Common Spine Problems with Aging

As you age, your spine can naturally lose its normal structure and function. Spinal sprains, strains and overuse over the course of a person’s life can cause gradual spinal degeneration. Most people over 40 experience some degeneration of spinal disks, which can cause back pain. Common spine problems with aging can often be prevented or treated without surgery, but sometimes an operation is the only option to relieve pain.

Talk to your doctor if you have chronic back pain. Your doctor will make diagnoses, recommend a plan of action, and monitor your condition. Seniors and Medicare-eligibles have health insurance resources at their disposal. Medicare will cover some diagnostic and treatment services for back pain in the elderly.

What is Spinal Degeneration?

The spine is composed of vertebrae and rubbery disks that act as cushions between the bones. Spinal degeneration is when the parts that make up your spine break down and lose function. Many conditions can contribute to spinal degeneration, including:

Osteoporosis

You lose bone density as you age, putting you at risk for osteoporosis, which means “porous bones.” Women are more susceptible to osteoporosis than men. Osteoporosis can often result in bone fractures, and oftentimes symptoms don’t surface until the first broken bone.

Herniated Disks

Spine disks have an outer portion that contains the rubbery part that cushions the vertebrae. A herniated disk occurs when the outer portion tears and the rubbery inside starts to poke through the outside.

Spinal Stenosis

As arthritis or disk degeneration becomes worse, the space that contains the spinal cord and nerve roots can become narrow and cause stenosis. When the space narrows, a ligament that goes over the space between the vertebrae can become short and thick. That narrowed space between the disks puts added pressure on the nerves and can cause pain.

Spinal Degeneration Symptoms

Common spine problems with aging usually include pain. Some people have manageable pain or discomfort, but others may experience incapacitating pain. Symptoms include:

• Pain in the lower back, buttocks, and legs
• Pain that starts in the neck and then travels to the arms and hands
• Pain that’s not as noticeable when you walk, but worsens when you sit down
• Pain that gets worse quickly when you bend, twist or lift things
• Pain that gets better depending on how you sit or lay

Long-term nerve damage that results from spinal degeneration may feel like tingling or numbness in your arms or legs.

Testing for Spinal Degeneration

Diagnosing spinal degeneration can be difficult because the conditions usually start small. As the components of your spine deteriorate, serious spine problems become more likely to occur. For example, degenerative disk disease can cause spinal degeneration that can eventually result in a herniated disk. However, lifting a heavy object the wrong way can also cause a herniated disk. Even though your doctor may be able to quickly diagnose a herniated disk, finding out that the root cause of the hernia is degenerative disk disease may take more in-depth screening.

Testing for common spine problems with aging may come in the form of diagnostic imaging including X-ray, MRI or EMG depending on your symptoms. Medicare will cover all three tests if your doctor orders them.

Elderly Back Pain Solutions

Many common spine problems in older adults can be prevented by practicing healthy habits. However, sometimes problems can become severe enough that the only way to treat the pain is surgery.

Nonsurgical Treatment

Back pain is oftentimes caused by the inflammation and pressure on the nerves that any spinal degeneration condition can bring. You can help relieve pain by:

• Proper posture: Exercising good posture can help stop chronic back pain before it starts. Medicare will cover a back brace to help remind you to keep your back straight.
• Physical activity: You’ll feel better the more active you are, and you can recover from back pain episodes sooner. Certain private insurance plans called Medicare Advantage plans cover fitness classes.
• Physical therapy: Your doctor can prescribe an exercise program to help improve your balance and mobility. Medicare covers doctor-prescribed physical therapy.
• Cold application: Use an ice pack to help relieve pain when you first experience pain. Applying ice for 20 minutes can help calm inflammation or muscle spasms. If you don’t have an ice pack, a bag of frozen peas will work.
• Heat application: If back pain persists for a couple of days, try using a heating pad or taking a warm bath. Heat can help relax your back muscles and increase blood flow. After you’ve applied heat, stretch your muscles to prevent muscle spasms.
• Over-the-counter pain medications: Non-steroidal anti-inflammatory medications (NSAID) such as ibuprofen, aspirin or naproxen can help stop pain. Talk to your doctor about when and how to take NSAIDs.
• Effective rest: You may want to stay in bed if you “throw your back out,” but gentle stretching will aid in your recovery much better. Bed rest can actually make back pain in the elderly worsen and last much longer.

