medicare insurance Archives - Page 31 of 38

Medicare Does NOT Cover Annual Physicals

Many Medicare beneficiaries confuse a yearly physical with a yearly wellness exam. Medicare WILL cover an annual wellness visit, but WILL NOT cover an annual physical. If you do not clarify exactly which exam you are receiving, you will end up with an unexpected hefty bill. So what is the difference exactly? An annual physical is a more detailed

Cartoon man holding a long sheet of paper to the floor that says "bill" on it. — *If you do not clarify what the visit is with your doctor, you may end up paying an unexpected bill.*

exam than a Medicare Wellness Visit. Let’s examine the difference between the two exams, and what Medicare does and does not cover.

Annual Physical

An annual physical is an extensive exam that requires blood work and other tests. Any blood work or lab tests that need to be done will not be covered by Medicare. The doctor will:

- Measure height and weight

- - Perform lung exam
- - Perform head and neck exam
- - Check vital signs
- - Perform a neurological exam
- Test your reflexes

- Review medical and family history

- - Measure BMI
- Submit urine and/or blood samples

- Assess risk factors for preventable diseases

*Any work done at both visits is bold, and italicized.

Chart explaining what exams are done during medicare annual visit and medicare wellness visits. — *Medicare Wellness VS Medicare Annual Visits*

Annual Wellness Visit

Medicare will cover annual wellness visits, after the initial “Welcome to Medicare” visit is done with your doctor. During the initial visit, the doctor will establish your health and create a plan for future care. Your medical and social history is reviewed and you will receive free preventive services. The services include certain screenings, shots, and referrals if needed, a vision test, body mass index (BMI) calculation, height and weight measurements, blood pressure measurements, depression screening, a plan with knowledge of which future screenings, shots, and other preventive services you need. This is only covered one time and is not required to be covered by the annual “wellness” visits.

The annual wellness visit’s focus is on preventing disease and disability. This happens with a personalized plan for future medical issues based on your health and risk factors. During the annual wellness visit, the doctor will:

Measure height and weight

- - Measure blood pressure and other routine measurements.
- Listen to your heart through your clothes

Review medical and family history

- Review Health Risk Assessment questionnaire

Assess risk factors and treatment options

- Update list of providers and prescriptions

- Set up screening for appropriate preventive services such as diabetes and depression

Check that you are up to date with preventative tests such as cancer screenings, and flu shots (which are all free)

Generally, during a wellness visit, the doctor will not perform exams. The visit is mainly to catch up on your vitals, assess your risks, and provide a treatment plan. When you call your doctor to set up an appointment, make sure to tell them exactly which exam you want. If you simply say “physical” then you will be responsible for what the doctor charges you for the services, which will not be covered by Medicare. A simple mistake could end up costing you hundreds of dollars!

Medication Not Covered Anymore? There’s a Transition Refill!

Imagine walking up to the pharmacy and hearing that your medication is no longer covered by Medicare, followed by the price of the drug. This happens often, and it can be overwhelming. Fortunately, there is something that can help: transition refills. A transition refill is a one-time, 30 day supply of the drug that Medicare no longer covers. This will ensure that you receive your medication for at least a month more.

Transition Refills Are Provided When:

Older caucasian man's hand dropping a pill onto his palm from a pill bottle. — *Transition refills will provide you with at leat 30 days more of your mediction that is no longer covered by your plan.*

You recently switched plans and your medication is not covered under your new plan. The plan will give you a 30-day transition refill within the first 90 days of enrollment.
Your plan dropped your medication/s from its formulary, or added coverage restrictions for the calendar year. Your plan will give you a 30-day transition refill within the first 90 days of the calendar year. They will also provide you with a notice about the new coverage policy.

Transition refills are not for new prescriptions, only for drugs you were taking before losing coverage or switching plans. The refills are not free, and you will have to pay the cost-sharing associated with the medication. This means you will have to pay as a Tier 4 or 5 Specialty Drug with 25% or more of the retail value.

