A few weeks ago, Medicare announced the new Part B premiums for 2022. While the Centers for Medicare and Medicaid Services (CMS) had projected a rise in premiums of 6.7% earlier in 2021, the actual increase in Part B premiums for 2022 is 14.5%, the largest increase ever seen. The huge increase is partly based on the potential cost of covering Aduhelm, a new drug to treat Alzheimer’s disease.
This massive increase will take premiums for beneficiaries in the lowest income bracket from $148.50 a month to $170.10 a month, which could be difficult for many Medicare beneficiaries living on a fixed income to afford. But now there is a chance that Medicare Part B premiums might be reduced.
The Reason For The $21.60 Hike
Medicare Part B premiums were hiked up to cover the new Alzheimer’s drug that has been approved by the FDA.
By law, CMS is required to set each year’s Part B premium at 25% of the estimated costs that will be incurred by that part of the program. One of the main reasons CMS gave for the large spike in Medicare Part B premiums for 2022 was that it needed to set aside money to cover Adulhem, the new Alzheimer’s drug that has recently been approved by the FDA. It was estimated that the drug would cost $56,000 a year.
Now the medication’s manufacturer, Biogen, has estimated that the drug will actually cost $28,200 a year. Because of this projected change in price, the Department of Health and Human Services is asking for a re-assessment of Medicare Part B premiums.
The Push To Reduce Premiums
Department of Health and Human Services Secretary Xavier Becerra has ordered the Centers for Medicare & Medicaid Services to reassess this year’s standard premium. “With the 50% price drop of Aduhelm on Jan. 1, there is a compelling basis for CMS to reexamine the previous recommendation,” Becerra said.
Other organizations are also calling for a reduction in Part B premiums. “It is unconscionable for a single outrageously priced drug to drive up premiums for all Medicare beneficiaries – many of whom are already struggling to make ends meet,” said Nancy LeaMond, AARP executive vice president and chief advocacy and engagement officer. “Now that the drugmaker has cut the price in half, the Medicare Part B premium increase should be lowered as well.
“This also highlights the importance of giving Medicare the authority to negotiate drug prices. Without it, we’ll keep seeing sky-high drug prices leading to premium hikes and higher out-of-pocket expenses for older Americans.”
A CMS spokesperson said the agency is “reviewing the secretary’s statement to determine next steps.”
You can save hundreds of dollars with a Medicare Supplement Plan.
Save Money
If you are like one of the millions of Medicare beneficiaries who are living on a fixed income, saving as much money as possible is a top priority. The best way to save money on healthcare is to find an affordable Medicare Supplement Plan – and the best way to do that? Speak to an EZ agent! We work with the top-rated insurance companies in the nation and can help find a plan that will save you money this year – maybe even hundreds of dollars. Let our agents take the stress off you by comparing plans and finding ways to help you save money. And because we want to help you save as much money as possible, our services are completely free- no obligation or hassle. To get free instant quotes for plans that cover your current doctors, simply enter your zip code in the bar on the side, or to speak to a licensed agent, call 888-753-7207.
Osteoporosis affects around one in three women, and one in five men, over the age of 50, meaning that more than 200 million people are suffering from osteoporosis in this country. There are many different kinds of treatments available for osteoporosis, with the current standard treatment being bisphosphonates. There is, though, another drug called Prolia, which clinical trials have found is just as effective as bisphosphonates. How these treatments work differs, so if bisphosphonates aren’t working for you, you might want to talk to your doctor about Prolia. Fortunately, Medicare does cover Prolia, so if this drug is right for you, you will be able to start your journey to healing with the help of Medicare.
How Prolia Works
Osteoporosis occurs when bones become weak, but Prolia can help with it.
Osteoporosis is a condition that causes your bones to become thin and weak; it typically affects women more than men. Some common symptoms of osteoporosis can include brittle and weak nails, receding gums, and weakened grip strength.
Prolia is a prescription drug that’s used to treat osteoporosis and other forms of bone loss. It works by stopping bone cells from breaking down and by further strengthening the bone. It is given as an injection in the side, upper arm, or belly. Prolia is generally used to treat osteoporosis in individuals who are post-menopausal, and at high risk for bone fractures.
“This drug works by preventing the osteoclasts from maturing or resorbing bone, so it’s a completely different mechanism of action [from that of bisphosphonates]. That said, it appears at the end of the day, in terms of reducing fractures and making bones stronger, the result is about the same as bisphosphonates,” says Nancy E. Lane, MD, director of the Center for Healthy Aging at the University of California, Davis.
The Price of Prolia
The cost of any prescription drug depends on various factors, including the type of coverage you have in addition to Original Medicare. Most Medicare plans will cover Prolia, but it depends on how you take the drug. If you have Original Medicare and self-administer the injection, a Part D plan should cover the cost. But if you have original Medicare and a home health nurse administers your injection, Part B will cover 80% of the cost of the drug, leaving you to pay the other 20% out-of-pocket.
