Medicare Plan G is one of several Medigap Plans you can buy from a private company to pay healthcare costs not covered by Medicare Part A and Medicare Part B. Medigap plans are often referred to as Supplemental plans as well.
These plans help cover co-payments, deductibles, and coverage during international travel.
Medigap plans are identified by letter, A through N. Current offerings include Plans A, B, C, D, F, G, K, L, M and N. Plans E, H, I, and J are no longer available to new subscribers.
It’s important to note that Medigap Plans A, B, C, and D are not the same as Medicare Parts with the same corresponding letters. Medicare has four parts, but Medigap policies are referred to as plans.
Overall, about 1 in 5 Medicare enrollees also purchase a Medigap plan.
Each plan is different in terms of exact coverage and costs. There are a variety of plans so that you can buy a plan that best fits your individual needs.
Plan G is characterized by providing excellent benefits to beneficiaries who want to pay a small annual deductible. That protects them from spending more on out-of-pocket expenses for unexpected health issues.
It is similar to Medicare Plan F, which is the most popular Medigap plan.
Many people choose Plan G because it has relatively low premiums. The other great thing is that Plan G tends to have more moderate rate increases from year to year than the more popular Plan F.
However, to decide if Plan G is right for you, it’s best to take a closer look at the specific benefits. You may also want to look at other plans to see if one is better suited for you as well.
What Medicare Plan G covers
Plan G covers all the gaps in Part A and Part B coverage, except for the Part B deductible. Specifically, those benefits include:
Part A deductible
Part A coinsurance and hospital costs
Part B coinsurance and co-payments
Blood work, and the first three pints of blood for medical needs
Hospice care co-payments and coinsurance
Foreign travel medical emergencies (up to $50,000)
Skilled nursing facility coinsurance
Outpatient medical services such as lab work, diabetes supplies, durable medical equipment, doctor visits, ambulance services, and more.
All Medigap plans do not include prescription drug coverage. You will need to buy a Part D plan to be covered unless medications are prescribed as part of Plan B coverage and include drugs such as for chemotherapy or autoimmune diseases that must be administered in a clinical setting.
Also, Medigap plans do not cover routine dental care.
How Medigap Plan G works with Original Medicare
To sign up for a Plan G policy, you must first be enrolled in Medicare Part A and Part B.
Original Medicare will pay its share of the Medicare-approved amount for covered services. Plan G will then pay its share.
It’s important to note that you cannot have a Medicare Part C plan and a Medigap plan in force at the same time.
Unlike Medicare Advantage plans, Medigap plans are all the same no matter from which company you buy a policy. This means you’ll get the same coverage if you buy a Plan G policy from Cigna or buy a Plan G policy from Aetna, or any other provider.
If you live in Wisconsin, Minnesota, or Massachusetts, you may not have access to Plan G. Medigap policies are standardized differently in these states:
Even though by law, Medigap Plan G policies must cover the same thing, premium costs can vary. These costs will depend on the carrier, zip code, age, gender, and whether or not you smoke.
Plans are typically priced between $80 and $170 per month and are in addition to your Part B premium. If you go with a high deductible Plan G, your premiums will be less.
Like other Medigap policies, a Plan G policy only covers one person. If you and your spouse both want Plan G coverage, you will both need to buy policies.
You’ll need to work with a licensed agent to plug in all the variables and come up with the best and most affordable plan for your particular needs.
Also, keep in mind that if you don’t enroll during your Initial Enrollment Period, there’s no guarantee you’ll get coverage, and if you do, it could cost you more. If you can get coverage and you have a pre-existing condition, you may have to wait for up to an additional six months for coverage to kick in.
One other important thing to know is that if you buy a Plan G policy and drop it, there’s no guarantee you be able to re-enroll.
Medigap Plan G vs. other Medicare Supplement plans
Here’s how Plan G stacks up against other Medigap plans.
Is Medicare Plan G better than Plan F?
Plan G and Plan F are almost identical to each other.
The only difference is that Plan F covers the Medicare Part B deductible. However, Plan C and Plan F are being phased out, and only people enrolled in those two plans before December 31, 2019, get to keep those plans.
The good news is that Plan G is cheaper than Plan F with almost identical benefits, so many beneficiaries prefer Plan G anyway because it is viewed as a better overall value.
For example, you will need to pay the Part B deductible, but with lower monthly premiums for Plan G, you could save $400 or more each year.
The standard Part B deductible in 2020 is $198, but Medicare also introduced a high deductible Plan G with an annual deductible of $2,340 in January 2020.
When Can I Get Medicare Supplement Plan G?
The best time to get a Plan G policy is during your Initial Enrollment Period. You are guaranteed coverage for any plan that’s available in your neighborhood, regardless of any existing health conditions.
You can enroll at any other time during the year, but an insurance company can charge you more for existing conditions or deny you coverage outright.
Your best bet is to speak with an agent who will give you complete details.
What you need to know before enrolling in Medigap Plan G
One of the most important aspects of all Medigap plans is that they are guaranteed renewable, even if you develop health problems. You can’t be canceled by an insurance company as long as you pay your premium.
Also, guaranteed issue rights are in play in certain situations. This means an insurance provider must offer you certain Medigap policies when you are not in your Medigap Open Enrollment Period.
If you qualify, a provider must sell you a policy, cover your pre-existing conditions, and can’t charge you more even if you have past or present health problems.
Typically, guaranteed issue rights are available when you lose other health coverage or your existing coverage changes. You also have a trial right if you decide to buy a Medicare Advantage plan and want to change your mind and return to a Medigap policy.
Guaranteed issue rights are federal law. Many states also provide additional Medigap rights.
Plan G policies are not going away per se, but first dollar coverage is, due to deductible coverage no longer being offered for Part B. High Deductible Plan G is also a new change for 2020 as well.
If you have questions about Medigap coverage in your state or to make sure you qualify for all benefits, contact your State Health Insurance Assistance Program (SHIP).
To buy an affordable Medigap plan, you need to compare policies to see which one best meets your needs. Your best bet is to work with a licensed insurance agent in your area.
You can also use the Medicare.gov website to find a Medigap policy or call your SHIP for information.
An agent will help you compare costs once you decide which plan to buy. Keep in mind all coverage by letter is the same, but premium costs can be different.
When you buy a policy, the insurance company must give you a plain-language summary of your benefits. Read it and make sure you understand everything. If you don’t, be sure to ask questions.
Companies that offer Plan G
You have several choices when deciding which Plan G to buy. Price is a significant factor. And there are also several A, and B rated companies that offer policies.
Overall, consider that companies with higher ratings have plans with higher ratings. Outstanding customer service is an essential factor.
Based on those factors, here’s a list of some of the top rated Medigap carriers for 2020:
AARP
Aetna
Amerigroup
Cigna
Humana
Mutual of Omaha
WellCare
The top of this Medicare supplement list doesn’t necessarily mean the best rates or the best claims ratio. The list is written in alphabetical order from top to bottom.
Prescription Discount Cards 101
Do you have a high deductible or copayment for your prescription drugs? Did you get a new prescription that is not covered by your insurance? Well, great news! A discounted prescriptions network may help cover some of those costs.
A discounted prescriptions network provides prescription discount cards. These discount cards for prescriptions are available to everyone and can prove to be an easy way to save on your prescriptions.
Many top-rated prescription discount cards can be emailed or texted directly to you for immediate use.
You may be able to enjoy prescription savings in the long run by understanding the truth about these cards and knowing the best prescription discount cards available. Visit websites that offer the best prescription discount card reviews to choose the right one for your particular needs.
Your free prescription card could be a Walgreens prescription discount card, a GoodRX discount coupon, a SingleCare discount card, and so on.
Sometimes generic drugs provide the same value as the original drug at the lowest price. Brand name prescription drugs don’t cost more because they are better, but because companies have to pay for safety, effectiveness, animal, and clinical studies.
What is a pharmacy benefit manager?
A pharmacy benefit manager (PBM) is the middleman between the pharmaceutical company and the pharmacy. They negotiate drug pricing from the pharmaceutical company for the pharmacy.
This means that there may be a significant cost difference for the same drug in different stores and locations.
Pharmacies will negotiate prices depending on their customer base. If one pharmacy has many older adult customers, they may charge less for heart medication.
However, they might charge more for another drug that has a lower demand to make up the price difference. This is why comparing drug prices and utilizing prescription discount cards is important.
The Truth About Prescription Discount Cards
A prescription discount card can be useful to many people, but as Medicare scams continue to rise, it’s understandable why you may be hesitant to use them.
Some prescription discount cards can be misleading and claim higher savings. However, a large portion of free prescription discount cards are credible, can be used at thousands of pharmacies across the US, and don’t require your personal information.
Are prescription discount cards legitimate? A legitimate prescription drug discount card program has the following signs:
The website offers an easy pricing tool for brand and generic medications.
Pharmacies near you accept the card.
The website offers a home delivery option via a trusted website.
The discounted amounts are comparable to other discount program card program websites.
What are the best prescription discount cards?
Don’t confuse a health insurance card with prescription drug discount cards. A health insurance ID card is proof of insurance to use when you visit a health care provider, physician, or hospital while a drug card helps you fill a prescription at a discounted price.
Not all prescription discount cards are created equal.
