilled nursing professional that performs this work in the area.

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