Glaucoma Tests and Medicare
The eye disease of glaucoma is a serious situation that afflicts many people as they get older in their lives. It is important to test for this regularly but it is also important to know what your insurance covers to avoid unexpected medical bills. If you are on Medicare there is a period of once every twelve months that screening for glaucoma is covered under your benefits. Read more…
Is EKG Screening Covered Under Medicare?
When you first start your Medicare coverage in your lifetime there will be a very important exam that you will get first thing. This exam is often referred to as the “Welcome to Medicare” physical exam and it will test for many different possible health issues. Among them is the possibility of having heart disease and if you appear to be at risk you could be referred for an EKG screening. Read more…
What is the Medicare 12 Month Rule for Mammograms?
Mammograms are very important for all women to get, especially women who are over the age of 30 due to the prevalence of breast cancer. To try to fight and prevent this ugly disease most health insurance companies will allow for some screenings to be done without charge. This preventive screening is also covered by Medicare but there are a few restrictions you should be aware of, such as the 12 month rule. Read more…
Should You Get a Medicare Authorized Representative?
There are times when things become a little too difficult to understand or follow and you may need the help or services of an assistant to get you through a certain situation. When this type of situation arises you should consider naming someone as your Medicare Authorized Representative so you can get help. The following are a few situations in which a Medicare Authorized Representative could help. Read more…
Medicare Part D: Help with the Donut Hole on Brand Name Medications
With the health care reform instituted by President Obama there has been a lot of talk in the media about the infamous Medicare Part D “Donut Hole”. This hole is caused by a gap in coverage that previously caused those enrolled to have to pay full price for medications after reaching a certain dollar amount of coverage. Talk in the media has centered around the rebate given to people in the donut hole this year and how it will go away completely by 2012, but there is more to it than that.
Many people who currently use Medicare Part D and will be using it in the future should be happy to know that in 2011 when you are in the donut hole you will be significantly better off. This is due to the fact that Medicare has negotiated a 50% discount on medications while in the gap in 2011. While this doesn’t offer you everything, it certainly is a better deal than before.
While this new healthcare law has caused anger, confusion and concern from some people it has definitely worked well for those on Medicare. The options for coverage are getting better and the cost of service has become much more affordable.
Is Medicare an Option for People on Social Security?
Medicare has long been thought of as a health insurance option for people who are on social security for whatever reason in their lives. What many people do not know is that Medicare is not really an option for you if you hope to be on Social Security. Medicare is not an option because it is something that you are forced to do in order to receive Medicare benefits. Read more…
What are the Medicare Inpatient Benefits?
An unexpected stay in a hospital can be bad enough for the emotional and physical reasons, the financial destruction is yet another byproduct. People who are enrolled in Medicare may not know what to do if they are suddenly and unexpectedly thrown into the hospital for a stay. Just what benefits are available to Medicare subscribers for this situation can be confusing so here is a little background. Read more…
Is Medicare Supplement Insurance Right for You?
Medicare is notorious for creating gaps in coverage that make it hard to accept when you get a bill for your money out-of-pocket. Not knowing what your premiums or deductibles are could get you into trouble with not knowing what is going on in an important game. You can walk in the door of multiple companies and get different quotes for Medigap policies from each and every one of woh. Read more…
Can You Enroll in Medicare Retroactively?
The importance of Medicare cannot be understated for those who absolutely need it as staying healthy is paramount. Enrollment has very specific rules and there are always times where those can be stretched but you don’t want to be the exception to the rule. You can enroll at an earlier date with Medicare in something called “retroactive enrollment” which means that you enroll before you are eligible. Read more…
Does Medicare Cover Home Health Aides?
People who are relegated to the home for a variety of different medical issues often have to get help around the house to live a normal life. In these instances it is not just the hard things like leaving the house or having a job that are the problems, doing normal routine things are hard too. For people that are struggling in this manner there is help from Medicare in the form of a home health aide. Read more…
Does Medicare Cover Cardiac Rehabilitation Program
With so many different potential ailments or conditions that people could have there is often an unknown element to Medicare for so many people. It can sometimes become very frustrating and confusing when you don’t know what is paid for. When you are recovering from a heart attack this is not a good approach to have in your life.
