Archive for December, 2008
With age many people start to face problems like memory loss and mental disorders, causing concern to the family. Many old people are scared of reaching this phase of their life. Unfortunately avoiding what they fear is beyond their control.
With more and more seniors facing such old age illnesses, we should be grateful for the rapidly growing old age care centers. Ideally, a personalized program is essential in order to achieve a comfortable and relaxing environment or atmosphere for the elderly. This is exactly what Alzheimer’s care is about. Alzheimer’s care is an example of specialized care that is different from other nursing or elder care. Several care homes or facilities specialize in Alzheimer’s care and offer not only exceptional programs but also adopt diverse approaches keeping in mind the differing backgrounds and lifestyles of people.
Providing Alzheimer’s care is indeed a challenging task, nevertheless it is beneficial for old people suffering from mental illnesses. Alzheimer’s care uses innovative approaches to take care of different people with different stages of memory disorders. Alzheimer’s care centers provide general amenities like therapeutic activities, trained-skilled staff and living space. Highly personalized assistance is given to inmates according to their needs and mental conditions.
Providing specialized Alzheimer’s care to those who need it goes a long way in giving special care to your loved ones. It helps protect the welfare of old helpless people. The success of Alzheimer’s care rests in proper monitoring, care and attention to the old. This is extremely important for their well-being and to help bring improvements in their health conditions.
Most importantly, for the success of Alzheimer’s care, there needs to be cooperation between the staff, families and elderly people. If seniors are given access to proper programs and amenities, they will enjoy the highest quality of life. An Alzheimer’s care center can provide a safe shelter and will enable them to live their life in the best possible way.
If you are covered under Medicare, you will see that it doesn’t entirely cover all the expenses that you may incur during hospitalization or medical treatment. Because of this, you may want to purchase one of the Medigap plans that AARP has to offer.
Basically, Medigap is also known as Medicare Supplement Insurance. What this kind of insurance does is that it will be able to fill in the gaps that Medicare has. It will be able to cover the expenses you incur during medical treatment that Medicare does not cover. With it, you can be sure that you will be able to save a lot of money.
However, you need to remember that there are quite a lot of plans that AARP offers in their Medigap health insurance program. You need to know what kind of health insurance plan is right for you in order for you to save money and get the most out of your health insurance plan in case you need it.
There are basically 12 plans that AARP Medigap offers.
If you need basic benefits more than the extra benefits, you may want to get plans A to J. Here, you will benefit from Medicare Part A coinsurance plus 365 additional days after Medicare benefits.
For people who needs preventive health services, plans K to L is for you. Here, you will be able to benefit from Medicare Part A coinsurance and it will be able to cover 50 to 75 percent of hospice cost sharing, three pints of blood every year and it will also be able to cover 50 to 75 percent of Medicare Part B coinsurance.
These are the things that you have to know about AARP Medigap Plans. By choosing the right plan, you will be able to make use of the benefit and also save money on premiums.
Many people are confused about Medicare and Medicaid including the question of what the differences are between the programs. There are some major differences between the two, but they are easy to sort out.
Medicare is a program that is funded by the federal government as an entitlement program, which mainly focuses on the older population. It is a social insurance program for individuals age 65 and over and it also covers medical bills of many individuals with disabilities. Medicare also covers individuals of all ages with end stage renal (kidney) disease.
There are several parts to Medicare. Part A covers hospital bills, Part B covers medical insurance and Part D covers prescriptions. There are other parts, as well, and they act as supplements, however, that discussion is for a different article.
Medicaid is different from Medicare in several ways. Medicaid is also an entitlement program, however, Medicaid is not funded only by federal government, there is a state component as well, and in some states, counties pay part of the cost, too.
Medicaid is based on need and social welfare, with eligibility based on income. If a person has limited income and/or limited financial resources, Medicaid covers a broader amount of services than Medicare does. It usually covers children, pregnant women, parents of eligible children, seniors and individuals with disabilities. Though poverty is used to determine eligibility, a person must fall into one of the other coverage groups in addition to being determined eligible due to being in poverty. Medicaid benefits are paid directly to the provider of services. So, if you go to the doctor, the doctor gets the payment, if you go to the pharmacy, Medicaid pays the pharmacy directly. In addition to covering individuals who meet financial requirements, in some states Medicaid covers individuals who cannot otherwise afford insurance.
Some individuals qualify for coverage by both programs. For more information regarding Medicare and Medicaid, go to www.medicaid.gov or www.medicare.gov or simply go to Google or another search engine and type in Medicare or Medicaid and you will get pages of information.
Right now we are in the middle of open enrollment for Medicare. Open Enrollment will last until December 31, 2008, and it is important that you know as much as possible about Medicare coverage so that you can make good choices for the next year.
Medicare and Medicare Supplements, also called Medigap, have a number of parts and they are not always easy to figure out. In fact, determining how all these parts fit together and what you need for your situation can be totally confusing. This brief overview will give you information on the basic parts of Medicare and what is covered by them.
Medicare Part A and B make up the original Medicare. Part A basically covers in-patient services including inpatient rehabilitation and inpatient psychiatric care. Many services are covered completely, but you will have to pay a co-payment for some of the others.