Sometimes back pain will become chronic and persistent, and you’ll need more invasive treatments. Your doctor might recommend:

• Nerve blocks:  A steroid injection can reduce back pain and inflammation at its source. Medicare covers medically necessary steroid injections, but it has specific requirements for Epidural Steroid Injections (ESI).
• Radiofrequency ablation: A needle that can transfer radiowaves can be inserted to block pain signals from nerves using high-frequency current. For some people, it can relieve chronic back pain for nine months or longer. Medicare will cover radiofrequency ablation if it’s medically necessary.
• Spinal cord stimulators: Stimulating part of the spinal cord can change some people’s pain perception. A small array of electrodes that works much like multiple pacemakers can be implanted to send electrical impulses to the spinal cord. The impulses can hide or divert pain signals so they don’t reach the brain.

Surgical Treatment

If more conservative therapies don’t work and pain persists for more than three months, it might be time for more drastic measures. Surgery is a last resort for people whose pain gets unmanageable. The surgeries used to treat spinal degeneration range from minimally invasive procedures to more involved procedures including:

• Minimally invasive lumbar decompression: An outpatient procedure that treats spinal stenosis by making a small incision and removing part of the disc to alleviate pressure on the nerves.
• Minimally invasive kyphoplasty or vertebroplasty: A procedure that uses cement to help treat a spine fracture. The cement helps relieve pain and return the patient to full function.
• Spinal fusion: A surgery that fuses two vertebrae together to make the spine more stable.  It can relieve extreme pain and help you bear your weight again.

Medicare will cover medically-necessary back surgery, but you may owe coinsurance and deductibles.

We Can Help

Your doctor can help you treat and prevent common spine problems with aging, and the right Medicare plan can help you cover the costs. A Medicare Plan Finder agent can help you find a plan that fits your budget and medical needs. Call us at 844-431-1832 or contact us here to arrange a no-obligation appointment.

Testing for Common Health Problems in Elderly People

As you age, your body breaks down and you may need to be more vigilant about regular health screenings. For example, what starts as slightly elevated blood pressure can turn into chronic hypertension, which dramatically increases your risk of stroke. However, if you stay on top of your health screenings and follow your doctor’s recommendations, you can help yourself stay ahead of some of the most common health problems in elderly people.

Preventing the Most Common Chronic Diseases in Older Adults

A variety of chronic health issues affect the elderly at higher rates than younger adults. The most common chronic diseases in older adults are:

• Type 2 diabetes
• Arthritis
• Kidney and bladder issues
• Dementia
• Alzheimer’s disease
• Parkinson’s disease
• Glaucoma
• Lung disease
• Cataracts
• Osteoporosis
• Prostate enlargement
• Macular degeneration
• Depression
• Cardiovascular disease

Thankfully, there are resources available for treating common elderly diseases. Anyone who qualifies for Medicare can receive regular health screenings and annual exams during which doctors can check for symptoms of the most common elderly diseases.

Blood Monitoring

According to the CDC, 64 percent of men and 69 percent of women ages 65-74 have high blood pressure, or hypertension. You may not notice symptoms until it’s too late. Chronic hypertension can lead to stroke or heart attack, so it’s important to monitor your blood pressure and have your doctor check it once a year during your Medicare annual wellness exam.

Your risk of stroke and heart attack is significantly reduced if you have a healthy triglyceride and cholesterol level. If you’re diagnosed with high cholesterol, work with your doctor to come up with a plan to maintain a healthy lifestyle including a nutritious diet and an exercise program. Medicare will cover a cholesterol test once every five years.

Cancer Screenings

As you age, your likelihood of developing cancer increases. Regular check-ups and testing for cancer is an important step in catching it before it becomes unmanageable. Medicare will cover screenings for certain cancers such as:

Colorectal Cancer Screenings

A colonoscopy is a screening where a doctor uses a small camera to scan your colon for cancerous growths called polyps. You should get a colonoscopy once every 10 years after your fiftieth birthday. Medicare will cover one colonoscopy every 10 years if you have an average risk of developing colon cancer, or once every two years if you have a high risk. You will have the best chance for successful treatment if you catch colorectal cancer early, so don’t skip out on your colonoscopies.

