medicare insurance Archives - Page 22 of 38

Prevent Heart Disease With Medicare Screenings

According to the Centers for Medicare and Medicaid Services (CMS), heart disease has been the leading cause of death for Americans ages 65 and over for the past several decades. One in four deaths is contributed to some form of heart disease, meaning any kind of condition, such as heart rhythm disorders, coronary heart disease, and congestive heart failure, that can lead to heart attack or stroke. The best way to prevent heart disease is to know your risk. Fortunately, because heart disease is so common – and deadly – in people aged 65 and older, Medicare offers multiple free screenings to help prevent it.

Medicare Coverage

Medicare Part B covers an annual cardiovascular disease risk reduction visit with your primary care physician. You do not need to show any signs or symptoms of heart disease in order to get screened. As long as your doctor or other health care provider accepts Medicare assignment, you will not pay anything for this screening. During the screening, your physician might:

Encourage aspirin use if the benefits outweigh the risks and:
- You are a man age 45-79
- You are a woman age 55-79
Check your blood pressure
Encourage a healthy diet

Once you get the initial screening, your doctor may advise further screenings, tests, and treatments. Medicare Part B also covers:

Aneurysm Screenings- Aortic aneurysms thin out areas in your arteries, which can weaken them. Medicare pays for a free screening for aneurysms as long you meet the following conditions: you have a family history of aortic aneurysm, or are a man between the ages of 65 and 75 who has smoked 100 or more cigarettes in his lifetime
Cholesterol Screenings- Having high cholesterol leads to build up in your arteries, which can restrict blood flow to the heart. Medicare covers one free cholesterol screening every 5 years. Any additional tests will not be free.
Medicare will only cover a cardiac stress test for people with known heart disease and symptoms.
Cardiac Stress Testing- During this test, your doctor will monitor your heart while you run or walk on a treadmill. They will also examine your heart with an electrocardiogram (EKG), echocardiogram (ultrasound of the heart), or imaging (pictures of your heart taken after you are injected with a radioactive tracer). **Medicare will only pay for the stress test for those with known heart disease and symptoms of chest pain, shortness of breath, etc. You will pay 20% coinsurance for this test.

For follow-ups after your free screenings or any outpatient services, Medicare will pay 80%, and you will pay the remaining 20% coinsurance out-of-pocket. If you are hospitalized or need surgery, Medicare Part A will cover your inpatient hospital stay as well as any skilled nursing care.

Paying The Medicare Coinsurance

If you are experiencing any symptoms that could be related to heart disease, or would simply like to get screened for heart disease, get yourself checked! Medicare will pay for one free screening related to heart disease. If there is an issue, or you have to seek further care for heart disease, Medicare will only pay 80% of the costs for visits, tests, and more. These costs can add up. Fortunately, Medicare Supplement Plans help pay for the 20% out-of-pocket costs that Original Medicare does not cover. Having one of these plans can help you better budget for and save money on medical expenses.

There are 10 different Medicare Supplement Plans. Each offers their own added coverage at different price points. They all help pay for any unexpected costs, and any further care management costs. EZ.Insure wants to protect your heart and your wallet by helping you find the right Medicare Supplement Plan for your needs. We will compare plans and guide you through the whole process, while answering any questions you might have. To get instant free quotes, simply enter your zip code in the bar above, or to speak directly with a licensed agent, call 888-753-7207.

Medicare & COPD

Chronic obstructive pulmonary disease, or COPD, is most common among individuals 65 and older. It is especially common among women age 65 to 74 years old. This disease is the third leading cause of death in the United States, and anyone with COPD has a significantly increased risk of severe illness or death from complications from the flu or respiratory illnesses like COVID-19.

When it comes to those suffering from COPD, life expectancy is determined by multiple factors such as history of smoking, and other conditions that might add further complications. While most patients with COPD can live with the disease for many years, they will need to constantly manage and treat this chronic condition. For older Americans, this continuous management can be costly, but fortunately, Medicare covers screenings and treatment up to a certain point.

What Is COPD?

For the over 30 million Americans who are living with COPD, every day can mean a struggle to breathe. COPD, a group of progressive lung diseases, such as emphysema, slowly destroys air sacs in the lung, causing air flow blockage and breathing-related problems. The disease develops over a long time, and the most common cause of it is smoking tobacco.

Because the disease is progressive, there is unfortunately no cure for COPD. However, treatments can help ease the symptoms and lower the chances of complications, while improving quality of life. If not treated, COPD can cause heart problems and worsening respiratory infection.