Some prescriptions may be covered by one discounted prescription network and not the other. The best prescription discount card is the one — or combination of several cards — that can save you the most on the medications you take every day.
The amount of savings, number of eligible pharmacies, and number of prescriptions available will vary by the discounted prescriptions network. You may want to consider these cards:
With the GoodRx app, prescription drug price comparison is available right at your fingertips. GoodRx compares prices for every FDA-approved drug at more than 70,000 pharmacies across the US.
Coupons can be printed, emailed, or texted to you and all you need to do is show the pharmacist your coupon to save up to 80% on your prescriptions.
US Pharmacy Card
This card is completely free and does not require any personal information. The US Pharmacy Card is accepted at roughly 59,000 pharmacies nationwide. You can have your card printed, emailed, or texted to you. Fun fact: this card can also be used on prescriptions for your pets!
Discount Drug Network
The Discount Drug Network card can save you up to 85% on your prescriptions with or without insurance. The only personal information you need to supply is your name, email, and address.
Your free prescription discount card will be mailed to you. Plus, the drug pricing tool on their website makes comparing prices a breeze.
SingleCare
A SingleCare prescription discount card is a savings card honored by a network of pharmacies across the country. Choose a pharmacy near you and present your card to the pharmacist at the counter.
If one of the participating pharmacies is Walmart, then show your prescription discount card at Walmart. Or if one of the participating pharmacies is CVS, then show your prescription discount card at CVS.
How to Use Your Drug Discount Card
When you want your prescription filled, go to one of U.S. pharmacies contractually obligated to honor your card. Visit participating pharmacies, such as Walmart, CVS, Walgreens, or Rite Aid, to get your discount.
A drug discount card mobile app may also be available for iPhone and Android.
If you haven’t already, click here to download your free prescription discount card. Then you can browse local pharmacies’ prices for your prescribed medications.
Prescription Drug Price Finder
Once you’ve downloaded your discount card, click here. Then type in your prescribed drug. For our purposes, we’re using rosuvastatin (Crestor), which is one of the best-selling drugs in the United States. Then enter your zip code. We used 37209, which the zip code of our headquarters in Nashville, Tennessee.
Then select your dosage and amount. We chose 20 mg and 30 tablets.
According to GoodRx, the average price without insurance for a 30-day supply of 20 mg is $161.64 as of March 2020. As you can see, you will pay just $8.44 at Walmart for the same thing with your free prescription discount card.
*Prices may vary. Always check with your pharmacist to find out the exact discounted price of your prescription.
Prescription Discount Cards and Medicare
Medicare and prescription drug coverage can be confusing. Fortunately, a licensed agent can help explain your prescription coverage options. If you’re interested in arranging a no-cost, no-obligation appointment with an agent, fill out this form or call us at 844-431-1832.
Contact Us | Medicare Plan Finder
This post was originally published on November 27, 2018, by Kelsey Davis. It was last updated on April 9, 2020, by Troy Frink.
Does Medicare Cover Cataract Surgery in 2021?
Surgeons perform more than 3.8 million cataract procedures every year in the United States. As you age, your risk of developing cataracts increases. Approximately half of all Americans will develop cataracts by age 75.
Before factoring in health care coverage, cataract surgery can cost $3,700 to $7,000 per eye. If you have one of the millions of cases of cataracts, you may wonder, “Does Medicare cover cataract surgery and implants?” Yes. Medicare covers these costs for qualified Medicare beneficiaries.
How Much Does Medicare Pay for Cataract Surgery?
Original Medicare (Part A or Part B) generally* does not include vision coverage. However, cataract surgery is an exception. Medicare Part B covers basic lens implants and cataract removal.
If your provider recommends an advanced lens implant, you may need to pay some or all of the additional costs. It’s essential to talk with your doctor to get a clear understanding of the necessary procedure.
*Medicare Part A may cover emergency services in a hospital.
Medicare Part D, which is the prescription drug plan, may cover any prescription medications you need after you have had your cataract surgery.
Incidentally, any medications you need before surgery, such as prescription eye drops, will be covered by Medicare Part B. Part B will also cover eyeglasses or a set of contact lenses for cataract surgery that implants monofocal intraocular lenses (IOL).
Since Part D has no deductibles, you may be responsible for a specified copayment amount that you must pay when you get your prescription drugs.
What Type of Cataract Surgery Does Medicare Cover?
Medicare covers two types of surgery: manual blade surgery and laser surgery.
Medicare will also pay for an intraocular lens (IOL), which corrects presbyopia or astigmatism, but only if these lenses should be replaced because of cataracts.
Does Medicare Pay for Laser Cataract Surgery?
Medicare coverage for cataract surgery doesn’t depend on the surgical method. Medicare will cover 80% of the cataract removal and basic lens whether the procedure is conventional or bladeless with a computer-controlled laser. Similar to conventional surgery, laser surgery requires you to pay the additional costs if you require an advanced lens.
Does Medicare Pay for Cataract Surgery With Astigmatism?
Since you can correct astigmatism with glasses, Medicare will only cover a cataract surgery with astigmatism if the cataract surgery itself is considered necessary. If this is the case, Medicare will pay for the cataract surgery.
Does Medicare Cover Glasses or Contacts?
For the most part, Medicare does not cover routine vision care, glasses, or contact lenses. However, Medicare can make an exception
You may be wondering, “How much does Medicare pay for glasses after cataract surgery?” After your surgery, Medicare will cover 80% of the costs for prescription glasses or contacts, but you must purchase them through a provider who accepts Medicare assignment.
You will be responsible for the remaining 20%. Some beneficiaries have trouble getting Medicare to cover the pair of glasses or contacts.
If you are denied coverage, you can appeal the decision and request that they are covered. If you already paid for them out of your own pocket, you can request reimbursement.
You and your health provider can write a letter to add to your appeal, just be sure to state that you had met the requirements for cataract surgery, so your glasses or contacts must be covered.
What Is the Average Cost of Cataract Surgery?
Cataract surgery can range from $3,800 to $7,000 per eye without a health insurance plan. For standard cataract surgery, the average cost is $3,700.
However, the average cost of astigmatism-correcting surgery is $5,000, and presbyopia-correcting is about $7,000.
What does Medicare pay toward cataract surgery? It depends on the Medicare plan you are enrolled in. If you are only enrolled in Original Medicare, you will need to pay a 20% coinsurance and your Medicare Part B deductible, which is $185 in 2019.
You may be able to get even more coverage through a Medicare Supplement plan (Medigap) or Medicare Advantage plan. Additionally, because cataracts cloud the eye lens, eye surgery is classified as a medical condition.
This means that Medicaid could also pay some of your cataract surgery costs.
How to Find a Cataract Surgeon Who Accepts Medicare
Ophthalmologists are eye doctors who specialize in vision correction and care. Many times your ophthalmologist will perform your cataract surgery.
Since not every ophthalmologist will accept Medicare Advantage and you may not want to go through the trouble of finding another healthcare provider, then ask your health insurance provider to give you a Medicare eye doctor list.
However, it may be a little more difficult to find a cataract surgeon who accepts Medicare in 2020 because the physician fee schedule has changed since last year. Eye surgeons have had to take a 15% cut in reimbursement compared to Medicare coverage for cataract surgery in 2019.
So another option is to use the Medicare.gov’s physician compare tool to help you find an eye surgeon who accepts Medicare.
Click here to get started. First you’ll come to the physician finder tool. Enter your zip code in the search bar beside the red arrow. We used 37209, which is our corporate offices’ zip code in Nashville, TN.
Then type “ophthalmology” in the search bar above the green arrow. Then click “Search” beside the yellow arrow.
Then you’ll come to a list of ophthalmologists who currently accept Medicare. Use the contact info to call different doctors to find the right fit.
Medicare Requirements for Cataract Surgery
Your vision must be 20/40 or worse to qualify for surgery. Your doctor will need to document that your vision is at this level or lower.
You also need to have difficulty completing daily living activities like reading, sewing, watching television, or driving.
It’s important to remember that the cloudiness in your eye is not directly correlated to the severeness of your cataracts. If you are unsure of your vision level or whether or not you qualify, visit your eye doctor.
Cataract Surgery and Medicare Supplements
Medicare Supplements work alongside Original Medicare and are a great way to add financial benefits to your current coverage. They can help cover your 20% coinsurance and your Medicare Part B deductible.
Plan F is currently the only plan that covers your Part B deductible.
However, Plan F was discontinued in 2020. If you enrolled in it before the start of 2020 you are locked into this plan and will maintain coverage. If you are interested in enrolling in Medicare Supplement Plans, fill out this form or give us a call at 844-431-1832 (TTY 711).
Cataract Surgery and Medicare Advantage
Medicare Advantage plans are required to cover, at a minimum, the same as Original Medicare. However, MA plans offer several additional benefits like prescription drug coverage, hearing and dental coverage, group fitness classes like SilverSneakers, and additional vision coverage.
Benefits will vary by plan but can include routine eye exams, eyeglasses, contacts, frames, and fittings. These benefits allow you to check your vision each year and update your prescription, lenses, and frames as needed.
If you are only enrolled in Original Medicare, you will need to pay for these expenses out of your own pocket.
What Are Cataracts?