Breast and Cervical Cancer Screenings

Women over 40 should get one mammogram per year, and one clinical breast cancer exam once every two years. Women 65 and older should have regular pap smears and pelvic exams to screen for cervical cancer. Medicare covers these tests as well as other gynecology services.

Prostate Cancer Screenings

A prostate cancer screening generally comes in two forms: digital rectal exams and a check for prostate-specific antigens (PSA) in your blood. Men should start having regular prostate cancer screenings starting at age 50. Medicare will pay for 100 percent of the PSA measurement, but you may have to pay coinsurance or a deductible for a digital rectal exam.

Skin Cancer (Melanoma) Screenings

Skin cancer usually starts small. If you find a new growth on your skin or a mole that changes color, go to a dermatologist for skin cancer testing. Medicare covers medically necessary dermatology services.

Certain moles are skin cancer warnings. They usually have recognizable characteristics. Before you visit the dermatologist, remember the ABCDEs of mole exams:

• Asymmetry: If you can draw a line down the middle of your mole and it the same shape appears on both sides, your mole is usually not cancerous.
• Border: Melanomas can have uneven borders that can look scalloped or notched.
• Color: Benign moles are usually all one shade of brown. Melanomas, however, are not. They can have different shades of brown or black, or even appear red, blue or white.
• Diameter: Melanomas are usually ¼ inch in diameter or larger, whereas benign moles are smaller.
• Evolving: If your mole changes color or starts to evolve in any way, it could be a melanoma.

Bone Density Test

As you age, your bone density may deteriorate. Elderly men are much less likely than women to get osteoporosis. Medicare will pay for one test every two years for women 65 and older, and one test every two years for men 70 and older.

Dental, Vision, and Hearing Tests

Original Medicare does not cover routine dental, vision or hearing services, but certain private insurance policies called Medicare Advantage plans do. Mouth, eye and ear health are still vital components over your overall well-being, so it’s crucial that you include whole-body health in your wellness plan.

It’s common for seniors to develop periodontal disease and start to loose teeth. A thorough daily oral hygiene routine and regular check-ups with a dentist can make a huge difference. A periodontal exam can be part of your semiannual teeth cleanings.

Adults 40 and older should have eye exams every year if they wear glasses or contact lenses. If you don’t need vision correction, ask your eye doctor how often you should take eye exams.

Your hearing will naturally decline as you age, but sometimes infections and diseases result in premature hearing loss. Medicare Part B (medical insurance) will cover a hearing test as a result of an injury or illness.

Diabetes Screening

Another common health problem in elderly patients is diabetes, which is when your blood sugar is so high that your pancreas can’t produce enough insulin. You should undergo annual diabetes testing if you display risk factors for diabetes such as obesity or prediabetes.

Medicare will cover diabetes testing such as fasting glucose tests and/or post-glucose challenge tests for people who have a history high blood sugar, hypertension or a history of high cholesterol.

Thyroid-stimulating Hormone Assessment

The thyroid is a gland in your neck that regulates metabolism, and sometimes it may not produce enough hormones. The lack of hormones may lead to lethargy, weight gain, and aches and pains. It can even cause erectile dysfunction in men. A blood test can assess your level of thyroid-stimulating hormones (TSH) and determine if your thyroid is functioning like it’s supposed to.

Vaccinations

Vaccinations can drastically reduce the risk of many common health problems in the elderly. Many of these vaccinations are covered in your annual wellness exam, including:

• Tetanus Booster Shots: You should receive a tetanus booster once every 10 years.
• Shingles vaccines: Everyone 60 and older should also receive shingles vaccines.
• Pneumococcal vaccine: In order to protect against pneumonia and other infections, get a pneumococcal vaccine. Pneumococcal disease can result in a variety of health problems, including:
  • Pneumonia
  • Sinusitis
  • Meningitis
  • Endocarditis
  • Pericarditis
  • Inner ear infections

Contact Us Today

Many common health problems in elderly patients can be treated or avoided altogether if they’re caught early. The right Medicare plan can cover elderly health screenings and help pay for treatment. If you need help finding a Medicare plan, call us at 844-431-1832 or fill out this form today.