COPD Symptoms

caucasian woman with short blonde hair holding her chest with one hand. — *Some COPD symptoms include shortness of breath and tightness in the chest.*

The symptoms of COPD come in stages. Early symptoms include occasional shortness of breath, a mild recurrent cough, and a frequent need to clear the throat. But if the symptoms are not treated, they can get progressively worse. Worsening symptoms include:

Shortness of breath with little exertion, such as from going up a flight of stairs
Tightness in the chest
Wheezing
Frequent colds, flu, or other respiratory infections
Chronic cough
Lack of energy

In the later stages of the disease, symptoms include weight loss, and swelling of the feet, ankles, or legs. If you are suffering from COPD, it is important to seek immediate medical care if you have trouble catching your breath, feel confused or faint, or have bluish or gray fingernails or lips.

Medicare COPD Coverage

There is no single test for COPD. Diagnosis is based on assessing the symptoms mentioned earlier, a physical exam, and diagnostic test results. To help diagnose you, Medicare Part B will cover a lung cancer screening with Low Dose Computed Tomography (LDCT). Medicare will cover this screening once a year if you:

Are 55 to 77 years old
Have a history of smoking at least 1 pack of cigarettes a day for 30 years
Are a current smoker or have quit smoking in the last 15 years
Are asymptomatic (don’t have signs or symptoms) of lung cancer
Get a written order from your doctor

As long as you meet all of the above criteria and your doctor accepts Medicare assignment, Medicare Part B will cover 100% of the screening.

If you have already been diagnosed with COPD, Medicare Part B will cover a pulmonary rehabilitation program to help manage your COPD. This program should help you breathe better and improve your quality of life. Medicare Part B will completely cover the pulmonary rehabilitation program as long as you have a referral from your doctor.

pink piggy bank — *Medicare Supplement Plans will help pay for the 20% Medicare does not cover, which will help you save more money.*

Getting More Coverage

Other expenses related to COPD treatment and management might only be covered 80% by Medicare, leaving you with 20% coinsurance to pay out-of-pocket. But you can save money on these expenses with a Medicare Supplement Plan, which will pay your 20% coinsurance for COPD coverage, as well as all other Medicare-covered conditions.

It can be overwhelming to review your options and go over all 10 different Medicare Supplement Plans, but that is what EZ.Insure is here for. EZ’s dedicated agent will compare all available plans in your area and review all of your options. We will provide you with quotes for free, and find a plan that fits your needs and budget, while helping you save hundreds of dollars a year. To get free instant quotes, simply enter your zip code in the bar above, or to speak directly with one of our agents, call 888-753-7207.

New Medicare Part D Rates

This year, Medicare Part B premiums rates are not the only rates on the rise. The Centers for Medicare and Medicaid (CMS) released the 2021 Medicare Part D rates back in October, and noted that, while there are more Part D plans being offered in 2021, plan rates have gone up slightly. Because prices for Medicare Parts A, B, and D continue to rise, there is no better time than now to look into Medicare Supplement Plans.

Part D Plans & Prices

The average Medicare beneficiary has a choice of almost 30 Medicare stand-alone drug plans. The following charts illustrate the costs of Part D plans and how income affects rates.

medicare part d benefit chart — *Medicare Part D Rates*

filing income medicare part d rates — *Medicare Part D Income Rates*

Part D Cost-Sharing

Cost-sharing amounts have also changed for medications in certain “tiers” in Part D plans. Each plan has a drug formulary, made up of tiers which determine the price of each drug. The typical five-tier formulary structure places medications into the following categories:

Preferred generics
Generics
Preferred brands
Non-preferred drugs
Specialty drugs

For all Part D Plans, the median standard cost sharing in 2021 is $0 for preferred generics, $5 for generics (up from $4 in 2020), $40 for preferred brands (down from $42 in 2020), 40% coinsurance for non-preferred drugs (up from 38% in 2020; the maximum allowed is 50%), and 25% coinsurance for specialty drugs (the same as in 2020; the maximum allowed is 33%).

Medicare Supplement Plans

Costs continue to increase yearly for Medicare beneficiaries, but that does not mean you have to live on a tight budget. Medicare Supplement Plans can help you pay for medical costs that Original Medicare does not cover. For example, Medicare Supplement Plans cover the 20% coinsurance that you usually pay for a medical service. There are 10 different types of Medicare Supplement Plans to choose, and each offers different coverage at different price points. To easily compare these plans within minutes, use an EZ agent. Our agents will compare prices, go over your financial and medical needs, and help you save hundreds a year – and we’ll do it all for free! Medicare rates are on the rise, but we will help you save! To get started, simply enter your zip code in the bar above, or to speak directly to a licensed agent, call 888-753-7207.

New Medicare Rule WIll Cut Emergency Doctors’ Pay During Pandemic

The coronavirus pandemic has hit the country hard. Many Americans have been affected financially, and now Medicare-accepting doctors are going to be among those suffering a pay cut. A new rule that is set to go into effect January 1st will lower the reimbursement rates that doctors receive for treating patients covered by Medicare. The new 2021 physician fee schedule final rule will affect many types of physicians, and now they are fighting back.