Our eyes have a lens that works much like a camera. The lens bends light so you can see your surroundings.
A cataract makes that clear lens cloudy, and it can be more difficult to read or drive a car.
What Causes Cataracts?
Most of the time, cataracts develop with age, or when an injury changes your eye’s lens. As you age, the lens can become stiffer, thicker, and less transparent.
Sometimes genetic disorders, other eye conditions, medical conditions such as diabetes, or past eye surgery can contribute to cataract development. Other causes can be long-term steroid medication use.
Cataract Symptoms
According to the Mayo Clinic, signs and symptoms of cataracts can include:
Cloudy, blurry or dim vision
Increasing difficulty seeing at night
Sensitivity to light and glare
Need for brighter light for reading and other activities
Seeing “halos” around lights
Frequent changes in glasses or contact lens prescription
Fading or yellowing of colors
Double vision in one eye
How Do You Know If You Need Cataract Surgery?
Talk to your doctor if you experience any changes to your vision such as cloudiness or halos around lights. According to Harvard University, you should have an eye exam every year if you’re 65 or older.
Dr. Laura Fine, an ophthalmologist with Massachusetts General Hospital, says you don’t need cataract surgery until you think you need to see better.
Learn More About Medicare and Cataract Surgery
A licensed agent with Medicare Plan Finder may be able to find plans in your area that fit your budget and lifestyle needs.
Are you interested in learning about available plans in your area? Fill out this form or give us a call at 1-844-431-1832 (TTY 711) to schedule a no-cost, no obligation appointment with a licensed agent.
Does Medicare Cover Genetic Testing for Cancer?
Cancer is the leading cause of death worldwide and impacts millions of patients and families each year. Fortunately, genetic testing for cancer, which is growing in popularity, can be a great tool for understanding your risk of developing cancer.
Does insurance pay for genetic testing of cancer? Yes, but coverage determination depends on certain circumstances.
The American Cancer Society estimates that 1 in 3 people in the United States will develop cancer at some point in their life. Data and research show that cancer risk is highest for those between the ages of 65 to 74 years and accounts for the largest portion of new cancer cases found each year.
While you may have a smaller chance of developing cancer if you are under the age of 65, it is still a good idea to get tested as early as possible so that you can make smart decisions about health insurance and your future.
Is Cancer Hereditary?
About 10% of cancers occur in someone who has inherited gene mutations. Hereditary cancer syndromes are caused by mutations in certain genes passed from parents to children.
Researchers have found mutations in more than 50 hereditary cancer syndromes.
These mutations are found in the genetic code of DNA and are represented by the letters A, T, C, and G. These codes can be long – for example, the BRCA 1 code is over 10,000 letters long.
However, not every mistake in the “code” should raise concern for cancer.
Reasons to Consider Genetic Testing for Cancer
If you have an inherited gene mutation, that doesn’t necessarily mean you’ll get cancer. It only means that you’re at a higher risk of developing certain types of cancer.
If your personal history or family history of cancer suggests you are at risk, find out how genetic counseling and genetic testing can help you understand and manage your concerns.
The following populations should also ask for specific types of genetic testing:
Those whose family members have had gynecologic cancer should get tested for fallopian tube cancer. This very rare cancer only affects about 1,500 to 2,000 women worldwide and only about 300 to 400 women are diagnosed with it every year in the United States.
Those with a family history of pancreatic cancer can get tested for inherited conditions that can increase the risk of getting this type of cancer.
Those with a personal history of breast cancer can take the BRCA gene test to see if they have an inherited mutation.
You may want to tell your family about your test results whether the results are positive or not.
Risk Factors for Hereditary Cancer
When cancers are linked to an inherited gene mutation, that’s called a family cancer syndrome.
Certain factors may make it more likely that you and your family members can pass cancer on to your loved ones including:
Many cases of the same kind of cancer (especially if the type of cancer is rare) — like ovarian cancer caused by BRCA1 and BRCA2 gene mutations
Cancers that occur much sooner than usual – like breast cancer in a teenager
One person who has multiple types of cancer (like a man who has both colon and prostate cancer)
Cancers that occur in pairs of organs (both kidneys or both breasts, for example)
Siblings who have childhood cancers
Cancer that occurs in the opposite sex of the one usually affected (breast cancer in a man, for example)
Cancer that occurs in several generations (like in a grandmother, mother, and daughter)
Hereditary Genetic Testing for Cancer
The estimated number of new cancer cases in 2018 was 1,735,350. If you are curious about your risk of developing cancer, consider hereditary cancer testing.
Hereditary testing kits can help you understand any mutations you may have and allow you to better prepare for any issues that may arise in the future. Plus, knowing about an inherited mutation gives you the power to take the necessary steps to reduce your risk of cancer or to help detect it at an early stage.
Kits often include a saliva collection kit and a prepaid return label. The testing kits analyze over 30 genes that can contribute to the most common hereditary cancers.
A certified medical professional will review your sample and provide clear results of the absence or presence of any cancer-causing mutations. This information is personalized to you and provides information on how your genetic makeup can impact your family.
Medicare Cancer Test Kits
Fortunately, you can complete a cancer genetic test in the comfort of your own home. This can help alleviate any stress that may come from testing in a doctor’s office.
Most at-home test companies provide return labels so the entire process is convenient and stress-free. However, if you prefer to go into a doctor’s office for your genetic testing, that is also an option.
If you decide to use a Medicare cancer test kit to screen for covered screenings, be sure to follow the test’s directions to the letter. This helps ensure that your test results will be accurate.
Breast Cancer Genetic Testing & the BRCA Testing Cost
It is easy to learn your genetic risk of the most common hereditary cancers, including BRCA 1 and BRCA 2 genes. BRCA stands for BReast CAncer genes. BRCA 1 is on chromosome 17 and BRCA 2 is on chromosome 13.
All it takes is a small DNA sample through saliva.
Plus, the test can be conveniently mailed to you and completed in the comfort of your home. The cost of a hereditary cancer testing kit can range from $100 to $200.
There are multiple genetic testing companies, including Color and 23andMe, but not all are approved by the FDA.
Aging and Cancer
The risk of cancer increases with age, but it’s never too early to start screening. According to the Dana-Farber Cancer Institute, the average age for a breast cancer diagnosis is 61 years.
The average age for a prostate cancer diagnosis is 66 years.
There is no single explanation as to why age and cancer correlate, but researchers believe sunlight, radiation, environmental chemicals, and ingredients in our food are large factors.
Physical exercise, a healthy diet, and adequate sleep can help lower the risk of cancer as you age.
Medicare Coverage and Genetic Testing for Cancer
Doctor and Nurse Discussing Cancer Risk With Patient | Medicare Plan Finder
Medicare beneficiaries who need genetic counseling can get it covered under Medicare Part A and Part B only if it has been ordered by a physician before starting medication covered under Part D or if it is medically necessary in a skilled nursing facility.
Medicare covers certain genetic cancer tests if they’re medically necessary. In 2020, Medicare will cover genetic testing if:
You have recurring, relapsed, refractory, metastatic, or advanced stage III or IV cancer
You have not used the same genetic test for the same cancer diagnosis previously
You have decided to seek further cancer treatment such as chemotherapy and radiation
You have signs or symptoms of a cancer like colorectal cancer that can be clarified or verified with diagnostic testing
You have a first-degree relative who has a known mutation such as Lynch syndrome
Does Medicare Cover BRCA Testing?
How much does the BRCA test cost? The price ranges from $475 to $4,000. Fortunately, Medicare covers FDA-approved genetic testing for BRCA 1 and 2 for those with a personal or family history.
So, it covers hereditary breast, tubal, epithelial ovarian, or primary peritoneal cancer tests as well.
Does Medicare Cover Genetic Testing for Melanoma?
Medicare currently covers the Myriad Genetics myPath and Castle Biosciences DecisionDx genetic tests for melanoma.
Medicare also covers screenings for lung, breast, prostate, and cervical cancer. Screenings are used to detect potential disease and a diagnostic test establishes the presence or absence of the disease.
Does Medicare Cover Genetic Testing for Prostate Cancer?
Medicare covers prostate cancer screening for men over 50 every 12 months. If cancer is detected, Medicare Part B coverage includes a variety of options, including genetic testing to help physicians distinguish between an aggressive and a non-aggressive tumor.
This essential information helps physicians design an optimal treatment plan for their patients.
What Happens During a Genetic Test for Cancer?
A genetic test for cancer may provide some insight into your medical history and the possibility of passing mutated genes on to your loved ones.
Your doctor will first ask you questions about your personal and family medical history such as, “Have you or an immediate family member been diagnosed with cancer?” Based on your answers, your doctor may refer you to a genetic counselor. (A genetic counselor is someone who has advanced training in medical genetics and counseling.)
2. Informed Consent
Before your test, you must give informed consent, which means that you’re aware of and that you agree to the following items:
The genetic test’s purpose
The type and nature of the genetic condition being tested
The test’s accuracy
The pros and cons of testing (including the limits of the results and what they might tell you)
Other testing options
Possible screening or treatment options depending on the test results
Further decisions you might need to make once the results are back
The possible consent to use the results for research purposes
Availability of counseling and support services
Your right to refuse testing
3. Collecting the Sample
Depending on the test, you may need to provide a saliva, blood, hair, cheek cells (usually a swab from inside your mouth), urine, or stool sample. Once your healthcare professional collects your sample, he or she will send it to the lab for testing.