Does Medicare Cover Sleep Apnea?

Sleep apnea is a condition in which a person repeatedly stops breathing while they sleep for about 10 seconds. Its effect on sleep quality is astronomical.

Sleep apnea is one of the leading causes of insomnia in adults over age 40. If you’re eligible for Medicare and have trouble sleeping, you may want to know, “Does Medicare cover sleep apnea?”

Medicare coverage for sleep apnea starts with Part B, and it includes some of the costs related to sleep apnea, such as doctor’s visits to diagnose and treat the condition.

Does Medicare Cover CPAP Machines?

Medicare Part B will cover a CPAP machine to help treat your sleep apnea if your doctor determines that it is medically necessary. A CPAP machine stops the airways from collapsing by sending pressurized air into the throat, allowing the user to sleep.

Medicare coverage for CPAP machines comes with a three-month trial period. You may be responsible for paying 20 percent of your CPAP rental with Medicare costs, and 20 percent of the masks and tubing costs.

If your doctor determines that the CPAP machine helps your sleeping disorder, Medicare will continue to cover your CPAP machine. Medicare will continue to pay for your CPAP rental for 13 months.

You own the machine after the rental period. If you already owned a CPAP machine before you enrolled in Medicare, you might be able to receive coverage for renting a replacement machine or accessories.

How to Get a CPAP Machine

The Centers for Medicare and Medicaid (CMS) consider CPAP machines to be durable medical equipment (DME). Medicare.gov has a resource for finding DME in your area.

If you have a prescription for a CPAP machine, click here. Enter your zip code to find your nearest Medicare-approved DME provider. For demonstration purposes, we chose 37209, which is the zip code for our corporate offices in Nashville, TN.

You will then reach a page that lists providers for many types of DME. Since we’re only going to cover CPAP machines, click the box marked “CPAP, RADs, & Related Supplies & Accessories” as shown below in red. Then click “Search” as shown below in blue.

Once you do that, you will come to a page that tells you how many CPAP machine providers are in your area that looks like this. Click on the box that tells you how many local results there are.

The next page will display contact information for the DME providers. Call them to discuss their services and costs. You may need to call more than one to find a good fit.

Does Medicare Cover Sleep Apnea Equipment?

Some people may not be able to use a CPAP machine. Medicare will cover an oral appliance in that case, if your doctor prescibes one. An oral appliance holds the jaw open and allows the user to breathe by keeping the airway clear.

Does Medicare Cover Sleep Apnea Testing?

Medicare Part B will cover sleep apnea testing if your doctor orders a test for you. Medicare will typically pay for 80 percent of the associated costs after you’ve met the Part B deductible.

Sleep tests are usually performed at a sleep center or at a hospital, and the tests record your nighttime sleep patterns. The tests provide your doctor with a detailed snapshot of how you sleep, and he or she can use the results to render a diagnosis.

Medicare will cover in-home test types I-IV  if you display sleep apnea symptoms. The in-home tests can only screen for sleep apnea and not for other sleep disorders.

What Else Does Medicare Cover for Sleep Apnea?

Medicare Part B is public health insurance. Its coverage is limited to what the federal government approves.

Sleep apnea affects every area of a person’s life, and patients should be treated with their overall health in mind.

Private insurance carriers offer policies called Medicare Part C (Medicare Advantage) plans that can provide coverage beyond Original Medicare. Some plans offer transportation to doctor’s appointments, meal delivery, fitness classes, and prescription drugs.

Doctors typically do not prescribe medications as a primary sleep apnea treatment, but sometimes doctors recommend drugs to help manage sleep apnea symptoms. Medicare Part D or certain Medicare Advantage plans will cover prescription drugs such as Ambien to help you sleep or Provigil to help you stay awake.