Options After Using A Transition Refill

Switch Medications– Speak with your doctor immediately and ask if there is a drug on the plan’s formulary that will work for you. The doctor will write a new prescription for you, with a generic form, or a different brand name.
File for a formulary exception– If the prescription you are taking is absolutely necessary, then your doctor can contact your plan to request an exception. If denied, then you can file an appeal. If the exception is not processed by the end of your 90-day transition refill period, then your plan must provide more refills until the exception is answered.

Caucasian hands holding a wallet, with one hand holding hundred dollar bills out of it. — *You will still have to pay for your transition refills. A Medicare agent can look over all plans to save you money on your medications.*

The Centers for Medicare and Medicaid Services (CMS) stated “The purpose of providing a transition supply is to promote continuity of care and avoid interruptions in drug therapy while a switch to a therapeutically equivalent drug or the completion of an exception request to maintain coverage of an existing drug based on medical necessity reasons can be effectuated.”

When signing up for a new Medicare Supplement Plan, you should ask your Medicare agent if all of your medication is covered. EZ.Insure offers you your own Medicare agent that will search the best plan options based on your medication list. We will provide you with your own personal Medicare agent that will do all the research and provide you with plan options reflecting your interests. To get an instant quote, simply enter your zip code in the bar above. To speak to an agent directly, call 855-220-1144, or email replies @ez.insure.

New Medicare Scam Alert!

Just when you think that you are aware of all the scams going around and feel educated and safe, another one is created. Unfortunately, scammers never stop trying to take your money and get your information. Just recently a new scam has surfaced with the promise of a free back, neck, or knee brace. While the idea of a free brace, that may be much needed, is enticing, you may pay more than just money. Medicare does not usually cover the costs of braces, except for some cases, where it is approved and ordered by your doctor. If you want to see what is covered within your Medicare plan, then you should call Medicare, or check your explanation of benefits.

*Scammers are now calling pretending to be from a hospital or medical supply company, offering free neck/back/knee braces.*

How It Works

These scammers call claiming to be from a local hospital or a Medicare representative from a medical supply company. They then ask you if you have any back, neck, or knee pain. Next, they state you can get a free brace called in by your doctor. If you answer yes to these questions, the scammers will ask for your Medicare information and Social Security number. Once you give them your information, they will steal hundreds to thousands of dollars from you.

If you say no to the scammers, they will call multiple times a day, harassing you until they hear a “yes”. Or the scammers will convince you to give them your personal information in order to be removed from their calling list.

What To Do

The first thing to know is that Medicare will never call you regarding any sort of brace, or any other products, or services. Scammers now have technology that changes their number to make it look like a local number or a 1-800 number. If an unknown number is calling, avoid answering it. Let it go to voicemail.

If you were approved for any sort of brace by your doctor, then make sure to call Medicare yourself and question the process. Make sure to ask them if it is covered, if they will pay for it, and when it will arrive. You can also read your Medicare Summary of Notice or Explanation of Benefits to make sure you were not charged for anything you didn’t order or didn’t receive.

A delivery may come to your door, if you did not order anything, then refuse the delivery. If you did order something, make sure it is the product before accepting it. Make sure to write down the senders name and address, so you can report it. To report suspected Medicare fraud, call 1-800-MEDICARE, or 1-800-633-4227.

Be Aware

*If you receive a call about a brace, then immediately hang up. Call Medicare and report the call, and call your agent to make sure you are protected and covered.*

Scammers are always looking for new ways every day to steal your information and money from you. They will never stop trying. In order to beat them at their own game, make sure that you are well informed to all the latest scams. And if you do not know, or just to be sure, never give out your information over the phone. Call Medicare directly and ask them any questions. The saying “nothing is free” is true, and if it seems too good to be true, then it probably is.

It is important to have a Medicare agent that you trust. One that you can call at any time with benefit questions, or just to make sure you are not being scammed. EZ.Insure is a trusted company that offers these exact agents. With EZ.Insure, you will receive your very own personal Medicare agent to help you with all your needs, explain your benefits, and steer you in the right direction towards saving money. Your agent will protect your information and make sure you are taken care of. To connect with one of our agents call 855-220-1144, or email [email protected]. Or if you would like an instant quote, just enter your zip code in the bar above.