The Pay Cut

Doctors practicing general surgery, emergency medicine, anesthesiology, and critical care medicine will be affected by the new rule. They will see a 10% cut in the “conversion factor,” which is used to determine their fee-for-service Medicare payment. The conversion factor is a multiplier that Medicare uses in order to calculate reimbursement for a particular service or procedure done by doctors. The conversion factor is multiplied by the relative value unit, RVU, which depends on the amount of work and type of work done by the physician.

The 2021 conversion factor will be $32.41, a decrease of $3.68 — or 10.2% — from the 2020 conversion factor of $36.09.

Doctors Voice Their Concerns

caucasian man that appears to look mad with teal scrubs on, mask and hat, as well as a stethoscope around his neck. — *Doctors who have been working long hours to help Medicare patients through the pandemic are not happy about the pay cut.*

The Centers for Medicare and Medicaid Services (CMS) first proposed the pay cuts in the summer. When the rule was presented to the country, doctors immediately began to voice their concerns, pointing out that they put their lives on the line every day and shouldn’t be facing a cut in pay at this critical time.

“We come to work every day and we work long hours and we put our lives on the line and took risks on a daily basis and it’s a slap in the face to say here’s how we’re gonna reward you — we’re going to be paying you less,” Dr. Lisa Moreno, an emergency medicine physician and the president of the American Academy of Emergency Medicine (AAEM), said.

The American College of Emergency Physicians (ACEP) also joined the AAEM in criticizing the rule, saying they were disappointed and dismayed that CMS was cutting physicians’ pay simply because they were helping take care of Medicare patients. “Emergency physicians and other health care providers battling on the frontlines of the ongoing pandemic are already under unprecedented financial strain as they continue to bear the brunt of COVID-19,” ACEP President Mark Rosenberg, DO, said in a statement. “These cuts would have a devastating impact for the future of emergency medicine and could seriously impede patients’ access to emergency care when they need it most.”

In addition, the ACEP voiced their concerns that the new rule would have wide reaching effects, and would mean more than just a pay cut to some doctors. “CMS chose to finalize a cut that will reverberate beyond just Medicare to other payors including private insurance, which often structure their payments to emergency physicians and other providers based on these Medicare rates. This will result in significant reimbursement reductions as well as widespread uncertainty and disruption across the system.”

The Fight

two blue gloves facing each other with a black background and a light shining on the bottom middle of the picture. — *Doctors and organizations are fighting back against the new Medicare rule by lobbying for a new legislation to maintain reimbursement.*

After receiving backlash for cutting reimbursement pay, CMS responded by stating that they will be “increasing payments to physicians and other practitioners for additional time they spend with patients, especially those with chronic conditions.”

“We value the contributions of all providers caring for patients on the front-lines of this historic pandemic, but this action is designed to address fundamental problems in Medicare reimbursement that long predate the current public health emergency. It is also important to note that physicians that see a higher proportion of patients’ visits will see increases in payments compared to physicians that do fewer visits or more procedures,” CMS wrote.

The ACEP, along with other health care organizations, are lobbying to maintain reimbursement in Medicare at 2020 levels for the next 2 years.

“Emergency physicians have courageously faced a global pandemic that has shaken our healthcare system to its core, unwavering in their commitment to their patients despite potentially deadly exposure to the disease for themselves and their families,” said Rosenberg. “Congress must act now in order for them to continue playing this vital role in our communities.”

Are Glaucoma Screenings Covered By Medicare?

Glaucoma is the cause of approximately 10% of cases of total blindness in the U.S. It mainly affects people over the age of 65; in fact, the American Academy of Family Physicians notes that about 75% of those who are legally blind because of glaucoma are older adults. What’s worse is that doctors believe that about half of all people with glaucoma have yet to be diagnosed. In order to help save your sight, it is important to get screened for this disorder. If you have Medicare Part B, then you need to know how glaucoma screenings are covered.

illustration of an eye with it partially open showing the nerves and inside — *Glaucoma mainly affects people over 65 years old, and can cause blindness.*

What Is Glaucoma?

Glaucoma damages the optic nerve at the back of the eye and can lead to partial vision loss or blindness. It is often hereditary. There are three different types of glaucoma:

Primary open-angle glaucoma- causes gradual vision loss, and typically has no other signs or symptoms.
Normal tension glaucoma- the nerve is damaged even if there is no high fluid pressure in the eye. Eyesight changes in the center of the person’s vision.
Angle-closure glaucoma– a rarer type that develops quickly when fluid cannot drain from the eye. Symptoms include nausea, eye pain, headache, and sudden loss of vision.