4. Getting the Results
Once the results are in, your genetic counselor or healthcare provider will tell you about your test results and the next steps you should take.
Questions to Ask Yourself About Medicare DNA Cancer Screening
Does Medicare pay for DNA cancer screening? Yes, because the Centers for Medicare & Medicaid Services (CMS) covers a broad range of FDA approved diagnostic tests, CMS cancer screening is available to detect many types of DNA cancers.
However, as with any type of medical screening, you should know what you’re getting into before you take the test. Before you take a Medicare cancer swab test, ask yourself:
Is this test legitimate? Unfortunately, genetic kits including Medicare cancer swab tests are the latest trend in Medicare fraud, according to many state and federal agencies. Your doctor can tell you what type of test to buy.
Is this test FDA-approved? Medicare will only cover FDA-approved tests.
How will this information benefit future generations? You may not want to know if you have genetic mutations that could lead to cancer. However, that information could help your children and grandchildren. If you have gene mutations associated with cancer, you can have Medicare cancer screening. Many forms of cancer can be treated if they’re detected early.
We Can Help You Find the Best Medicare Plans for Cancer Patients
A Medicare Advantage (MA) plan is a great option if you are looking for additional benefits like genetic testing beyond BRCA 1 and 2 and myPath.
Some may even offer fitness classes like SilverSneakers®, which can help promote a healthy, physically active lifestyle and help lower your risk of cancer.
If you’re diagnosed with cancer, you may be eligible for a type of MA plan called a Chronic Special Needs Plan (C-SNP). These plans are specially designed for people with certain chronic illnesses and conditions. Your C-SNP will involve a network of healthcare providers that will coordinate your treatment plan with each other.
If you are interested in arranging a no-cost, no-obligation appointment with a licensed agent to discuss your options for MA plans including C-SNPs, call us at 844-431-1832 or fill out this form.
Contact Us | Medicare Plan Finder
This post was originally published on November 29, 2018, by Kelsey Davis and updated on March 24, 2020, by Troy Frink.
2020 Assistive Devices for the Elderly: Feel Comfortable With Independent Living
As you age, simple tasks like buttoning your shirt, getting out of your chair, and putting on your shoes can become increasingly difficult. Assistive devices can help restore your confidence, improve mobility, and increase safety in your home.
The first step in making your day-to-day life easier is understanding assistive technology, durable medical equipment, and the role of Medicare.
What Is Assistive Technology?
Assistive technology (AT) covers a wide platform of devices for older adults who may need just a little bit of help. Assistive, adaptive, and rehabilitative devices all fall under the assistive technology umbrella.
Assistive devices help seniors maintain their functional independence. This, in turn, promotes their well-being. Communication aids, pill organizers, spectacles, memory aids, prostheses, or wheelchairs assist family members with cognitive decline or physical challenges with their daily activities.
Caregivers can improve an elderly person’s range of activities of daily living by carefully selecting the most appropriate assistive devices for safe, independent living.
For instance, encouraging the use of personal care products for good hygiene, grooming, and dressing can help older people maintain their dignity, raise their self-esteem, and improve their mobility by allowing them to take care of themselves.
Assistive technology can be used in various settings, such as living at home, in a nursing home, or in an assisted living facility.
Common Assistive Devices
High-tech mobility devices, such as walking canes, stairlifts, power wheelchairs, and scooters, can help seniors maintain their mobility. Mobility aids may also include low-tech assistive devices like transfer benches and bed rails because they reduce the risk of falls.
Meanwhile, adaptive devices are designed to make an available technology more accessible. For example, adaptive switches will allow an elderly person to activate switch-adapted electronics.
There are also assistive listening devices, called Frequency Modulation systems, that connect hearing aids to media such as tablets, smartphones, computers, and music players. Additionally, screen magnifiers are software products that interface with the graphical output of a computer to enlarge content on a screen.
We’ll split assistive technologies into health, home, and comfort categories. You can purchase these products online and in-store from companies like Amazon, Walmart, and Target. Some health devices can be priced as low as five dollars.
Health Devices
Health devices act as an extra layer of protection and are a great way to prevent falls and accidents. For example, grab bars in the bathroom can help you get in and out of the shower and keep you stabilized and balanced. Consider purchasing:
Activator poles to keep you stabilized and balanced.
Grab bars to keep your balance in hallways, stairwells, bathrooms, etc.
A bed cane to help you get in and out of bed.
A shower bench so you can sit and avoid falling in the shower.
Toilet rails to help you sit down and keep your balance.
Stairlifts so you can go up or down stairs with ease.
Wheelchair ramps so you can easily get into and out of your home.
Slip-free stair strips to keep you from slipping on slick surfaces.
Home Devices
Home devices are a fantastic way to increase independence and confidence in your home and make it easier for you to be home alone. For example, if you need a walker or cane to get around comfortably, an automatic swing door opener allows you to open the door hands-free. Common home devices include:
Video doorbells so you can see who’s at the door before you get up.
Fall detectors to alert your friends and family if you take a tumble.
A power failure alarm to alert you of lost power and provide emergency lighting.
An automatic swing door opener so you can open doors hands-free.
A talking thermostat so you can hear the temperature settings.
Voice-activated lights to turn your lights on and off without getting up.
Comfort Devices
Sometimes the smallest tasks can cause the largest frustrations. For example, you may be easily annoyed if you can’t button your shirt yourself or hear the television well. Common comfort devices include:
A buttoning hook to help you button shirts and pants.
A zipper pull so you don’t have to fumble with small zippers.
A modified keyboard so you can see the letters on the keys more clearly.
Robotic vacuums so you can have clean floors without lifting a finger.
A table tray so you can eat anywhere in your home.
A mattress lift so you can get in and out of your bed with ease.
A sound amplifier to help you hear conversations, television shows, etc.
Assistive Technology Devices
Georgia Tech describes high-tech assistive technology gadgets for seniors who want to remain independent as complex devices with digital or electronic parts that can be computerized.
They point out that these devices are often expensive, usually require training, and take some effort to learn. Some examples of helpful things for elderly people that have a small learning curve are power wheelchairs, digital hearing aids, and voice-activated telephones.
Durable Medical Equipment
Durable Medical Equipment (DME) includes equipment like hospital beds, oxygen equipment, sleep apnea devices, glucose monitors, and some of the assistive devices mentioned above. DME devices are covered under Medicare Part B. You will be responsible for 20%.
The equipment must be durable, used for a medical reason in your home, and have an expected lifetime of at least three years for Part B to cover it.
Medicare Advantage (MA) plans can also cover DME and assistive devices. The difference is that MA plans are able to offer additional benefits that Original Medicare does not. This includes benefits like hearing, dental, and vision coverage.
Some MA plans even offer group fitness classes like Silver Sneakers or an over-the-counter monthly allowance. If you’re looking for additional coverage and benefits beyond Original Medicare, a Medicare Advantage plan may be perfect for you!
How to Choose an Assistive Device
With so many products for elderly people living alone, it can often be difficult for a caregiver or senior to make a decision on what to buy. For instance, a senior who asks, “How do I choose a walking aid?” has to select between wheeled frames, walking frames without wheels, folding frames, indoor trolleys, and outdoor trolleys.
Consequently, the right decision requires a clear assessment of needs and then matching those needs with available features.
If deciding on a walking aid is complex, imagine how much more bewildering it must be for caregivers to select the best smart device for elderly patients? For instance, when it comes to smartphones, GreatCall offers a variety of options, such as the Jitterbug Smart 2 and the Jitterbug Flip.
Again, it’s about matching needs with features. Some expert advice from someone familiar with technology is helpful.
What to Consider Before Purchasing
A family caregiver helping a loved one decide what assistive device to purchase must consider factors like independence, specific needs, personal goals, simplicity, and so on. Before making a purchase, it’s useful to talk to a professional or people who have purchased the device, consider the cost, and ask if a trial is available.
Implementing assistive technology in the home may require some structural modifications to a room. When considering interior home modifications, such as relocating switches, installing emergency alarms, or lowering bench heights, it’s usually practical and cost-effective to only modify necessary areas in an apartment or house.
Assistive technology devices for elderly people can be classified into two broad groups, high-tech AT, such as smartphone systems and sensors, and low-tech AT, such as pill organizers and canes. Usually, people who need assistive devices require both kinds.
In addition to mobility AT, personal care AT, and communication AT, there are a number of assistive technology devices for seniors with cognitive decline. For instance, seniors with Alzheimer’s or Parkinson’s disease with significant memory loss can benefit from wearable timers that have set and forget features for managing things like turning off the stove after cooking or running water in a bath.
They will also benefit from smartphone apps that remind them of to-do lists or appointments.
Where to Buy Assistive Devices
A caregiver or senior can buy assistive technology from online tech stores. In 5 Assistive Technology Stores for your Techie with Special Needs, author Lauren Lewis recommends five top online stores that sell assistive devices: EnablingDevices.com, Boundless Assistive Technology, Enable Mart, Infogrip, and Able Net. Her article covers each store’s specialty.