Sleep Apnea Causes

The most common form of sleep apnea is obstructive sleep apnea. It occurs when the throat muscles relax and block the airway. Throat muscles support the tongue, the side walls of the throat, and the tonsils.

With sleep apnea, the muscles relax and your airway collapses, you can’t get enough air into your lungs, and your oxygen levels decline. To compensate for this decline, your brain will wake you up so that you can breathe freely.

The time awake is often so brief that you don’t remember it, but the frequent sleep interruptions make it impossible for you to enter into a deep sleep. Your body needs that deep sleep to produce hormones and repair muscle and bone tissue.

Central sleep apnea is less common, and it occurs when your brain doesn’t signal your breathing muscles to activate. This means your brain won’t make an effort to breathe for a brief period, and you’ll wake up with shortness of breath and likely have a tough time falling asleep again.

Risk Factors for Obstructive Sleep Apnea

Obstructive sleep apnea risk factors include:

• Obesity: Excess weight dramatically increases the risk of sleep apnea. Fat deposits surrounding your upper throat can block your breathing.
• Neck circumference: Thicker necks can mean narrower airways for some people.
• Sex: Adult males are twice as likely to develop sleep apnea than women.
• Age: Older adults have a much higher rate of sleep apnea than younger adults.
• Family history: If you have immediate family members with sleep apnea, that can mean a greater risk of you developing the sleep disorder.
• Smoking: People who smoke are at a significantly higher risk of sleep apnea because tobacco use can increase throat inflammation and fluid retention.
• Nasal congestion: If breathing through your nose is difficult because of allergies or an anatomical problem, you’re at a higher risk of developing obstructive sleep apnea.

Risk Factors for Central Sleep Apnea

Central sleep apnea risk factors include:

• Age: Like with obstructive sleep apnea, older adults have a higher risk of developing central sleep apnea.
• Sex: Males more commonly develop central sleep apnea than females, just like with obstructive sleep apnea.
• Heart conditions and stroke: Having congestive heart failure means you’re more likely to develop central sleep apnea.

Why Sleep Apnea is Dangerous

Sleep apnea is a serious condition that can be associated with a host of other conditions. Chronic sleep problems can lead to extreme daytime fatigue, which means you’re more likely to fall asleep while driving.

Sleep apnea makes heart attacks and strokes more likely because it can cause an irregular heartbeat. You can develop insulin resistance with sleep apnea, which means type 2 diabetes is a strong possibility. Your liver can develop scar tissue that signifies nonalcoholic fatty liver disease.

You may have sleep apnea if you have symptoms such as loud snoring, if you wake up with dry mouth every morning, or if your partner tells you that you stop breathing while you sleep. If you experience those symptoms, you should talk to your doctor.

We Can Help You Find Medicare Sleep Apnea Coverage

Original Medicare will help cover the cost of your CPAP machine, but you may need a Medicare Advantage plan to cover other parts of your sleep apnea treatment. There are many Medicare Advantage plans to choose from, and a licensed agent can help you choose the right one for you. Call us at 844-431-1832 or contact us here today.

Medicare HIV Coverage

Medicare is the government-run health insurance program for people 65 and older, and also for younger adults with qualifying disabilities. It has become a crucial source of health insurance for people who have HIV and AIDS.

The term Original Medicare refers to the federal program that started in 1965, and it describes Medicare Parts A (hospital coverage) and B (medical coverage). Medicare Part C refers to Medicare Advantage, a form of Medicare that is owned and operated by private companies, not the federal government. Medicare Advantage plans offer everything that the government Medicare program offers but can also offer additional benefits for people with HIV and AIDS.

HIV in the United States

HIV is an abbreviation for human immunodeficiency virus. The virus depletes your immune system by killing the white blood cells that fight off infection and illness. A compromised immune system means you are more likely to contract certain infections and even cancers.

More than 35 years have passed since the first documented cases of HIV in 1981. Advances in HIV prevention, care and treatment have transformed an HIV diagnosis from a death sentence to something manageable.
The population of HIV positive people in the US has grown over time to 1.1 million people. Part of this is due to improved treatment options which make for longer lifespans, but it is also due to a large number of new HIV diagnoses. According to HIV.gov, there were about 38,700 new infections in 2016 alone.