Vision loss can happen gradually, so you may not notice anything until the damage is already done. This is why it is important to get screened for glaucoma regularly.

The Test

Glaucoma screenings are fairly simple. The doctor will put drops in your eyes to dilate them and then will use instruments to conduct the following tests:

Tonometry: measures fluid pressure behind your eye.
Ophthalmoscopy: examines your optic nerve.
Perimetry: tests your peripheral vision.
Gonioscopy: inspects the angle where your iris and cornea meet.
Pachymetry: measures the thickness of your cornea.

Medicare Coverage & Costs

Medicare part B will cover one glaucoma screening test every 12 months if you’re considered high-risk. High-risk individuals are those who:

Are over the age of 60
Have diabetes
Have a family history of glaucoma
Are African American and age 50 or older
Are Hispanic American and age 65 or older

Once you have met your deductible, Medicare will pay for 80% of the screening, and you will pay 20% of the Medicare-approved amount for the test. If the test is done in an outpatient setting, you might also be responsible for any facility charges. If you require surgery to treat the glaucoma, Medicare Part A will pay for it.

hundred dollar bill sticking out of a wallet. — *Medicare Supplement Plans will help pay for what Original Medicare does not cover, which puts more money back in your wallet.*

Medicare Supplement Plan

As with most medical services, Medicare only covers 80% of glaucoma screenings. The 20% that you have to pay out-of-pocket for services can start to add up, especially if you are living on a fixed income. Medicare Supplement Plans help cover the gaps in your Medicare coverage, including your 20% out-of-pocket payments. There are 10 different Medicare Supplement Plans to choose from, all with different coverage at different price points. This means that you will be sure to find one that suits your needs.

To easily compare Medicare Supplement Plans in minutes, and to find an affordable plan that helps you save hundreds of dollars, talk to an EZ agent. Our agent will do all the work for you, inform you of the differences between each plan, and help you figure out which one will best suit your financial and medical needs. There is no obligation, just free quotes. Start comparing quotes for free by entering your zip code in the bar above, or to speak directly to one of our licensed agents, call 888-753-7207.

Preparing for Medicare Open Enrollment: Know Your Rights During Medicare Open Enrollment

Shopping for Medicare can be an exciting time; it is when you can find a plan that offers the coverage you need and saves you money. But it can also be a hectic and frustrating time, when you could get scammed or hounded by ads, calls, and mail telling you which plan to enroll into or which insurance company to use. Remember, you have rights during Medicare Open Enrollment, and knowing them will protect you from some of the nuisances that tend to happen at this time.

Limitations on Contact

Did you know that Medicare agents cannot call you without your consent? They can only contact you if you fill out a form agreeing to be contacted. You cannot be contacted:

If you do not have a relationship with the company.
By email unless you have agreed to receive emails from the agent.
With flyers, door hangers or visits to your home unless an agent has a scheduled appointment with you.

Limitations on Sales

If you do agree to be contacted by an agent, they can then talk to you about Medicare options that can help save you money. However, they are limited in what they can discuss with you. They cannot try to sell you all different kinds of Medicare plans; they can only speak to you about what you are interested in. You will fill out a Scope of Appointment form prior to the meeting, and this form will set limits on what they can discuss. For example, if you check that you are only interested in Medicare Supplement Plan options, then that is the only thing they will speak to you about.

person holding a cellphone with an unknown caller on the screen — Scammers will try to call to steal your information during the Open *Enrollment*, which is why it is important to never give out your information over the phone.

Be aware that no agent ever has the right to threaten you with taking away your benefits if you do not sign up for a plan. They also cannot try to bribe you with gifts to try and get you to sign up for a plan.

Side note: Scammers might try to call you and act as a representative from Medicare in order to try and steal your Medicare ID number and other personal information. No Medicare representatives will ever call and ask you for that information over the phone; if they do need to connect with you, they will send you something in the mail. Unless you specifically filled out a form to be contacted by a Medicare agent, hang up – and never give out any information over the phone!

Use A Professional Licensed Agent

With EZ.Insure, you will never have to worry about your privacy being compromised or your rights being violated. Our licensed insurance agents are highly trained and pride themselves on providing help in a professional yet caring manner. In order to protect you, EZ.Insure uses state-of-the-art technology to keep your information secure when you fill out our form. We go a step further by providing you with one and only one agent to work with- you will never get bounced around from agent to agent.

We work hard in order to make sure you save money. We’ll compare all available plans in your area, so you can find a Medicare Supplement Plan that will help pay for what Original Medicare does not. To get free instant quotes, simply enter your zip code in the bar above, or to speak directly with one of our licensed agents, call 888-753-7207.

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