Assistive Technology and Devices Coverage
Assistive technology and devices can improve your life in several areas. If you are interested in learning more about things to help at home, such as increasing your independence, improving your quality of life, supporting your health, and restoring your confidence, let us help you!
We have licensed agents across 38 states that are contracted with all of the major carriers and can help you find a plan that makes it easier for you to afford assistive devices for elderly parents or patients. To get started, call 844-431-1832 or click here.
Alzheimer’s Care Guide: Symptoms, Stages, Prevention, and Treatment
There are more than 5.7 million Americans living with Alzheimer’s. This number is expected to reach 14 million by 2050.
The complications from this disease make Alzheimer’s the sixth leading cause of death in the United States, so it’s important to educate yourself on the symptoms, signs, stages, prevention, and treatment.
Difference Between Alzheimer’s and Dementia
Dementia is a syndrome and used to describe symptoms that include memory loss, difficulty problem solving, and struggling with thoughts and language. Alzheimer’s is a disease and is a type of dementia.
In fact, there are over 100 types of dementia. Some forms of dementia can be temporary, reversed, or cured, however, Alzheimer’s disease cannot.
Alzheimer’s Symptoms and Stages
Alzheimer’s can cause changes in the brain long before any symptoms or signs start to show. Understanding the symptoms can help you detect Alzheimer’s early on and increase your chance of benefiting from treatment.
The risk of developing Alzheimer’s will vary per individual, but the following are the largest risk factors.
Age: Alzheimer’s is not a normal part of aging, however, your risk increases with age. Most people with Alzheimer’s are diagnosed after the age of 65. After 65, your risk doubles every five years.
Family History: If your parent or sibling was diagnosed with Alzheimer’s, you are more likely to develop the disease. This risk increases with the number of diagnosed family members.
Other Risks: There is a strong connection between our hearts and our brain. If you have heart disease, are overweight, or lack regular exercise, you’re at a higher risk of developing Alzheimer’s.
What Are the Very First Signs of Alzheimer’s?
Alzheimer’s is a slow progressing brain disease. If you notice any of the following warning signs, contact your doctor:
Forgetting recently learned information (dates, appointments, events, etc.)
Trouble following a recipe
Difficulty driving to a familiar location
Losing track of dates, seasons, and times
Difficulty reading
Trouble judging distances
Struggling with vocabulary
Misplacing things around the home
Paying less attention to hygiene needs
Avoiding social activities
Changing personality
What Are the 7 Stages of Alzheimer’s?
There are three general stages of Alzheimer’s – mild (early stage), moderate (middle stage), and severe (late stage). However, these stages can be broken down into seven more specific stages.
Keep in mind that the seven stages can overlap, and placing someone into a specific stage can be difficult.
Stage 1 – No Impairment: Alzheimer’s is not detectable in this stage. There are no signs of memory problems or other symptoms.
Stage 2 – Very Mild Decline: Minor memory problems may begin to surface. You would still perform well on memory tests, and Alzheimer’s will be difficult to detect.
Stage 3 – Mild Decline: At this stage, you or family members may start to notice small symptoms. Memory tests may be affected and doctors can detect impaired function. Someone in this stage may be unable to find the right words in conversation or remember new names.
Stage 4 – Moderate Decline: This stage is much more clear-cut. Someone in this stage may have difficulty with basic math problems, have short-term memory loss, be unable to manage bills, and may forget details of the past.
Stage 5 – Moderately Severe Decline: Those in this stage may begin to require assistance in day-to-day life. They may be unable to get dressed appropriately, be unable to recall details like their phone number, and demonstrate significant confusion.
Stage 6 – Severe Decline: People in this stage need constant supervision and may require professional care. They may be unaware of their environment, unable to recognize faces, and unable to remember most of their personal history. Loss of bladder control, personality changes, and wandering are also common in this stage.
Stage 7 – Very Severe Decline: This is the final stage of Alzheimer’s. People at this stage are unable to communicate and respond to their environment. Their speech may be limited to less than six words and they are unable to sit up independently.
How Quickly Does Alzheimer’s Progress?
The rate that Alzheimer’s symptoms progress can vary, but the average person lives four to eight years after diagnosis. However, early detection and a healthy lifestyle can help someone with Alzheimer’s live 20+ years after diagnosis.
Alzheimer’s Test
There is no single test that can diagnose someone with Alzheimer’s. Doctors use a combination of medical history, physical exams, neurological exams, mental status tests, and brain imaging when diagnosing.
Neurological exams address reflexes, coordination, eye movement, speech, and sensation. Mental status tests give an overall sense if a person is able to understand dates, times, locations, and simple instructions or calculations.
The Main Cause of Alzheimer’s
Although scientists don’t fully understand all the causes of Alzheimer’s, research suggests that this progressive disease is related to aging, genetics, and underlying health conditions.
Environmental and lifestyle factors may also contribute. Often the disease could be a combination of these factors.
Alzheimer’s Prevention
Complex factors like age, genetics, environment, lifestyle, and existing medical conditions play a role in developing Alzheimer’s. However, while you can’t change your genes or your age, there are plenty of steps you can take to help prevent Alzheimer’s.
Can Alzheimer’s Be Prevented?
There is strong evidence that shows changing your lifestyle promotes a healthy heart and lowers your risk of Alzheimer’s.
Prevention tips include:
Healthy Heart: There are several connections between our heart and brain. Studies have shown that about 80% of people with Alzheimer’s also have some form of heart disease. Manage your blood pressure, diabetes, and cholesterol levels to lower the risk of developing any heart conditions.
Exercise and Diet: Regular exercise and a healthy diet directly benefit your brain cells. Exercise increases blood flow and oxygen to the brain and a healthy diet limits your intake of sugars and saturated fats.
Social Activities: Staying social helps build and maintain strong connections. This can keep you mentally active. Researchers believe these connections can lower your risk of Alzheimer’s by increasing mental stimulation and reinforcing connections between nerve cells and your brain.
Alzheimer’s Disease Treatment
There is no cure for Alzheimer’s and no way to stop its progression. However, there are drug and non-drug options to help treat the symptoms. These include:
Medications for Memory: Cholinesterase inhibitors and memantine are common drugs used to treat memory loss and confusion. A doctor can prescribe these medications, so be sure to contact your health care provider.
Behavior Treatments: Some doctors may prescribe antidepressants, anxiolytics, or antipsychotic medications for people who demonstrate drastic behavior.
Alternative Treatments: Researchers believe that herbal remedies, dietary supplements, and certain foods can enhance memory and prevent Alzheimer’s. Some examples include coconut oil, coral calcium, and omega-3 fatty acids. To see an extended list, click here.
Alzheimer’s Care
Are you a caregiver? There are several options available to help a loved one diagnosed with Alzheimer’s. These options include:
Minor Assistance: You can help your loved one with simple tasks like removing objects that could cause injury, maintaining smoke alarms and fire extinguishers, and keeping dark areas, like stairwells, well lit.
Home Care: Home health services and adult day centers are two options that can help with more intensive health and well-being tasks, while the patient is still living in the home.
Residential Care: Residential care is common in the later stages of Alzheimer’s. Residential care can include assisted living, nursing homes, and Alzheimer’s special care units. These options can help with tasks like meal preparation, dressing, bathing, and other everyday tasks.
Alzheimer’s, like other forms of dementia, will often require long-term care. The type of care someone will need will change as the disease progresses; so, at some point, outside care will probably be necessary.
Outside care options include nursing home care, assisted living, adult care services, and respite care. Caring for Alzheimer’s patients in a nursing home is necessary when caring for your loved one at home has become overwhelming.
Alzheimer’s and Dementia Care: Tips for Daily Tasks
The Mayo Clinic organizes tips for caring for some with Alzheimer’s into two groups: things to do to reduce frustration and guidelines to follow to ensure a safe environment.
A care plan to reduce frustration could include the following:
Creating a daily routine for the patient.
Allowing the patient to take their time.
Doing tasks that involve the patient.
Offering the patient choices, such as offering finger foods if it’s time to eat but they are not hungry.
Providing instructions that are easy to understand and simple to follow. Establish eye contact to make sure the patient understands what has been said.
Reducing napping time so that the patient remains aware of whether it is day or night.
Reducing distractions when they are eating, such as turning off the television during mealtime to make it easier to focus on eating.
Some safety tips on dealing with Alzheimer’s patients could include the following:
Preventing falls by avoiding things that could trip a patient up, like extension cords, and installing handrails in places like bathrooms.
Putting locks on all cabinets that could contain dangerous equipment or materials, such as guns, power tools, utensils, cleaning detergents, and so on.
Checking water temperature before showers or baths to avoid scalding.
Avoid accidental fires by supervising smoking.
Making sure all carbon monoxide detectors and smoke alarms have charged batteries.
When applying these dementia caregiver tips, the caregiver needs to be patient and flexible and be open to changing routines as the symptoms of the disease progress.
Caring for the Caregiver
Family caregivers, such as a son or daughter caring for an Alzheimer’s parent, must prepare for a series of distressing experiences as they watch their mother or father forget favorite family memories and lose practical self-care skills.
It’s often challenging dealing with an Alzheimer’s parent because of the overwhelming emotions, the fatigue, the isolation, and the financial complications. Still, it’s rewarding to bond with a parent by providing them with care and service and solving their problems.
