How Does Skilled Nursing Facility Work with Medicare?

You might require a skilled nursing facility if you’ve got a major injury or disorder which requires monitoring or medical procedure. Skilled nursing care offers 24 hrs care for folks who require rehabilitation services or are suffering from serious health disorders which might be too complex for home treatment. A few skilled nursing cares may come with lab, pharmacy & radiology services, educational & social programs, as well as limited transport to essential health services which aren’t offered by the facility.

Ways to Reduce Your Skilled Nursing Care Expenses:

You may want to take into consideration Medicare Supplement plans which can allow you to pay your skilled nursing care out of pocket expenses. Supplemental Plans which are also known as Medigap plans can pay for additional costs under Part A Medicare & Part B Medicare. In a number of states, the benefits of these plans are standardized by the government. Each of the ten Medigap plans offers a different level of coverage and benefits. Majority of these plans might help the enrollee cover some amount of copayments associated with SNF (skilled nursing facility) at a minimum.

Who Is Eligible for Skilled Nursing Care?

Most times, Medicare assists you to pay for your skilled nursing care provided the below requirements are met:

  1. You were in the hospital as an inpatient for a minimum of 3 days consecutively (excluding the day of your departure), and you utilized a Medicare-approved SNF inside 1 month of leaving the facility.
  2. You already have Part A Medicare that includes hospital insurance.
  3. Your physician suggested you to get SNF 7 days per week or services associated with skilled therapy 5 days per week as a minimum.
  4. You require care which can be only offered via SNF & it’s considered essential and reasonable.
  5. Your skilled nursing facility is associated with a disorder you received a treatment for in a hospital, or is another disorder which begun while you were receiving the treatment.

You are yet to utilize the given days in Medicare benefit term. The term begins the day when you get admitted as an in-patient to the hospital. It will terminate when you no more stay as an inpatient in the SNF or hospital for 2 months back to back.

Importance of Personal Assistance for Seniors

As we age, we have to rely more and more on others. The fact is, at some point in your life, you won’t be capable enough to take care of yourself & hence will need assistance.

Personal assistance can help relieve the stress which seniors suffer every now and then and produce a safer surrounding for them inside their house. Besides, seniors who’re being left alone can also get a much-required company through these services.

Will Medicare Pay for Personal Home Care?

Medicare or Medicare Supplement Plans won’t cover personal home care services. Medicare only pays for medical services that are essential and suggested by a Medicare-approved doctor.

Advantages of Personal Home Care Services:

  1. Personal hygiene:

As we age, it becomes more and more difficult for us to be able to move, no matter if it’s climbing up the stairs, taking a bath or other similar thing.

Medicare Supplement Plans 2019Bathing, in particular, can become very challenging for people with restricted movement. A weak attempt might even result in a fall that may break bones & cause serious medical complications.

With a personal assistance, seniors can be assured to enjoy a safe bath without having to worry about an accident. Besides, they’ll assist them in washing areas which are hard for them to reach like the feet and the back.

Personal assistance also includes helping seniors use the lavatory. In short, personal assistance focus on every single aspect of the day to day care of an elderly, irrespective of how messy or embarrassing it might be.

  1. Company of others:

Personal assistance is not just looking after the elderly. Carers undergo training that allows them to be attentive & friendly towards seniors. Some seniors might feel lonely after their partner passes away or their loved ones move away. Hence, at times the thing they most care for is having a friend who can offer them a company.

Through a 24hr personal assistance service, seniors won’t have to feel alone ever again.

  1. Assistance with House Maintenance

As the body weakens, it gets more difficult for seniors to maintain a clean & tidy house. Dusting regions that are high to reach can become very tough & the extra strain while reaching these regions might put unwanted pressure on the body potentially resulting in an injury.

With personal assistance seniors can be assured that they don’t need to go off their way for keeping their house tidy.

Oxygen Therapy: Does Medicare Cover it?

People enrolled in Part A & Part B Medicare might be allowed to rent equipment related to oxygen therapy for home usage. In addition, Medicare might also assist in covering oxygen along with other supplies in case you already have the equipment required for the therapy. Most oxygen accessories & equipment fall under the DME category for Medicare. Medicare (Part B) covers 80 percent of the total costs while the enrollee needs to pay the remaining 20 percent amount in addition to the deductible for Part B Medicare if any. Do check out Medicare Supplement Plans which can help you cover costs which Medicare doesn’t cover for oxygen therapy.

