In past blogs, we’ve been going over each of these Medicare parts and what they generally cover. Today, let's look closely at Medicare Part A to start seniors thinking about what they need in terms of Medicare and supplemental Medicare plans.
First of all, Part A is the part of Medicare coverage that covers in-facility treatments.
That can mean hospital or hospice stays, or a stint in a skilled nursing care facility. So how are these elements covered under Medicare? Knowing more will help you to navigate this system in a better way.
One of the first things that's important to understand is that although Part A covers skilled nursing care, it doesn't cover it long-term.
Here, the word “covers” can seem deceptive, because of the way that the coverage is structured.
Here's, essentially, how it works: for the first number of days, Medicare pays all costs in a skilled nursing facility.
After that number of days, coinsurance applies which is set at over $100 per day.
After about 100 days, Medicare Part A stops paying completely, and the customer is on the hook for the rest of the costs for that year. So if someone stays in a skilled nursing facility year-round, they are paying about 260 days out of the year out-of-pocket.
Daily Skilled Nursing Costs
Now, Google average daily skilled nursing facility costs, and you come up with a number – $275.
That's over $9000 per month, so for the additional six or seven months, you're paying over $50,000 for the year.
Of course, Medicare Part A did pay a significant component of all of the skilled nursing costs, but patients who thought they had very little financial responsibility are sadly surprised when they exceed the stay limitations.
Now, it's important to clarify here that people don't choose how long they are in skilled nursing care. It's a clinical determination. Let's also add that most patients don't suddenly stop needing skilled nursing care. When they are deteriorated to the point where they have limited range of motion and mobility, they often need skilled nursing care year-round. That’s not an unreasonable care need! But then there can be significant logistical problems with how that works.
Medicare Advantage and Supplemental Plans
Here's where supplemental Medicare plans come in. Patients have to choose additional coverage to limit their financial responsibility. We can help make those decisions! Do your research to come up with a plan that will make you feel financially secure in a rapidly changing world.
Have you ever received a Medicare survey in the mail? These usually arrive in your mailbox in an “official” envelope. Upon opening it, you find a letter requesting that you fill out a health care survey.
You may not realize this thick envelope is your chance to ensure your voice is heard. Learn more about these surveys and why they are important for your health and well-being here.
Who Sends Medicare Surveys?Most of the surveys for Medicare are sent from the Centers for Medicare and Medicaid Services. It’s a federal organization that is tasked with keeping tags on how Medicare plans around the country are doing – be this positive or negative.
With these surveys, you are encouraged to give honest responses. Every survey goes through a third-party survey group, ensuring your identity is fully protected. Answers are confidential, and therefore it is such a great opportunity. You have the chance to say what you really think without having your name known by a hospital, clinic, or health insurance plan.
The Impact of Surveys on Your HealthUsually, health care plans and care systems use survey results for planning purposes. It helps them understand where they can improve to improve health care options and opportunities. This includes how easily you can get the care needed, what the care is like, the cost of the care, customer service quality, and anything else that ensures a health care plan works as expected.
When you give honest answers, these organizations receive the information and will know what they aren’t doing well.
Modern health care plans have quite a few incentives to do better.
Some of these incentives include:
Star RatingsEvery Medicare plan, which includes dual-eligible Medicaid and Medicare plans, has star ratings from one to five. It indicates how they performed over the prior year—one factor in determining that rating is the surveys and the answers received.
There’s Power in NumbersIf enough people don’t answer the surveys, the results won’t be posted. That’s another way that your responses make a difference.
Your Time Makes a Huge ImpactWhen you fill out a survey, you are doing something good for yourself and your health. Surveys don’t take a lot of time, but they can make a huge difference in providing health care. Also, the purpose of the surveys is to help ensure things get better. If you make a point of answering the questions, you also can make things better.
How to Tell if It’s a Real SurveyMost people get a lot of junk mail. Because of this, you may wonder if it’s a real survey.
All real surveys include a cover letter to see a 1-800 number to find out who sent the survey. There are only certain times that these surveys are sent, as well.
If you get a survey that is not in this period, you may want to call and find out more about it before taking the time to fill it out.
Medicare's open enrollment period from October 15th, 2021, to December 7th, 2021, is a time for you to review your benefits and make changes as needed. This could be as routine as signing up again if your current plan offers coverage through 2022. It could also mean changing plans or providers because you want to change your prescription drug coverage or need extra living help. If you're enrolled in Medicare or getting ready to register you might have questions. Here's what you need to know.