Medicare Part B covers Cardiac Rehab programs that will help you recover as long as your doctor recommends it and you have had:
• A heart attack in the last 12 months
• Coronary bypass surgery
• Current stable angina pectoris (chest pain)
• Heart valve repair/replacement
• Angioplasty (a medical procedure used to open a blocked artery) or coronary stenting (device used to keep an artery open)
• A heart or heart-lung transplant
As you can see, Medicare benefits are there to help you when you are in a crisis as long as you know where to look and what you are looking for. Taking part in rehabilitation exercises to help you build up strength and regain some of your normal functions in life is worth your time and Medicare’s money. Medicare will pay all but 20% of the fee to have this done unless you have outpatient procedures done, in which it would be a copay for your portion of the claim.
What is the Influenza Treatment Demonstration?
As flu season approaches there are sure to be headlines in newspapers and segments in the evening news about the costs associated with flu shots. People with Medicare benefits are often curious as to how their flu prevention costs will be affected from year-to-year, with good reason. This year the government has offered a new program that you may not have heard of, courtesy of the Medicare.gov website: Read more…
Mental Health Services can be Covered by Medicare Part B
Medicare is about helping you and those around you deal with the conditions that you have so you can enjoy your life. There is a big part of the coverage that has to do with your physical well-being, but Medicare also covers the mental side of things. Medicare Part B, as a matter of fact, will pay for services to treat your mental health condition so you can live a normal life.
Medicare Part B will cover a psychiatric evaluation that may be necessary to diagnose your treatment so that you may seek assistance. This is a great service that can help you understand what your situation is and how you can deal with it on your own terms.
Medication management is also offered by Medicare Part B as a way of helping you understand what drugs you should use and why. This is a great way to learn about the effects that certain types of medication can have on you and can be beneficial for family as well.
Occupational therapy that’s part of your mental health treatment is covered by Medicare Part B so that you can function as close to normal as possible. The better you can get around in your normal life, the better your quality of life will be and that is the entire point of Medicare.
When do you have to pay your Medicare Premium?
When you get any kind of insurance coverage, including that of Medicare coverage of any kind, you will be required to pay a premium for the payment. Premium is just a fancy word for a monthly bill that will be required to be paid in order to keep your coverage valid. You will not always get a bill for your Medicare premium, but if you do it is very easy to pay.
First, understand that you will always receive a bill for your Medicare Part A insurance premiums, regardless of your situation. If you are receiving checks from the Railroad Retirement Board (RRB), Civil Services, or SSA (Social Security Administration) the Part B premium will be deducted from your check. If not you will receive a bill for your Part B and Part A premiums that you must pay on time.
All you have to do when you are ready to make your payment is to send the check to the Medicare payment processing center. You can mail your premium payments to the Medicare Premium Collection Center, P.O. Box 790355, St. Louis, MO 63179-0355. If you get a bill from the RRB, mail your premium payments to RRB, Medicare Premium Payments, P.O. Box 9024, St. Louis, MO 63197-9024.
Skilled Nursing Care and Your Medicare Benefits
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.
Speech-Language and Occupational Therapy Benefits through Medicare
Medicare is like most health insurance carriers in that they provide benefits for services that will improve your health or quality of life. Two services that fall under this realm are speech-language therapy and occupational therapy as they help you handle day to day stresses and frustrations. These benefits will help you incur the financial strain involved with getting therapy.
Medicare defines these services as follows: “…Speech-language therapy (pathology services) includes exercise to regain and strengthen speech skills. Occupational therapy includes exercise to help you do usual daily activities by yourself. You might learn new ways to eat, put on clothes, comb your hair, and perform other usual daily activities. You may continue to receive occupational therapy if ordered by your doctor even if you no longer need other skilled care…”
If you feel that you qualify for these services you should talk to your doctor or another medical professional as soon as possible. You could be paying for services that are covered under the Medicare policy that you have and are paying premiums for. Ask your doctor specifically if you qualify for these services and make a point of telling him or her that you think this could improve your quality of life. Don’t quit trying to get the services that you are contractually able to receive.