There are also new relationships with others they meet in a similar situation through support groups.
Getting Help With Caregiving
Initially, family caregivers can reduce stress by sharing their caregiving challenges with their support groups.
However, caregiver stress will increase as the disease progresses. While medications used for Alzheimer’s will control some symptoms, they can only provide a limited amount of memory care support before a patient experiences significant memory loss.
Eventually, it will become necessary to consider outside care options, such as respite care, senior care, or moving the patient to a skilled nursing senior center.
For information or support on what to do when caregiving for an Alzheimer patient becomes difficult, visit the Alzheimer’s Association at www.alz.org.
Coping With the Last Stages of Alzheimer’s
Alzheimer’s disease and related dementias affecting older adults get severe during the last stages of the disease. Patients will need considerable support because they will lose touch with what is going on around them.
It can be difficult to figure out how to talk to someone with Alzheimer’s when they don’t respond to what is happening in their environment, can’t communicate any discomfort or pain, and have difficulty controlling their movements.
Legal and Financial Planning
Legal and financial planning for someone with Alzheimer’s requires a specialized lawyer because any general powers of attorney will not work for asset protection planning. A skilled and experienced lawyer is also necessary if the patient needs a health care power of attorney document.
Role of Medicare and Alzheimer’s
Original Medicare (Parts A and B) cover inpatient hospital care and some doctor’s fees associated with Alzheimer’s. Plus, Medicare will pay up to 100 days of skilled nursing home care in certain circumstances.
Long-term custodial care, like a nursing home, is not covered. Medicare will pay for hospice care in-home or at a hospice facility.
Medicare Advantage plans are great options for coverage beyond Original Medicare.
Some people with Alzheimer’s may be eligible for a Medicare Special Needs Plan. SNPs are a different type of Medicare Advantage plan and generally provide coverage for doctor visits, hospital services, and prescription drugs. Some of these plans can coordinate care services to help you better understand your condition and your doctor’s plan.
If you qualify for a Medicare Special Needs Plan, you may also qualify for a Special Enrollment Period. This means you can enroll or change Medicare plans throughout the year!
If you have any questions about Medicare Special Needs Plans or Special Enrollment Periods do not hesitate to contact us. Our licensed agents are contracted with all the major carriers across 38 states and can help you enroll in a plan that fits your needs and budget.
To schedule a no-cost, no-obligation appointment, click here or call us at 844-431-1832.
Medicare for the Blind
In a world full of technology, it is easy to assume we all have equal access to Medicare information. But for those who are blind or have visual impairment, this isn’t always the case. In 2016, three blind Medicare beneficiaries changed the path for blind seniors and Medicare eligibles.
National Federation of the Blind vs. Centers for Medicare and Medicaid Services (CMS)
What happened in 2016 to change Medicare for the blind? Three blind beneficiaries decided to challenge how Medicare information is provided to those who are blind or have low vision.
This dispute brought attention to those who are Medicare-eligible and blind and highlighted that they are not provided with equal access to Medicare information. They explained that there was a lack of materials available to someone who was blind or had vision loss.
The Case Results in New Medicare Benefits for the Blind
Two years later, NFB and CMS reached an agreement that requires CMS to provide health care materials for blind or visually impaired beneficiaries in formats such as Braille, large print, and audio. CMS is also now required to extend any time restraints for beneficiaries who have difficulty accessing time-sensitive information.
CMS has responded quickly and implemented critical procedural policies, including training employees in compliance with Section 504 of the Rehabilitation Act of 1973. They are also testing the accessibility of materials on Medicare.gov, providing e-books, and establishing Customer Accessibility Resource Staff.
Medicare and Disability for Blindness
Blind beneficiaries may qualify for benefits from the Social Security Administration (SSA) paid through Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI). These monthly payments can be used to help ensure you have what you need.
The SSA is the organization that administers Medicare benefits for most enrollees. Eligible retired railroad employees get Medicare benefits through the Railroad Retirement Board.
Legally Blind Meaning for Medicare
The Social Security Administration defines blindness as, “vision [that] can’t be corrected to better than 20/200 in your better eye or if your visual field is 20 degrees or less in your better eye for a period that lasted or is expected to last at least 12 months.”
If you think you qualify for SSDI benefits because of your blindness, click here to apply. Be sure to review this disability checklist before you start your application.
Medicare Benefits for the Blind
In general, any disease or medical issue that affects your vision will likely qualify for coverage Medicare Part B. Treatments, as well as yearly preventive visits and diagnostic exams, could be covered for conditions like macular degeneration or glaucoma.
Medicare may also cover routine eye exams for certain high-risk groups, such as diabetics who are more likely to develop conditions that impair their visual acuity.
Unfortunately, Medicare does not classify eyeglasses or contact lenses as “durable medical equipment” and will not pay for them in most cases. Some exceptions include Part B beneficiaries who have had cataract surgery or have a congenital absence.
Medicare Coverage for Service Animals
Medical coverage at the state and federal level do not cover service animals. The average service animal costs between $15,000-$30,000 to adopt. So if you’re on a restricted income, this might be too costly. What can you do if you need a service animal and can’t afford one?
There are numerous nonprofit organizations that raise, train, and offer service animals for reduced costs. Some organizations provide a service animal free of charge if you qualify.
Additionally, while Medicare benefits won’t pay for the obtaining, feeding, or care for the animal, disability benefits may be able to help cover this additional cost. Other necessities, such as support canes, may also be covered by these disability benefits.
The Americans with Disabilities Act (ADA) does not consider “emotional support animals, or companion animals” to be service animals. In order for your service animal qualify, it must be a dog, and help you “perform specific tasks” directly related to your disability. For example, many service animals are guide dogs that help blind owners get from point A to point B.
Qualifying for Medicaid & Medicare Benefits for the Blind
Medicaid is a state and federal program that provides medical benefits to people who meet certain income eligibility requirements. Medicare is public health insurance available to most people 65 and older, and most people who have ALS, ESRD, or who have received SSDI for at least 25 months.
People who qualify for both Medicare and Medicaid may be eligible for a type of Medicare Advantage plan called a Dual Special Needs Plan (DSNP). Medicare Advantage plans are private insurance policies that can offer many benefits that Original Medicare cannot such as meal delivery, non-emergency medical transportation, and coverage for hearing aids.
Your DSNP SEP allows you to make one change per quarter from January to September. You can still make changes to your coverage from October to December, however, but you can only make a change during AEP. The changes you make during this period will take effect on January 1 the following year.
Do you have the right Medicare coverage?
Are you looking for an insurance plan that provides benefits specific to you? Our licensed agents can explain your coverage options and help you find a plan that best fits your needs and budget.
If you are interested in arranging a no-cost, no-obligation appointment with an agent, complete this form or give us a call today at 844-431-1832.
This post was originally published on August 23, 2018, by Kelsey Davis. The latest update was on December 9, 2020, by Addison McNatt.
Medicare Plan F Going Away (and Plan C) | ENROLL NOW!
What’s all this talk about “Medicare Plan F?” Is Plan F going away?
It’s true – Medicare Supplement Plan F is GOING AWAY in 2020! If you still want Plan F, you only have until December 31, 2019, to get locked in.
When you enroll in Original Medicare (Part A and Part B), you have the option of increasing coverage by purchasing a Medicare Supplement plan (also called Medigap). These plans work alongside Original Medicare and add financial benefits (like help paying for your copayments, coinsurance, and yearly deductibles).
Every state (except Massachusetts, Minnesota, and Wisconsin) has ten different types of plans. Each plan is represented by a different letter (A, B, C, D, F, G, K, L, M, and N). Plan F and Plan C are the most inclusive, and in turn, are the most popular. But did you know both plans are going away in 2020?
Plan F has been a top-seller in many states for years and is the most comprehensive Medigap plan. Medicare Plan F covers:
Blood work copays up to three pints (100%)
Foreign travel emergency (80%)
Hospice coinsurance and copayments (100%)
Part A coinsurance and hospital costs (100%)
Part A deductible (100%)
Part B coinsurance and copayments (100%)
Part B deductible (100%)
Part B excess charges (100%)
Skilled nursing facility coinsurance (100%)
Medicare Plan C Benefits
Medicare Plan C covers all of the gaps from Original Medicare except for Part B excess charges. More specifically, Plan C includes the following:
Blood work copays up to three pints (100%)
Foreign travel emergency (80%)
Hospice coinsurance and copayments (100%)
Part A coinsurance and hospital costs (100%)
Part A deductible (100%)
Part B coinsurance and copayments (100%)
Part B deductible (100%)
Skilled nursing facility coinsurance (100%)
Plan F vs Plan C
Plan F is very similar to Plan C. The only difference is that Plan C does not cover Medicare excess charges. If a doctor does not accept Medicare assignment rates, you will be responsible for excess charges, but it can not exceed 15% of what Medicare pays. Some states do not allow doctors to issue excess charges. If this is the case, Plan C will operate identically to Plan F.
Back in 2015, Congress passed the Medicare Access and CHIP Reauthorization Act. According to the act, starting on January 1, 2020, Medicare Supplement plans can no longer cover the Part B deductible, something that only Medigap Plans F and C currently cover.