What Is The Difference Between Medicare Advantage And Original Medicare?
Original Medicare is managed by the federal government and offers you hospital (Part A) and outpatient (Part B) coverage, including doctors' visits, tests, and procedures. Medicare Advantage plans are designed for people with Medicare Parts A and B who get additional coverage from a private insurance company.
These managed-care plans provide the same basic coverage as the original Medicare program but may offer additional benefits such as prescription medication coverage and vision and hearing care. If you are on original Medicare, you can purchase supplemental plans to help cover any of your additional healthcare costs or a Part D prescription drug plan.
Which Plan Is Right For Me?
Between Original Medicare or Medicare Advantage plans, there are wide-ranging effects on the cost of healthcare for you—and your budget. These differences apply even if you already have employer-sponsored insurance. Original Medicare is accepted by most doctors across the country, which could be an asset if you ever need care while traveling out of state.
Like most employer-based insurance plans, Medicare Advantage plans come with a specific network of doctors and hospitals. You have to use a doctor or hospital on the list. If you visit any other doctor, it may not be covered or may cost extra.
What Is The Difference Between Coinsurance, A Copay, A Premium, And A Deductible?
There are three cost-sharing types: premium, deductible, and copay. Plans may require copays when you receive treatment or purchase prescriptions. Copays are set by your plan and may vary from one plan to the next. The annual premium is the amount charged for each year of insurance. You should also consider other fees, such as the application fee and any discounts you may qualify for, including multi-vehicle, non-smoker discounts.
Your new plan will have a predetermined yearly deductible, depending on the plan selected. The amount you'll have to spend out of pocket before your plan starts to pay its share of covered benefits is called the deductible. Your new plan has a yearly deductible plus a percentage of your medical expenses after you meet that deductible. We call this percentage coinsurance. Original Medicare has an annual deductible plus coinsurance that is 20% once your deductible is met.
Children with elderly parents can find it challenging to stay on top of their healthcare needs even as they lead their own lives. It is easier to seek the help of a licensed agent who can ensure that the enrollment is done on time and the premiums are paid promptly. You never know when your parents may be in need of urgent medical care.
Do You Need A Medicare Agent?
Invariably, senior citizens and their caregivers find it more than a tad challenging to navigate the various Medicare options. It can be time-consuming and seem complicated. A Medicare agent who is licensed and qualified can provide the necessary education, assistance and help translate the information making it easier to understand. This is helpful even if you have been paying the health insurance premiums year after year and are not new to it. A knowledgeable source can help you make an informed decision and pick the best plan for your family.
What Can Medicare Advantage Agents Do?
Medicare advantage agents keep abreast of the latest news in the Medicare industry and have access to all the pertinent information. They also have access to different plans from various insurance providers and can zero in on the plan most suited to you quickly. The best part of working with an agent is that you get personalized attention.
The agent gathers the information and the quotes and is better positioned to guide you, keeping your financial situation in mind. They can advise you on the most cost-effective options for Medicare Advantage, Prescription Drug Plans, and the Supplemental Insurance Plans (Medigap) that will fit in your budget.
Find The Right Medicare Agent
The key to selecting the right Medicare advantage agent is checking their credentials.
Licensed: The agents must be licensed, and the state insurance department can verify that. These agents would have a license number on their cards.
Experienced: An insurance broker or agent would ideally have sufficient experience selling
Medicare plans in the state. Referrals from family and friends would help. Another way of checking their experience would be to ask them about their existing customers and the type of plans they have handled.
Needless to say, Medicare or Medicare Advantage plans are essential for senior citizens. Sudden illnesses can be unpredictable and with medical expenses so high across the country, having healthcare coverage is critical for your peace of mind.
Lots of us know that Medicare is a very complicated government entitlement program with its own rules and regulations and a pretty complex design.
But that idea is also front and center in new campaigns from Medicare supplement plans that describe Medicare as a pyramid of various levels, with different parts and pieces fitting together in an interlocking design.
It's enough to make you dizzy. Some of these descriptions of the Medicare program compare it to the vintage government food pyramid, where you have things like grains, proteins, green vegetables, sugar and fat in an ascending set of shaped levels that show us a little bit about how our daily diet should look. But where the food pyramid is intuitive, the Medicare pyramid is just confusing, partly because the parts and pieces themselves may not be labeled well to help people understand just what it is that they do.