Part B covers your doctor visits and other outpatient services determined to be “medically necessary” for you. It also covers certain tests to determine if you have an illness. There is a deductible, which is $135 for the year 2008, and there are also some copayments with it.
Medicare Part C is also called Medicare Advantage. The Medicare Advantage Plans are not part of the actual Medicare system, but they work with it. Medicare Advantage is an alternative to Medicare and the plans are run by private companies. There are a variety of plans that all work differently. Some plans work as HMO’s others charge a Fee for Service allowing you to go to any doctor as long as the doctor will accept payment from Medicare as payment in full. It is very important to research and find out whether the Medicare Advantage Plan you are choosing will actually work with your medical needs.
Part D covers Prescriptions. These are covered by private insurance companies approved by Medicare. This coverage is important, and you must determine what type Part D coverage you need. You should figure out what you need in advance so that you can enroll immediately when you are eligible. If not, you will be charged a substantial late fee. If you enroll in a certain Part D plan and feel it isn’t right for you, every year you will have an opportunity to change between November 15th and December 31st which is where we are right now. If you need to change plans, now is the time to do it.
That was the easy part. Now for the Supplements – the Medigap policies. There are 12 policies that cover services that are not otherwise covered. Each supplement is different and covers different things. In addition, it is possible to purchase these supplements from private insurance companies, get them from you or your spouse’s employer or from various government programs.
All Medigap Policies are standardized and approved by Medicare. This means that for policies E on up the alphabet, each lettered plan offers the same coverage no matter what company you purchase it from. An insurance company can charge whatever they want to charge, so compare companies and rates carefully. That way you won’t buy from a company that charges much more as another company for the same coverage.
So, do your research and determine which Medicare Supplemental Insurance is the best for you and find the best price. If you need information, check the web at www.Medicare.gov.
Many Medicare recipients have found themselves in situations where their physician feels they need a particular procedure but Medicare won’t approve it. When this happens, most people don’t know what to do.
There is a national nonprofit organization called the Medicare Rights Center. They advise that the best thing to do in this situation is to appeal the decision. Medicare is supposed to approve any medically necessary procedures, however, quite often Medicare doesn’t agree with the doctor’s idea of what is medically necessary.
According to the Medicare Rights Center, it is often easy to win appeals for a number of reasons. One thing that often happens is that the denial is based on an accidental coding error, which means that someone put the wrong number or letter into a computer, making the computer think that you are requesting something different than you actually are requesting, and you end up being denied.
The Medicare Rights Center also says that many people don’t know that they have the right to appeal, or they think that the appeal process is too difficult. Everyone has the right to appeal and the process is not too difficult.
To have a successful appeal the Medicare Rights Center suggests:
• Sign the back of the Medicare Summary Notice (MSN) and write on the front of it “Please Review”- send it back to the correct address by certified mail or with delivery confirmation;
• Include a letter with the MSN asking for an appeal and explaining why it should have been covered;
• Have the doctor write a letter explaining why the procedure is medically necessary and why it should be approved;
• Make photocopies of all written and oral communication, including notes, names and dates of phone calls;
• Do all of these things well within the 120 days allowed, so it does not end up too late to appeal;
• If you are in a private plan such as an HMO or PPO you only have 60 days to appeal and some of the steps may be different.
It can be frustrating to get a denial. This information can be helpful if you ever find yourself in this situation. Hopefully, this will not happen to you, but if it does, following these guidelines can assist you in obtaining a successful appeal.
Many cities and towns throughout the country are issuing warnings for seniors and individuals with disabilities about scams aimed at them – especially during this open enrollment period which lasts until the end of the year.
Some of these scams involve people calling Medicare recipients and telling them that they are from Medicare and they are calling to warn the recipient that their benefits will cancel in 30 days. The callers also tell recipients that in order to keep their Medicare benefits, they need to give the callers personal information bank account numbers, social security numbers and Medicare number. Callers will also say that updating this information is free.
These types of scams are becoming more and more common throughout the country. People prey on the elderly and on individuals with disabilities, and these people sound so authentic that they often get the information they are asking for. Once they have this personal information they use it in a fraudulent way.
No matter where you live, Do NOT give out ANY personal information – especially social security numbers, bank account numbers and Medicare or other information that should remain private and protected.
Actual Medicare or Social Security representatives will NEVER ask you for personal information and they will NEVER ask you to pay them over the phone. They may verify your information, but if they are authentic, they already have the information and are trying to make sure that you are who you say you are. In addition, they usually only ask for the last 4 digits of your Social Security number. Medicare sends out information about bills and statements to recipients if there are any amounts due. Most of the time the amount would be set up in advance to be deducted from your bank account and you would receive statement in the mail showing the deduction. Official Medicare, Social Security and banking information is usually sent to you in writing in a statement or letter. If they need information from you, they usually ask for it in writing.
If someone calls you trying to get information that is private, do not give it to them. Try to get their name and number and report them to your local police or sheriff’s department.
Keep yourself and your private, personal information safe. Don’t let scammers trick you into revealing and sharing information that should stay private.