When people don’t have to pay a deductible for services, they can end up overusing the doctor. For example, the might schedule an appointment with their doctor for a flu shot instead of using the free clinic inside their local grocery store. By visiting the doctor unnecessarily (and not paying for it), doctor’s offices are getting crowded and doctors aren’t being fully compensated for their time.
Eliminating Part B deductible coverage through Medigap works better financially for the Medicare program and for the doctors who accept it.
Thankfully, that Part B deductible is a small price to pay at less than $200 per year.
When will Medicare Plan F be discontinued? What about Plan C?
If you currently have Medicare Supplement Plan F or Plan C, don’t fret! This policy change only affects new beneficiaries. While your rates may increase (as they technically do every year), you will not lose your current coverage. However, if you leave your Medigap Plan F or Plan C for whatever reason, you will not be able to go back to it after 2020. If you do not have Plan F or Plan C, but you would like to, you can lock yourself in by enrolling NOW. You must enroll before January 1, 2020, to receive Plan F or Plan C coverage.
Due to this change, Plan F and Plan C beneficiaries will be given a chance to compare rates and switch to a new policy. If you decide you may want to switch, you can start by using our Medicare Plan Finder tool to decide what plan option (other than F) is best for you. If you still need help, click here to request a call from a local and licensed agent!
Will Plan F Costs Go Up in 2020?
It is certainly possible that Plan F costs will go up as it is phased out, though it hasn’t been confirmed yet.
Uniquely, the state of Idaho released a memo stating that the Idaho Department of Insurance “is NOT anticipating abnormally large premium increases on Plan F after 2020” in response to questions about Plan F leaving the market. Even people who already have Plan F in Idaho and want to switch to a different Plan F after this year should not face large rate increases.
Can I Get Plan F in 2020?
Medicare Plan F is discontinued in 2020. If you missed the deadline of December 31, 2019, you won’t be able to enroll in Plan F for the first time. If you already have Plan F, don’t worry – you can keep your coverage.
You’ll be asked to enter your zip code to get started. Then, you’ll have to answer a few questions: your gender, your date of birth, whether or not you smoke, and what kind of premium you want. After submitting some basic information, you’ll see a list of the plans that the tool recommends for you.
The system may or may not recommend Plan F based on the way you answered the questions.
Medicare Plan Finder Tool Results
When to Enroll in Plan F
If you still want Medigap Plan F, you have just a little bit of time left to enroll. The deadline is December 31, 2019. After then, Plan F will be discontinued for new members.
What is a good alternative to Plan F?
Many seniors and Medicare eligibles who already have Plan F are deciding to drop Plan F altogether and switch to Plan G. Plan G covers everything that Plan F does minus the Part B deductible, and it typically has a lower monthly premium.
Another popular plan is Plan N. The only benefit that is included in Plan G and not Plan N is the coverage for Part B excess charges. However, the thing to remember about excess charges is they are relatively rare. You will only be charged an excess charge if your provider does not accept Medicare.
Medicare Plan F vs Plan G
Great news! Plan G is almost identical to Plan F! The only difference is that Plan G does not cover the Part B deductible. Plan F may technically cover more, but many people consider Plan G to be a better value. Yes, you will need to pay your Part B deductible upon your first outpatient visit, but after you pay the deductible, you won’t need to pull your wallet out for the remainder of the year. Since you have to pay the Part B deductible yourself, Plan G has lower monthly premiums, and you could save more than $400 a year!
The standard Part B deductible for 2020 is $198, so the savings from choosing G over F significantly outweighs the cost of the deductible.
Is Medicare going away or just certain plans?
No, Medicare is not going away! Don’t panic!
Both Medicare Plan F and Medicare Plan C will be discontinued on January 1, 2020, but other options may be available in your area. We get it, Medicare coverage and plan options can be confusing and stressful. Policies are constantly changing, and healthcare will continue to evolve.
At Medicare Plan Finder, our agents are kept up to date on all the plans in your area and can help you find a plan that suits your needs and budget. If you’re interested in arranging a no-cost, no-obligation appointment, click here or give us a call at 833-431-1832.
This blog was originally published on October 23, 2018, by Kelsey Davis. The latest update was updated on December 5, 2019, by Troy Frink.
Winter Wellness Tips for Seniors and Medicare Eligibles
Winter often consists of lower temperatures, less sunlight, and more time indoors. The same weather that is bothersome to most can prove to be dangerous for others.
Winter Safety Tips for the Elderly
love, winter holidays and people concept – happy senior couple with takeaway coffee at christmas market on town hall square in tallinn, estonia
Seniors and Medicare eligibles face several dangers including falling on ice or snow, frostbite, and hypothermia. Use these winter wellness tips to help ensure you are healthy, safe, and able to enjoy the holidays with your friends and family.
Falling on Ice or Snow
According to the Centers for Disease Control and Prevention, falls are the leading cause of injury and death in older adults. Fall prevention is important outside and in your home, but snow and ice can easily blindside you. Tips to protect yourself from falling on ice or snow include:
Understand the side effects of your medications. Some medicines can cause dizziness or vision issues, so be cautious when leaving your home.
Wear weather-appropriate shoes. Make sure your shoes are the right size and have good traction.
Allow extra time when commuting to your destination. Don’t rush when you’re walking and take small deliberate steps.
Use sand or cat litter on sidewalks or walkways.
When going inside, wipe your feet off before you enter. Wet shoes can cause you to slip on dry surfaces.
Keep your hands free whenever possible. If you are carrying bags, take several trips so you do not overload yourself. Always ask for help if possible.
Have emergency numbers stored in your phone. Take your phone whenever you leave the house, even on short trips to your car or mailbox. If you fall, you can easily access your phone and call for help.
Frostbite and Hypothermia in the Elderly
As temperatures drop, there is an increased risk of frostbite and hypothermia in the elderly. Frostbite and hypothermia are a result of cold weather and can be difficult to notice. Understanding the differences, warning signs, and symptoms are important when practicing winter wellness.
Frostbite occurs when your skin is exposed during extreme winter conditions. The cold weather causes your tissues underneath your skin to freeze. Frostbite causes you to lose feeling in the exposed area, which is commonly your fingers, toes, nose, ears, cheeks, and chin. If your skin turns white or a grayish-yellow color, or feels firm or waxy, seek medical care immediately.
Hypothermia occurs when your body’s core temperature becomes abnormally low. Hypothermia in the elderly is more likely due to a decreased production of body heat.
Warning signs of hypothermia include shivering, exhaustion, confusion, memory loss, slurred speech, and drowsiness. If you are experiencing these warning signs, take your temperature if possible. If your temperature is below 95 degrees, seek medical health immediately.
Prevention is key to protect yourself from frostbite and hypothermia. Make sure your home is well heated and insulated and be sure to eat healthy foods to fuel your body.
If you need to go outside or travel for any given reason, check the weather, and if possible, avoid extremely low temperatures. However, if you must venture out, wear plenty of weather-appropriate clothing.
Senior Isolation in the Winter
Many seniors and Medicare eligibles may be unable to leave their home in the winter. This can lead to a lack of social interaction. Feeling isolated can disrupt sleep, raise blood pressure, increase the risk of depression, and lower your overall well-being. Tips to prevent isolation include:
Call, email, or FaceTime friends and family regularly.
Consider getting your meals delivered to encourage a healthy diet. Programs like Meals on Wheels are great options.
Reach out to friends, family, and neighbors.
If you really struggle with isolation, consider moving into an assisted living facility.
Fire Hazards
Home fires can start at any time but are more common in the colder months. It’s important to practice fire safety and have an emergency action plan in place. Here’s what you should remember:
Make sure you have smoke alarms in the appropriate areas of your home, especially near any sleeping areas. Test alarms regularly and have spare batteries on hand.
Never walk away from a room when cooking. Plus, you should always have a fire extinguisher handy.
Keep curtains and drapes away from any heat source.
Never leave a burning candle unattended.
If you have a fireplace, get it inspected annually.
Place space heaters in an area that is open and clear.
If you smoke, avoid smoking indoors and around oxygen tanks.
Seasonal Affective Disorder (SAD)
Seasonal affective disorder (SAD) is a type of depression that’s associated with changes in seasons. The disorder begins and ends at about the same time every year, with symptoms starting in autumn and continuing until spring.
Symptoms of SAD
SAD symptoms may include:
Feeling depressed most of the day almost every day
Loss of interest in activities you’d normally enjoy
Low energy
Having problems falling or staying sleeping asleep (or sleeping too much)
Changes in your appetite or weight
Feeling sluggish or irritable
Difficulty concentrating
Feeling hopeless, worthless or guilty
Frequent thoughts of death or suicide*
*If you or someone you love experiences thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255.
Combat SAD With a Winter Fitness Plan for Retirees
Retirees and Medicare eligibles can fight SAD with a great fitness plan. According to Harvard Medical School, fitness is as effective as antidepressants in some cases. Although a gym membership with fitness classes may help, you can get a great workout at home. All you need is some dumbbells, resistance bands, or even a chair.
In some locations, going for a walk outside isn’t an option due to weather concerns. Have you considered going for a walk at the mall? Many indoor shopping centers open their doors to “mall walkers” before the stores open.