Medicare Parts and Pieces
In the Medicare pyramid, you have Medicare parts A and B, and then you have part C and part D, and even part E, where each of these addresses specific parts of your Medicare coverage. It is not a straightforward process, as we pointed out in past blog posts. It really takes some research and some critical thinking to understand how Medicare works. One part covers prescription drugs. But which part is that? One part is essentially an overlap for certain kinds of supplementary cost. All of it is infuriating to someone’s sense of organization and neatness. But when you turn 65, it’s your turn to navigate this world, because not having this unique senior coverage provided by the government is virtually unthinkable, given the costs of modern healthcare.
In addition, many professionals would admit that Medicare is one of the ultimate examples of alphabet soup. What is a BNI or CCIP? The casual reader knows next to nothing about these terms, and finds themselves helplessly marooned on an island of acronyms. Everything in a Medicare transmittal does something different, and the rules that the system gives out to providers are elaborately arcane.
So what if you’re just a regular person who needs help with Medicare?
Get help from Comprehensive Medicare Solutions in Nevada to access the Medicare resources that you need. Or ask for an elderly family member. We’ll walk you through the process and help you to make the decisions that are best, with our experience handling Medicare and related policies. It doesn’t have to be scary, although, without a light, it really is quite a dark forest.
For many children of aging parents, navigating the complexities of government programs for their loved ones can be an overwhelming experience. Yet, caregivers of seniors are often called upon to give advice on Medicare and help guide their loved ones through the process. Like anything in life, being prepared is essential to success, so we’ve gathered a few basic tips to help make navigating the Medicare process less stressful for senior caregivers.
Know The ABC’s Of Medicare
Medicare has several different parts which need to be understood to make the process of helping your loved one easier. Once you are familiar with these parts, you will be better prepared to assist in navigating Medicare. Part A is hospital insurance, and Part B is medical insurance. Original Medicare includes both Parts A and B; the caveat is that Part A is free, where Part B contains premiums, deductibles, and co-pays.
It is important to note that Part A typically covers nursing home care, home health services, hospice, and hospital and skilled nursing facility care. Part C covers Parts A and B. Part D covers prescription drugs and supplemental insurance added to Original Medicare, which requires premiums.
Meeting Deadlines Is Vital; Missing Deadlines Is Bad News
As overwhelming as it may be to take on helping a loved one manage their Medicare, remaining prudent with timing is vital. Missing deadlines to apply for Medicare can lead to higher premiums and penalties that create unnecessary, burdensome costs. Caregivers must remain vigilant of Medicare deadlines when aiding their loved ones.
Typically, people are eligible to apply for Medicare three months before their 65th birthday. An Initial Enrollment Period (IEP) includes the three-month periods before and after the 65th birthday and is the primary opportunity to enroll in Medicare. Medicare sign-up should take place during this window to be the most effective. Delays in signing up and missing the time frames may result in higher premiums throughout the lifetime of the Medicare coverage.
Meeting With A Medicare Professional
As with navigating any governmental program, meeting with a professional to discuss Medicare options can help you streamline the Medicare planning and process for your loved one. Experienced agents can more easily break down the cycle into manageable parts that will allow you to feel in control, informed, and ahead of the game.
For caregivers of seniors, navigating the world of Medicare can be a breeze with knowledge, time management, and help from Medicare solutions specialists.
We are super excited to announce that we are going to be launching a new podcast series on June 14 called "The True View of Medicare". You will be able to find us on all major streaming platforms such as: Spotify, Apple Music, Youtube, and here on Facebook.
We will be talking about Medicare and all the different aspects of aging, including: nutrition, fitness, mental health, and more! Feel free to let us know what kind of topics you want to hear on our show, and we will be happy to bring them up.
Our team can't wait to share this series with you!
Now that summer is coming up and places are starting to lift their Covid-19 restrictions, people are wanting to go out more often. That's a great thing! But let's not forget to take care of our skin to make sure that no crazy damage happens to it while enjoying the warmer weather.
UV radiation from the sun can be dangerous, and it's sneaky to (Skin Cancer Foundation). You might not know that your skin is being damaged by the sun, so it's good to practice prevention prior to starting your activities this summer.
The Skin Cancer Foundation came up with these great tips on how to properly take care of your skin while you're out:
· Seek the shade, especially between 10 AM and 4 PM