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In order to receive coverage for oxygen accessories & supplies, seniors are required to meet the below-mentioned requirements:

  1. Your physician confirms you’ve got a severe lung disorder or you are unable to get an adequate supply of oxygen.
  2. Your overall well-being can be improved via oxygen therapy.
  3. The blood gas level within your arteries is less than a particular range.
  4. Alternative treatment options weren’t enough to improve your health.
  5. Your

Once you start the therapy, more often than not you will be able to rent the oxygen supplies during the initial 3 years after which the supplier need to continue providing oxygen, service as well as maintenance for up to 5 years without any additional costs provided you still require oxygen. After 60 months or 5 years, you can stay with the current supplier or pick a new one, & the 3-year rental period will start over again.

Rental payments that come on a monthly basis might be able to cover oxygen services & accessories like:

Mouth-piece and/or tubing

Oxygen content

Reparations, maintenance & servicing

Note: Durable medical equipment might be based upon a Competitive Bidding Program in some states. In case you reside in a state in which competitive bidding is applicable, then the equipment must be rented from a supplier who allows Medicare enrollees. Your doctor can assist tell you whether it’s applicable to you & which suppliers you’ll be able to use within your region.

Overnight Senior Care: When Is It Necessary?

Accidents may happen at any period of time. Seniors with chronic disorders, in particular, can be at high risk. In case they’re living alone & slip down the stairway or during a shower, they might suffer tremendous pain & even lose their mobility.

If an elderly individual in your life is in need of constant supervision, then you must ensure they receive proper care even during the night time.

  1. Overnight senior care can ensure there’s always somebody who’ll be able to protect the senior in case of an emergency.
  2. Seniors with a restricted mobility need assistance almost throughout the day. Overnight senior care ensures somebody will always be there for your elderly loved one to assist.

Seniors might require overnight care in case they:

  1. Tend to forget to a level where things get out of control (like leaving the microwave oven turned on after usage).

 

  1. Are trying to recover from a severe injury or medical treatment.

 

  1. Are diagnosed with a medical disorder which needs constant monitoring.

 

  1. Suffer from dementia or other similar condition.

 

  1. Have almost lost their ability to move & cannot get out of their bed by themselves.

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  1. Show suicidal tendencies or signs of depression.

In case you find that one or more conditions are applicable to your elderly loved one, realize that their requirements might exceed the usual care which a member of their family could provide.

After determining that your elderly loved one requires overnight care, you want to consider all the available options as well as the costs associated with each of them. Please note that Medicare or Medigap (Medicare Supplement Plans) won’t cover the costs of overnight senior care unless it’s absolutely necessary for the senior.

Private care providers can be another alternative for people who’re on a tight budget since they are likely to charge 20 percent to 30 percent less as compared to agencies. In case you are considering a private senior care provider, then make sure that you check their previous work history and qualifications.

To conclude, hiring overnight senior care might make a huge impact when it comes to the health and well-being of your elderly loved one. Not only does it allows seniors to live a happy and comfortable life, but it’ll also let you take care of your personal health & well being. The good news is, you have plenty of options when it comes to overnight care for elderly with various budgets so that you’re able to provide your loved one the care which they deserve and require, irrespective of their current financial state.

Top 5 Reasons for Getting a Medigap Plan

Although Medicare Supplement Plans offers a number of benefits, below you’ll find top 5 reasons why you need to consider them once you become eligible for Medicare coverage.

  1. They’re ideal for covering your medical bills

Let’s assume you constantly need to buy medications that are covered by Medicare but cost you too much. A Part B Medicare policy can cover 80% of your costs, however, the remaining 20% will still be your responsibility. Also, it is required that you reach your annual Part B Medicare deductible before you get your share from Medicare. The deductible am

  1. They offer assured acceptance

Depending upon your selected Medigap plan, your insurance agency will need to accept you although you may have health concerns, and it won’t be able to charge you a greater amount due to your disorder. However, you need to purchase the Supplemental plan within the Period of Open Enrollment.

If you decide to purchase the plan after this period, most times your health insurance company might refuse you the coverage.

At times, in case you are losing additional Medicare coverage, you can have Medigap guaranteed issue rights for getting the Supplemental coverage plan even if you purchase it after the period of Open Enrollment is over.

  1. They offer assured renewable policies

Even for people with health issues, all eligible Medigap plans provide guaranteed renewable. This means insurance agencies won’t be able to cancel your coverage if you are paying your premiums without any gaps. Furthermore, your policy is likely to be auto-renewed each year.