Winter Wellness and Medicare
Winter wellness is important in maintaining a healthy lifestyle through the holidays and into spring. However, it’s important to focus on your wellness year around. Medicare Advantage plans have additional benefits and coverage that can help you become the healthiest version of you!
Many plans offer hearing, dental, and vision coverage. Plus, some even offer fitness classes like through SilverSneakers®! If you’re interested in hearing more about these additional benefits or have any questions regarding your Medicare coverage, call us at 844-431-1832 or fill out this form to get in contact with a licensed agent.
This post was originally published on December 11, 2018, and updated on November 22, 2019.
Yoga for Seniors and Medicare Eligibles
Yoga for seniors and Medicare eligibles is an effective way to improve your mental and physical wellness. When some people think of yoga, they may picture complex poses with intricate twists. That image of an unattainable exercise may make the ancient practice seem intimidating.
However, yoga doesn’t have to be intimidating or unattainable. Yoga has many health benefits, and it can even be included in certain Medicare plans.
Health Benefits of Yoga for Seniors
Yoga combines physical movements, breathing, and meditation into one exercise. If you struggle with joint pain, balance issues, body stiffness, sleep issues, stress, or anxiety, yoga may be able to help! The health benefits of yoga for seniors and Medicare eligibles are as follows:
Balance and Stability
As you age, your risk of falling increases. Yoga focuses on slow and measured movements and the strengthening of your muscles. These exercises can help keep you upright and strong to avoid tripping or falling. Your focus, strength, and body alignment can all improve with yoga and increase your balance and stability.
Flexibility
At any age, stretching is important. Simple tasks, like tying your shoes, can quickly become difficult without proper daily stretching. Yoga allows you to increase your flexibility through each exercise.
Breathing
Respiratory limitations can be developed when our oxygen level begins to deplete. Studies have shown that after twelve weeks of yoga, many seniors and Medicare eligibles have seen significant respiratory improvement. Plus, the deep breathing exercises that encompass basic yoga sequences and poses can improve overall lung function in a low-impact environment.
Stress and Anxiety
Yoga for seniors and Medicare beneficiaries can help reduce stress and promotes mental clarity. Yoga is so much more than just “stretching.” It is a practice that requires both the mind and body. Meditation and relaxation are heavily incorporated. These exercises can help you be more mindful and aware of the present moment in time.
Yoga for Obese Seniors
According to the Mayo Clinic, yoga may be a “useful addition to an overall weight-loss plan.” You may not burn as many calories with yoga as you do with aerobic exercise, but it can help improve your self-esteem and overall mood.
Obesity can put excess stress on your joints, and yoga may be a safe form of exercise that may not cause additional pain.
If you want to do yoga, it may be a great addition to a comprehensive fitness program that includes aerobic activity such as cycling or walking.
Beginning Yoga for Seniors and Medicare Eligibles
Yoga doesn’t have to be intimidating. There are gentle yoga poses for seniors and Medicare eligibles and some poses incorporate chairs to help aid any balance or stability issues.
Gentle Yoga Poses for Seniors and Medicare Eligibles
Simple yoga for seniors and Medicare eligibles is generally low-impact and great for beginners. There are numerous gentle yoga poses for seniors and Medicare eligibles that are available, but the most popular are as follows:
Seated Forward Bend: Sit on the floor and keep your legs straight in front of you. Inhale and lean forward as far as you can. To avoid potential injuries, never force or push your body. This pose can calm the brain and help relieve stress. It stretches the spine, shoulders, and hamstrings and stimulates your liver and kidneys.
Legs Up The Wall: Find a sturdy wall and bring your tailbone as close as possible and raise your legs. Stay in this position for 10-15 minutes and focus on your breathing. This pose reduces gravity on your body and helps calm the nervous system.
Easy Pose: This yoga pose has been depicted as far as 2,000 years ago. Keep your back straight and cross your legs. This pose is great for meditation and breathing exercises. This pose comes naturally to children, but as you age, it may become more difficult. With practice, you can open your hips and help your spine return to proper alignment.
Corpse Pose: Lie flat on your back with your feet spread shoulder-width apart. Have your palms facing upwards. This pose is usually done at the end of your yoga practice and is more than just laying down. It relaxes your whole body and can release any stress, fatigue, or tension you may have.
Gentle Yoga Poses for Seniors and Medicare Eligibles | Medicare Plan Finder
Chair Yoga Poses for Seniors and Medicare Eligibles
If the balancing aspect of yoga intimidates you – good news, a chair can help! Many yoga poses can be modified to incorporate a chair. There are still significant benefits to this type of yoga, and it is very popular among people who have balancing issues. The following are chair yoga poses for seniors and Medicare eligibles:
Forward Fold: Sit in a chair and bend forward. When you inhale, raise your arms over your head and reach as far as possible. This yoga pose stretches your hips, hamstrings, and calves. This pose calms the brain and relieves stress. Plus, it stimulates your livers and kidneys and improves digestion.
Spinal Twist: When you are sitting on a chair, reach back as far as you can and twist your torso. It’s important to keep a good posture while twisting. This can lengthen, relax, and align your spine. Plus, it stretches your entire upper body. This can prevent your spine from becoming stiff and can help you maintain a normal spinal rotation.
Pigeon: The normal Pigeon pose can be quite difficult for seniors to do, so a chair can help tremendously! Sit up straight in your chair and keep your feet shoulder-width apart. Bring your right or left leg onto the other knee. Push the knee downward, and if possible, pull your foot up slightly. Repeat this 3-5 times and then switch to the other leg. Pigeon pose helps open your hip joints and helps lengthen your hip flexors. It can also help prevent or relieve sciatica pain.
Cat and Cow: Keep your feet flat on the floor and keep your back straight. When you inhale, arch your spine and roll your shoulders back. When you exhale, arch your spine the other way and drop your chin to your chest. This is great for breathing exercises. This stretches the lungs and chest, which makes breathing easier. This also stretches the hips, back, and abdomen.
Chest Expansion: Sit as straight as possible and reach your hands to the back of your chair. Lift your chest and take a deep breath. Do this for 3-5 breaths and then repeat. This strengthens your hand, arm, shoulder, and back muscles.
Chair Yoga for Seniors | Medicare Plan Finder
For more yoga poses for seniors, check out this video “Yoga for Seniors” by Yoga With Adriene:
Does Medicare Cover Yoga?
Original Medicare does not cover yoga or any other fitness classes. However, certain private insurance plans called Medicare Advantage cover the same benefits as Original Medicare (Part A and B) and can cover additional benefits such as vision, dental, and hearing coverage along with coverage for fitness classes.
These plans are growing in popularity. According to the Henry J Kaiser Family Foundation, enrollment has tripled to 19 million beneficiaries since 2003.
SilverSneakers ® Yoga Classes
Medicare SilverSneakers® is a fitness benefit found in many Medicare Advantage plans. SilverSneakers® hosts fitness programs for seniors that focus on general fitness, strength, flexibility, and walking ability for seniors and Medicare eligibles just like you. Medicare SilverSneakers® fitness events can also help seniors find new friends who also want to pursue an active lifestyle.
SilverSneakers® yoga classes provide a unique opportunity for seniors and Medicare eligibles to practice yoga in a judgment-free, inclusive group. These classes often incorporate chair yoga poses for seniors and Medicare eligibles.
More than 65% of leading Medicare Advantage plans include Medicare SilverSneakers.® This is generally provided at no cost.
Plus, there are over 11,000 locations across the US that offer SilverSneakers® yoga classes. Once you are enrolled in a Medicare Advantage plan that includes SilverSneakers® yoga, you will have access to any participating facility.
How to Find SilverSneakers ® Yoga Classes Near You
The SilverSneakers® website has a location finder so you can find participating gyms with classes near you. To get started, click here. You’ll come to the SilverSneakers® homepage, which looks like this. Click on the magnifying glass with the word “Locations” under it.
How to Find SilverSneakers ® Yoga Near You Step 1 | Medicare Plan Finder
That will lead you to the location finder tool. Enter your zip code in the search bar as shown in red. We chose 37209, which is the zip code for our corporate offices in Nashville, TN. Then click the carrot shown in green. After you do that, select SilverSneakers® as shown in blue. The final part of this step is clicking the magnifying glass shown in yellow.
How to Find SilverSneakers Yoga Near You Step 2 | Medicare Plan Finder
The next page lists the SilverSneakers® partners in your area. Clicking the listed gym names will show you the amenities at each location. We only clicked on the first location for demonstration purposes.
How to Find SilverSneakers ® Yoga Near You Step 3| Medicare Plan Finder
Here, you can see that the Gordon Jewish Community Center offers SilverSneakers® yoga classes in red. Use the contact information shown in blue to learn how to get started.
How to Find SilverSneakers Yoga Near You Step 4| Medicare Plan Finder
Enroll in Medicare Advantage
If SilverSneakers® yoga is something you’re interested in, then you should consider enrolling in a Medicare Advantage plan.
If you interested in enrolling in the best MA plan for your needs and budget, fill out this form or call us at 844-431-1832 to speak with a licensed agent. These appointments are no-cost to you and obligation-free. Our licensed agents can answer any questions you may have, and best of all, make sure you get SilverSneakers® yoga.
This post was originally published on October 25, 2018, by Kelsey Davis and was updated on November 18, 2019, by Troy Frink.
