If you're approaching or over 65 or disabled, Medicare is an important part of how you get your healthcare. Understanding what's included and how to make the most of it is important!
Medicare is health insurance provided by the U.S.
government for eligible people turning 65 or retiring. There are certain times
people can sign up for Medicare and depending on the circumstances, some people
may be enrolled automatically while others must apply manually. The first time you can enroll will be a
7-month period usually beginning 3 months before the month you turn 65, the
month you turn 65, and will end 3 months after the month you turn 65. It is
important to note that if you do not apply when you are first eligible for
Medicare, you may have to pay a Part B late enrollment penalty, and have a
possible gap in coverage if you decide to enroll in Part B later.
What Medicare Plans are There, and Which
One is Right for Me?
Medicare includes two plans based on the needs of the
person applying for insurance. Medicare Part A is hospital insurance and covers
inpatient hospital stays, care in nursing facilities, hospice care, and some
home health care. Medicare Part B is Medical Insurance which includes certain
doctor’s services, outpatient care, medical supplies, and preventative
services. It is recommended that most people enroll in Part A when they turn
65, even if they have previous health insurance.
Medicare Part A Plan:
This Medicare plan is targeted towards people who need
hospital insurance. Talk to a doctor about your need for certain services or
supplies and if Medicare will cover the cost of them for your care. Medicare
coverage is based on federal and state laws, national coverage decisions made
by Medicare, and local coverage decisions made by companies in each state on
whether something is medically necessary and should be covered in your area.
Medicare Part B Plan:
Medicare Part B is targeted towards people who need
Medical Insurance. Medicare Part B covers a “Welcome to Medicare” preventative
visit within the first 12 months of your enrollment. If your doctor or health
professional accepts assignment, you will pay nothing for this visit, and the
Part B deductible does not apply. This visit is not a physical, but a time for
your doctor or health care provider to get to know you and your needs. Medicare
Part B is designed to prevent diseases and disabilities based on your current
state of health and possible risk factors. Your health care provider will ask
that you fill out a questionnaire called a “Health Risk Assessment” to help
formulate a personalized prevention plan for you to maintain a healthy status.
The visit includes:
review of your medical and family history
and updating a list of current providers and prescriptions
weight, blood pressure, vision test, and other routine measurements
of any cognitive impairment
for flu and pneumococcal immunization
on advance directives and screenings for potential risk of depression
list of risk factors and possible treatments options for you
It is important to note that any additional tests or
services your health care provider performs in the same preventive visit may
include a co-insurance or co-payment, and a Part B deductible may apply.
Medicare Part C Plan:
Also known as Medicare Advantage.
Medicare Part D Plan:
Prescription drug coverage.
Yearly Medicare Wellness Visits
If you’ve had Medicare Part B for longer than 12
months, you should schedule a yearly “Wellness” visit to update your health
record and personalize a prevention plan. The wellness visit is designed to
keep you healthy and prevent disease. Yearly Medicare Wellness visits also
include a screening schedule for appropriate preventative services.
Preventative Services Include:
Done every 5 years
Cancer Screening- Done every 12 months
and Vaginal Cancer Screening- Done every 24 months
Occult Blood test- Done every 12 months
Sigmoidoscopy- Done every 48 months
Colonoscopy- Done every 120 months
Annual wellness visits are an important way to keep healthy
and should be part of your fall prevention plan. 1 out of 3 seniors fall in
their home each year, but with a
Care Alert Fall Detection System
seniors can have peace
of mind that help is on the way in the case of an emergency. Medicare generally does not pay for a Personal Emergency Response System, but some
Medicare Advantage Plans do...check with your provider.