Increase Your Lifespan By Spending Time With Those You Love

It has always been said that being around kids keeps you young, and this theory applies to seniors as well. Seniors who babysit, or are around their grandchildren often live up to 5 years longer than seniors who do not. Research analyzed over a 20 year period concluded that out of 500 seniors 70 years old and older, those who provided some form of care to their grandkids had a lower death ratio than those who did not. The study was published in Evolution and Human Behavior, and showed that the senior babysitters had a 37% lower mortality risk. There are multiple

*Being around your grandkids help keep you more active.*

health benefits to watching your grandkids apart from staying alive longer.

Improves Brain Function

Being around kids keeps your brain function high, because you are either helping them with their homework, or learning new things from them. Your brain is constantly working when you are with children, which helps your cognitive function better and for longer. Studies also show that your memory improves as well.

Keeps You Active

When you are not learning new things from your grandkids, chances are you are running around with them and playing catch or doing an outdoor activity with them. You are more likely to get up and be more active when your grandkids are around than when they are not.

Lowers Risk of Depression

Can you think of anything better than the love you receive and feel from family, especially your grandkids? Being around your grandchildren will increase your happiness and mental health. Seniors are less likely to be depressed when they are around their grandkids consistently.

Geriatric medicine specialist Dr. Ronan Factora thinks that the reasoning for a longer life is due to the reduction of stress when with your grandkids. Dr. Ronan Factora said, “there is a link between providing this care and reducing stress and we know the relationship between stress and higher risk of dying. If providing care to grandchildren and

*The benefits of being around your grandchildren include helping you feel younger, decrease stress, increase your lifespan, and make you happier overall.*

others in need is one way that can actually reduce stress, then these activities should be of benefit to folks who are grandparents and provide this care to their grandkids.”

As of course with everything, moderation is key. Do not overexert yourself with babysitting every single day. That will only create stress and tire you out, because let’s be honest, kids are a handful! Take some time 2-3 times a week to plan some hangout time with your grandkids, you will all benefit from it. Your relationship with your grandkids is important to both you and your grandkids. A strong bond with them reduces depression, and makes your time together more enjoyable and fun. Your adult grandkids also receive some mental health benefits from a strong relationship with you. Call your children and begin setting up some playdates with your grandkids, it will increase your life’s expectancy and value.

Loved One With Alzheimer’s: How To Cope

Hearing that someone you love is diagnosed with Alzheimer’s can be devastating. It is not only tough for the person going through it, it is also tough for the entire family. Over 16 million people in the U.S. care for someone that has Alzheimer’s. Watching someone you love slowly forget who you are and the details of their life is challenging and overwhelming. It will bring on feelings of frustration, and depression. Learning about the disease, and strategies to cope with it can make the process a little easier. It can also help you prepare for the future of what is to come before the disease worsens.

Educating yourself about Alzheimer's can help you understand the disease, and prepare you for what's to come. — *Educating yourself about Alzheimer’s can help you understand the disease, and prepare you for what’s to come.*

Educate Yourself About The Disease

Alzheimer’s is the 6th leading cause of death in the U.S. with 1 in 3 seniors dying with Alzheimer’s or dementia. Learning as much as you can about the disease and how it progresses can help you understand how to deal with it and cope. Understanding what the disease entails will help you empathize with your loved one and provide you with the knowledge to help slow it down, and treatment options.

Create Realistic Expectations

People with Alzheimer’s do not get better unfortunately, symptoms progress and worsen. Information you provide your loved one with Alzheimer’s will be forgotten, so it is important not to set unrealistic expectations for them. You should learn to expect the unexpected, and take it one day at a time.

Respond Gentler

When a loved one is suffering from Alzheimer’s disease, it can be really frustrating to constantly remind them of something. It hurts that they are losing memories and recognition of who you are, but it is important to be more gentle with them. Using validation instead of frustration and anger. It will only frustrate them, which will make it even harder for them to remember anything.

Remind Your Loved One

There will be many times, especially after the disease progresses, that your loved one will forget your name and things. Simply remind them who you are, and show them pictures and videos of family and friends. This can help trigger their memory, and if not, then it will be nice for them to hear the stories of the people who love them.