  1. Huge variety of options

All the ten standard Medigap plans provide different coverages so as to help enrollees pay their Traditional Medicare costs. The plans offering maximum coverage obviously have higher premium amounts each month. Thus, you can pick a Medigap policy according to your needs.

  1. They allow you to pick any doctor or physician who accepts Medicare patients

Majority of the Medigap policies offer coverage as long as you select any Medicare-approved hospital or doctor with the only exception being that of Medicare SELECT plans. With a Medigap SELECT plan, you might be allowed to visit hospitals or providers within its network only.

Importance of Yoga for Senior Citizens

Yoga can be a great form of meditation as well as exercise for individuals of all age groups & it’s definitely among the preferred workouts for the elderly. It’s very relaxing and gentle on your joints & bones. Often, it’s suggested for the elderly when they’re feeling depressed as it helps them lift their spirits & also refreshes their body and mind likewise. Yoga is also ideal for seniors who’re unable to do harder workouts because of weakness or some sort of disability which doesn’t let them do alternative workouts. Yoga might also help you reduce your blood pressure & offer relief from the symptoms of arthritis.

Nevertheless, if you’re considering Yoga, be sure to talk to your doctor first prior to starting your sessions. Although Yoga is known to be a very gentle form of exercise, it might be challenging for individuals with weak muscle mass, or dizzy spells. Also, in case you’re a diabetic, your blood sugar levels could go quite low while doing Yoga.

Whilst initially starting with Yoga, it’s best to try out only the basic poses. Since these are mostly static, they can help enhance your endurance & also the odds of injury are almost negligible. They’re known as asanas. It’s also good to learn some breathing methods known as called cleansing breath or Kapalabhati. They’re short but rapid means of breathing which need to come from your diaphragm.

Adho Mukha Svanasana is another great pose which you would want to master during your Yoga sessions. The pose is ideal for your back muscles as well as spine. To start with, you get on the floor pose & ensure that your shoulders & hands get properly aligned with hips & knees. After this, you try to lift one of your knees off the ground so that it reaches to the point where the body creates a V-shape. Also, at this point, your head must come as close to the ground as possible.

A yoga coach or teacher is highly recommended for seniors who are just starting out with Yoga.

Are Yoga Classes Covered Under Medicare?

Medicare or Medicare Supplement Plans does not cover fitness programs like Yoga or gym memberships. So, you might require additional coverage for this.

Importance of Strength Training for Seniors

Among the major reasons why senior citizens especially those above the age of 65 lose their balance and fall is because of the lack of necessary strength in their muscles. The human body is meant to move & most elderly avoid regular exercise sessions, making them lose their strength as well as balance. Getting used to a workout program created especially for seniors can prove vital in preventing falls.

Most seniors find strengthening & balancing workouts to be challenging. So, it’s best to always start a workout program alongside an experienced Senior Fitness coach. They can thoroughly asses your strength & balance issues, which can include skeletal issues, soft tissue injuries, etc.

A cardio workout program that’s designed taking into account your specific fitness needs is likely to enhance the oxygen uptake & blood flow to essential organs in your body.

Stretching workouts can lengthen muscle tissues which may have been shortened as a result of inactivity. This will allow you to move more freely as well as ease the muscular pain if any.

Strength exercises can be crucial in keeping your bones and muscles strong. Strength exercises are proven to minimize osteoporosis while increasing the bone mass. This greatly helps minimize deformity within the fractures & limbs especially in your spine and hip area. Lack of balance and tone in muscles can be easily minimized through strength exercises.

Cardio workouts, balance workouts, stretching sessions, and strength training not only adds essential physical improvements in your daily routine but also makes you strong and capable mentally. An increased flow of oxygen and blood cells towards the brain & other major organs can help improve your efficiency while minimizing the odds of memory loss which is most common as you age.

Starting a workout routine might seem like a major challenge at first, however getting a professional assistance from a trainer who specializes in senior health can be the job a lot easier. Always be sure to consult with your doctor prior to starting any workout program.

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If you already have a Medicare plan and are looking to cut down your out of pocket costs, then we highly suggest you check out Medicare Supplement Plans that may help you cover your out of pocket expenses entirely.

When Should You Get the Medicare Supplement Plans?

You could purchase the Medicare Supplement Plans if you are over the age of 65 and have Medicare. This will help to cover the costs that the original medical plan does not offer to you. The gaps that are created in the traditional Medicare plan are huge and this could end up in you paying lots from your pocket. With the Medigap plan you can save on these out of the pocket costs.