Does Medicare Cover HIV Testing?

Medicare Part B covers one annual HIV screening for those 15-65 years old. Medicare will also cover testing if you’re older than 65 or younger than 15 if you have an increased risk for HIV. Certain factors do contribute to infection susceptibility. You are at an increased risk for HIV if you have:

• Received donated blood prior to 1985: If you received a blood transfusion or blood products before 1985, it’s possible you’ve been infected with HIV because those products weren’t tested for infection. All blood products post-1985 are tested for HIV.
• A mother who was HIV positive: Pregnant women who are infected with HIV can pass the disease to their children before they give birth, during labor or through breast milk.
• Certain genes: Some people have fewer copies of a gene that fights off HIV, and some gene mutations can actually resist HIV. Genetic testing can determine whether or not you’re at an increased risk (fewer gene copies) or a decreased risk (resistant genetic mutation).

You should get tested every year, especially if you’re at risk. The first symptom of HIV is a fever accompanied with fatigue, swollen lymph nodes and sore throat. Regular testing for HIV can mean the difference between catching an infection early or letting it go untreated and progressing to AIDS. You will pay nothing if your doctor accepts your request.

Does Medicare Cover HIV Treatment?

According to the US Department of Health and Human Services, you should begin antiretroviral therapy (ART), using HIV medications to treat infection, as soon as you receive an HIV diagnosis. ART is not a cure for HIV, but the different medicines do help people live healthier, longer lives. HIV drugs prevent the virus from multiplying and therefore reducing the overall amount of HIV in the body.

When HIV replicates, sometimes the virus mutates and makes different versions of itself. Those variations can become resistant any current ART, so you must schedule regular check-ups with your doctor so he or she can reassess your treatment plan as needed.
In 2006, Medicare Part D added prescription drug benefits by offering subsidized prescriptions for otherwise costly HIV medications including approved antiretrovirals (ARVs). Part D plans are not required to cover non-ARV drugs to combat HIV-related illnesses. Certain Medicare Advantage (Part C) plans also cover FDA-approved treatments for the facial wasting (lipoatrophy) that ARVs can cause.

Medicare Special Enrollment Period and HIV

Medicare has a Special Enrollment Period (SEP) which allows people with a qualifying disability to enroll in or change coverage at any time during the year. Most people have to wait for the Initial Enrollment Period (IEP) – the three months surrounding their 65th birthday month – to enroll in coverage, or the Annual Enrollment Period (October 15 – December 7) to change coverage, but an HIV diagnosis means you qualify for a Special Enrollment Period.
A chronic, disabling condition such as HIV allows people to enroll in a Special Needs Plan (SNP). Plans for chronic conditions are called Chronic-Condition Special Needs Plans (C-SNP), and they can target one or more conditions.

Get Medicare Coverage for HIV

HIV treatment and testing have come a long way since the disease was first discovered in 1981, but it is still a serious autoimmune condition that can have dire consequences. With regular testing and preventive care, you can stay on top of your health. If you are diagnosed with HIV and qualify for the Special Enrollment Period, one of our highly qualified agents can help you find the right plan for you. Call us at 844-431-1832 or contact us here today.

Essential Medicare Benefits for All Medicare Plans

Prior to 1965 when Medicare was created, people over the age of 65 found it almost impossible to be covered by private health insurance companies after retirement. Original Medicare is the program the government created to cover essential medical needs like hospital stays and doctor visits. There are two parts: A and B.

The term Medicare has expanded since the 1960s to include other important services and programs in order to help people be as healthy as possible. Now, private health insurance companies can sell “Medicare Advantage” plans, often known as Part C. “Extra” Services such as vision insurance, hearing coverage and physical fitness programs typically fall under Part C.

Does Medicare Count for Minimum Essential Benefits?

The Affordable Care Act originally required that everyone have a health plan with the minimum essential benefits, which included:

• Ambulatory outpatient services
• Emergency services
• Hospitalization
• Pregnancy/maternity/newborn care
• Mental health and substance abuse services
• Prescription drugs
• Rehabilitative services/devices
• Lab services
• Preventive/wellness services
• Pediatrics (including dental and vision for kids)

If you had Medicare, you would have met the minimum essential benefits requirement. The federal government dropped the requirement that you have a minimum coverage level under the Affordable Care Act (also known as ACA or Obamacare) in 2019. However, certain states still impose penalties.