Develop Routines/Schedule

Create a daily routine and schedule for your loved one do they can have some sort of structure in their life. It is important to have set schedules for them to help get rid of as much confusion and frustration as possible. Allow your loved one to do as many things as possible by themselves if they can. It helps them restore some confidence.

Accept Changes

There is not point in trying to change your loved one to the person they were before the disease. Learn to grieve the loss, and accept who they are now and that the only thing you can change is your attitude towards it. Your relationship with your loved one will constantly change over time.

Good Nutrition Can Help

Research has linked Alzheimer’s to nutrition. Limit refined sugars and increase vegetable intake to help manage the disease. Leafy green vegetables has been linked to improved cognitive performance.

Prepare Wills & Finances

Make sure the loved one’s living will and finances are all prepared and completed. This will help alleviate any stress or issues that may come along as the disease worsens, leading to medical bills such as hospice.

Take Care Of Yourself

Do not burn yourself out, and remember to take care of yourself. Being a caretaker for a loved one with Alzheimer’s gets to be very time consuming. You focus all your time and energy on them and forget to take time for yourself. Take some time for yourself throughout the day. You can join a support group and talk with others who are going through

Caring for a loved one with Alzheimer's can be a lot to take on. Lean on family for help so you can take a break. — *Caring for a loved one with Alzheimer’s can be a lot to take on. Lean on family for help so you can take a break.*

the same feelings as you of loss, sadness, and even resentment.

Involve The Family More

Taking care of your loved one alone is really stressful. You can rely on your family for help when needed, and ask your family for more support. If you feel like you need to take a break, lean on your family members, and ask them to help you when you need it. It is a lot of work emotionally and mentally helping someone that has Alzheimer’s. Create a care plan with your family so they can help pick up the slack in some areas such as cleaning.

Taking care of a loved one with Alzheimer’s or even going through the whole process is draining and releases a flush of emotions. The first and foremost thing is to remember that there is nothing you can do or change, but your attitude towards the situation. Remain as calm as possible around your loved one and remind them of the good times. They may not remember memories over time, but one thing they can still remember is emotions and can sense yours. Be more patient and grieve the loss of who they were, but you can create new memories with them and have fun together. Take advantage of the time you have together, and ask for help and a break when needed.

Activities To Do While Cooped Up Inside

With the weather getting worse during the winter months, you end up getting stuck inside your home a lot. Being cooped up indoors for a long time can drive anyone crazy, and for some cause seasonal affective disorder. Seasonal affective disorder is when you get depressed during the change of seasons, typically begins fall and carried on through the winter season. Because it is safer indoors than being out in the frigid cold, it is important to try and find ways to manage the distress. It can be a fun time, as long as you make it that way. There are entertaining things you can do while homebound in order to avoid depression, isolation, and boredom.

Board games

Games and puzzles are a great way to kill time, while having fun. You can play by yourself, or play with loved ones.

Games like scrabble and Sudoku are fun and work your brain at the same time. You can also play card games such as solitaire, or online games if you can manage.

Volunteer

If you are bored, then you can consider doing some charity work. You can call the local hospital or church and see if you can help out with anything, such as knitting or crocheting blankets from the comfort of your home.

Connect With Friends & Family

Take the time of being stranded indoors to catch up with family or friends. You can take the time to write a letter, or make some calls to connect with loved ones.

Learn Something New

Take an online class or tutorial! There are many options to choose from, whether learning a new language, DIY crafts, drawing, painting, modeling clay, play an instrument, or cooking classes. Use the time to learn a new hobby from the comfort of your own home.

Plan A Vacation

What a better time to think about your next vacation than when you are snowed in? Start planning a vacation you would like to go on with loved ones or alone for the spring and/or summer. You can also take the time to plan your next get-together with friends.

Exercise

Get up and move! There are many safe exercises you can do from the comfort of your

*Take the time to catch up on a good book.*

own home that will boost your mood. You can even use a chair to do some exercises, including yoga.

Spend Time Reading

Reading has a lot of benefits for the brain. You enhance your cognitive skills when you read a book everyday. It improves memory, reduces stress, and you can expand your vocabulary by learning new words.

Watch A Movie/Show

Make a day of popcorn and your favorite movies on the couch. Remember that too much TV is not good for your health, so keep the movie/show days to a minimum.

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