Are there any Drugs Excluded in Medicare Part D?
Any type of coverage of anything at all that is offered by the government will have its fair share of exclusions. These exclusions generally exclude things that are not completely vital for a human being to function from day to day. Sure, they may help you live a happier and enjoyable, more care-free life but they are not completely necessary to life itself.
Generally, weight loss drugs are excluded under Medicare Part D because they are not completely necessary to day-to-day functioning. These drugs could help you lose weight which may indirectly cause happiness to be more attainable, but they are not completely necessary. Weight loss can generally be attained through other means, though it may not be as quick and painless.
Erectile dysfunction drugs are also not usually covered under Medicare Part D because everyone can agree they don’t sustain your life. They can improve your enjoyment of life and may give you something to look forward to, but that is not what health insurance is about. There are a few other excluded drugs under Part D, including benzodiazepines and barbiturates, but none are as discussed as these two.
Medicare Benefits Cover what is Necessary
Many people are confused by Medicare and what the Medicare benefits pay for and what they don’t as it appears to be an endless maze. While it is true that the government doesn’t make anything easy and wants you to work to find out what is covered, it is pretty easy to discern at times. Try to discern between what is absolutely necessary and what isn’t. Chances are the first one is covered and the second isn’t. Read more…
Random Facts About Medicare Part B
Medicare has about as many twists and turns as a road in the Rocky Mountains and this causes a lot of facts to fall through the cracks. Instead of waiting for a time to cover everything about certain services in a separate article we decided to throw a few random things into one group. Here are a few random things you may or may not know about Medicare Part B: Read more…
Medicare Part A and Your Hospital Stay
There is nothing scarier in our mortal human lives than going to the hospital for the simple reason that the consequences will be unknown. The consequences or repercussions could be on the medical end of things, or it could be that your finances have been thrown a massive curveball. If you are a subscriber to Medicare Part A you should know what will be paid for with your hospital stay in 2010. Read more…
Getting the $250 Donut Hole Rebate for Medicare Part D
There is an endless amount of ways that you can get in to financial trouble trying to pay your insurance premiums, one being paying for prescription drugs. In the past there was no relief for anyone hitting the coverage gap known as the donut hole, you hit it and you were out money. For this year only there is help for you and if you have hit the coverage gap you will be receiving a $250 payment in no time. Read more…
Is There a Medicare Special Enrollment for the Working Aged?
Medicare has multiple special enrollment times for different people and different situations and you have to be aware when your time has come. If you or your spouse was working AND had group health coverage through a current employer or union or you are disabled and working, or you have coverage from a family member there are special enrollment rules. There are a few situations where the special enrollment period applies.
If you are still covered by an employer or union group health plan or through your spouse’s employer you can enroll in the special enrollment period. Or, if you are in the 8 months following the month when the employer or union group health plan coverage ended or when the employment ends. This may be confusing, but a Medicare specialist at your state insurance office should be able to provide guidance.
Medicare Benefits Cover Diabetes Self-Management Training
Being diagnosed as a diabetic is not a fun moment for anyone that has the unfortunate experience in their life. You must change your entire life to treat the condition and it becomes a very difficult situation to overcome in your existence. However, with the help of your Medicare insurance you can get help with your diabetes and live a better life.
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.
Medicare Part D: How Much is Covered for One Year?
When insurance is such a big part of taking care of you for a year of your life it is important to pick the right policy. What is even more important than picking the right policy is knowing what is covered under the policy that you choose. With Medicare Part D drug coverage you should know just how much is covered during one plan year. Read more…
Medicare Part A: Is Blood Paid for?
The very question in and of itself is terrifying and very grim, but the question has been asked by many a Medicare patient, is the blood I need covered? Many people don’t realize that some of your Medicare Part A coverage may kick in when this situation arises. If you are in the situation that you need blood don’t wait on your insurance to decide if it will be covered or not. Read more…