You meet minimum coverage requirements if you have coverage under Part A, Parts A and B together, or a Medicare Advantage plan (Part C). If you’re covered by any one of those plans, you will not have to pay the penalty for not having health insurance. If you were only enrolled in Part B, you would not meet the government-mandated minimum requirements.

What Does Medicare Cover?

When people talk about Medicare benefits, they are referring to Original Medicare plans. However, specific plans cover different things, and not all plans have the same coverage. Here’s what Original Medicare plans cover:

• Preventive care
• Annual wellness appointments
• Doctor visits
• Telehealth
• Mental health
• Ambulance transportation
• Home health (limited)

Original Medicare plans do not cover prescription drugs – except in limited cases, such as for oral cancer medications. Most prescription drugs require a Medicare Part D coverage or certain Medicare Advantage plans.

Difference Between Part A and Part B

Medicare Parts A and B fall under Original Medicare. Part A is Medicare hospital insurance, and it covers hospital visits and stays. It does not cover ambulance transportation. (That’s included in Part B.) Part B covers doctor’s appointments, telehealth, mental health, preventive care, annual wellness visits, ambulance transportation, and limited home health.

Medicare Health Benefits

If you need more coverage than what Part A and Part B provide, you’ll want to look towards a Medicare Supplement plan or Medicare Part C. Part C plans can include:

• Dental
• Vision
• Hearing
• Fitness classes and gym memberships
• Non-emergency transportation, such as trips to the doctor’s office
• Meal delivery
• And more!

Many people will find that Original Medicare benefits cover most of their needs as they age, but it’s important to consider the quality of life that can be obtained when you have access to a gym or have taxi fare to get to the doctor. We can’t think of anything more important than your health and well-being, and a Part C plan can provide the additional benefits you need to be healthy and happy.

Medicare Advantage

While you aren’t required to enroll in Medicare Part C, it is a valuable asset for most people. Medicare Parts A and B cover only the most basic needs for health care. There are thousands of Medicare Advantage plans to choose from, and a qualified professional can help you sort through them and find one that suits your needs.

Medicare Advantage plans are private health insurance plans that cover every service Original Medicare covers. Advantage plans are often used along with government-run plans to ensure the patient has coverage for what he or she needs, which can include dental, vision, and even meal delivery.

Medigap

Medigap policies cannot be used in conjunction with Medicare Advantage. Medicare supplements pick up where Original Medicare falls off. Medigap plans can help with coinsurance, co-payments, and deductibles. These plans are strictly for financial coverage, and not health coverage.

How to Get More Benefits

If you need coverage for things that don’t fall under the Original Medicare umbrella, you need to know a few things before you enroll. Medicare Advantage (Part C) and Medicare Supplements (also called Medigap) can serve different needs, and either can be beneficial depending on your circumstances.

The Initial Enrollment Period (IEP) consists of the six months surrounding your 65th birthday and your birthday month. This is important to know because you must select a policy in that timeframe in order to be covered. If you do not enroll in Medicare Advantage during that time, the only other time you can do that is during the Annual Enrollment Period (AEP), which is every year from October 15 through December 7.

While most people who wish to make changes to their health insurance or get new coverage must enroll during the AEP, the Special Enrollment Period (SEP) allows people – even those younger than 65 – to enroll if they are diagnosed with specific, chronic health conditions. If you qualify for the SEP, you can add or change coverage once per quarter during the first three quarters of the year. Some people may have limited special enrollment periods that surround qualifying events. For example, if you move to a new service area where different plans are available, you may be granted a temporary (typically 60 day) special enrollment period.

Get Essential Medicare Health Benefits

A comprehensive Medicare plan can help you live your best life. If you’re ready to enroll in Medicare benefits and need assistance in selecting the right plan for you, we can help you find a plan that fits your budget and lifestyle. Call us at 844-431-1832 or contact us here today.