The Medicare Supplement Plans need to be purchased and they are not offered for free. You buy it from a private insurance company and pay a premium towards the plan. This is additional to the costs that you pay towards Medicare.

The basics of the Medicare Supplement Plans

The Medigap plan is a standardized plan and is regulated. The plans are identified by letters namely A, B, C, D, F, G, K, L, M and N. The plans that have the same letters have the same benefits. But the premium cost could vary from one insurance company to another.

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The Medicare supplement plans availability could vary from one location to another as well as is different from one insurance company to another. Plan A is something that every insurance company will have but the other plans could be different. The cost could also be different based on where you reside as well as the plan that you opt for.

Why should you buy Medigap plan?

It is not necessary that everyone does have a Medigap plan. These are some reasons why you should consider purchasing the Medigap plans.

  • You are retired or unemployed. If you do not have a plan that is sponsored by your employer for Medicare then the Medigap plan helps you.
  • If you are being treated for some health condition. If you are seeing your doctor regularly then the Medigap plan can offer you a lot of protection.
  • The medical expenses could come unexpected and thus this supplement insurance gives you peace of mind.
  • You do not qualify to fall under the low income category to get medical expense benefits. In this case a Medigap policy helps you with the deductible and copayments and you are also saved from the huge out of the pocket expenses.

If you have a Medicare plan but are not willing to pay a lot of money towards some unplanned medical expenses then you would have to supplement your medical plan. The Medigap plan is your best bet for the peace of mind that it offers to you.

How to Lower your Medicare Costs with Assignment

Besides Medicare’s programs that assist people with low incomes and help them pay their plans, and Medicare’s plans like Medigap policies that help you save money, there are other ways in which you can reduce costs when using health care services. One of them is assignment, which can be really useful when going to the doctor. In this article we will explain you how to lower your Medicare costs with assignment.

What is assignment?

Before going to the doctor, you should check if he or she accepts assignment. Accepting assignment means that your doctor (or health care supplier/provider) agreed to accept Medicare-approved amounts as full payment for the services. Sometimes, doctors and health care providers and suppliers are required by law to accept assignment.

What are the benefits of going to a doctor that accepts assignment?

     Benefits of going to a doctor that accepts assignment are the following:

  • Your out-of-pocket costs will be lower.
  • You will be charged only the Medicare deductible and coinsurance amount. You will have to wait until Medicare pays its share before being asked to pay your share.
  • Your claim will be directly submitted to Medicare and you won’t be charged for that.

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How does assignment work?

Doctors who accept Medicare-approved amounts as full payment for the services are called participating doctors. When you receive a service, Medicare will be charge 80% of it and you will be charged 20%, as part of Part B benefits. This will happen after you pay your annual Part B deductible.

In case you are getting a preventive service that Medicare provides for free, like a mammogram, it will be free only if it is provided by a doctor or other qualified health provider that accepts assignment.

What happens if my doctor does not accept assignment?

Doctors who do not accept Medicare-approved amounts as full payment for the services are called non-participating doctors. When you receive a service from this kind of doctors (or health care provider/supplier) you will have to pay an additional charge of 15% above the cost of the service, because that is the charge limit for non-participating doctors. This is called Medicare excess charge. This means that you will have to pay up to 35% of the Medicare-approved amount instead of 20%.

This limiting charge only applies to certain services covered by Medicare and does not apply to some supplies and medical equipment.

It can also happen that a doctor has opted out Medicare. This is very common as doctor usually change insurance networks. If this is your case, the doctor can charge the amount of money he desires and you will have to pay the entire cost of the services you receive. We suggest to find another doctor if you don’t want to pay for the services on your own.

What happens if I don’t have Original Medicare or I have a Medigap policy?

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The rules mentioned above only apply if you have Original Medicare. In case you have a Medicare Advantage plan instead of Original Medicare, you will have to pay what your plan requires.

In case you have a Medigap policy, remember that all Medicare Supplement Plans partially or fully cover Part B copayments, which is the 20% mentioned above, so you won’t have to pay for it and that amount should be charge directly to your Medigap policy.

Additionally, there are two Medigap policies that cover excess charges from doctors that do not accept assignment, which is the 15% mentioned above. These are Medicare Supplement Plan F and Medicare Supplement Plan G.

How do I know if a health care provider accepts assignment?

Discovering if your health provider accepts assignment is really simple. You can use Medicare’s tool called “Physician compare”, in which you can search doctors in your area based on if they participate in Medicare or not. You can also simply contact them and ask if they accept it, in case you were considering a particular doctor.