Medicare Eligibility For Prolia Coverage
While Medicare will usually cover Prolia, there are some criteria. To be Medicare-eligible for osteoporosis drugs in general, you must:
Be a woman
Have a bone fracture that a doctor has certified is related to postmenopausal osteoporosis.
Is Prolia Right For You?
As with any drug, you should ask your doctor about the benefits and the risks of Prolia, especially if you have any of the following issues:
Thyroid disease
Kidney disease- Kidney problems can cause low calcium levels, and treatment with Prolia can further lower your calcium levels, which can be dangerous.
Low calcium levels- Same as above. Your doctor might recommend that you increase your calcium levels before you begin taking the drug.
Weakened immune system
Trouble absorbing minerals
In addition, it is important to notify your doctor about any medications you are taking regularly, including over-the-counter medications, so they can inform you of any interactions between these medications and Prolia.
Extra Coverage
If you are interested in receiving the Prolia injection but are afraid of having to pay 20% out-of-pocket every time you get an injection, it might be time to look for extra coverage. Your 20% coinsurance can really add up, especially if you are living on a fixed income, as many Medicare beneficiaries are. Fortunately, though, you can save money on all of your medical expenses and get extra coverage by purchasing a Medicare Supplement Plan.
There are 10 different Medicare Supplement Plans to choose from, each offering different coverage options and rates. It’s worth looking into a Medicare Supplement Plan to save as much money as you can, so speak to an EZ agent for all of your options. EZ’s agents work with the top-rated insurance companies in the nation and can compare plans in minutes for you at no cost. To get free instant quotes for plans that cover your current doctors, simply enter your zip code in the bar on the side, or to speak to a licensed agent, call 888-753-7207.
If you’re about to turn 65, now is the time to think about purchasing a Medicare Supplement Plan. Your Open Enrollment Period for Medicare Supplement Plans automatically starts the first month you have Medicare Part B (Medical Insurance) and you’re 65 or older, and lasts for 6 months. During this time you can avoid medical underwriting and get a much better deal on a plan. Not only that, but you will also have the ability to change plans within 30 days of purchasing your plan if you’re not happy with it.
But what if those 30 days are up, and your plan has changed or no longer fits your needs? What if a year has passed, or even a couple of years? Did you know that, in some states, you can change your plan every year without medical underwriting? In states that have adopted what is known as the Medicare Supplement Plan Birthday Rule, Medicare beneficiaries can change plans around their birthday each year. Find out which states have this rule, and how it works, so you can save money and find a plan that suits your needs.
The Birthday Rule
The Medicare Supplement Plan Birthday Rule applies to people with Medicare Supplement Plans, and not to those with Medicare Advantage Plans. If your state has this rule, you will have an Open Enrollment Period each year on your birthday that allows you to change your Medicare Supplement Plan to a different one that meets your budget and medical needs.
Each state’s birthday rule is different, with some allowing you to change to another plan or insurance carrier, while others only allow you to change plans from the same insurance carrier. You can make these changes without going through medical screening or having a new waiting period.
Which States Have The Medicare Supplement Plan Birthday Rule?
Currently, California and Oregon have birthday rules; Illinois and Nevada will be adding the rule in January of 2022, and Idaho will be adding it in March of 2022. Each state has its own sets of rules:
California: You can change to a plan that is of equal or lesser benefit from any carrier 30 days before your birthday, and the 60 days following it.
Oregon: You can change to any insurance carrier or plan of equal or lesser benefit 30 days before your birthday and 30 days following it.
Illinois: If you are between the ages of 65 and 75, you will be able to enroll in any plan from your current insurance carrier starting on your birthday, and for the following 45 days. Your new Medicare Supplement Plan’s benefit level cannot exceed that of your current plan.
Nevada: Starting on the first day of your birth month, and for the 61 days following your birthday, you will be able to change your insurance carrier or plan to one that offers equal or lesser benefits.
Idaho: Starting on your birthday, and for the following 63 days, you will be able to enroll in another plan of equal or lesser benefit from any insurance carrier.
Why Change Your Plan?
There might be a need to change your Medicare Supplement Plan, depending on the changes in your life, whether medical or budget.
Life changes, and so can your budget and medical needs – and the Medicare Supplement Plan that you purchased when you were 65 might no longer meet those needs. That means it might be time to assess your plan and consider switching if you can, so you can get more coverage, or save some money. The best way to find the Medicare Supplement Plan that is right for you is to assess your needs and budget, and then compare all available plans in your area. Working with an EZ agent will make the process quick and easy, because we give you quotes in minutes. No hassle or obligation, just free help finding and comparing plans. To get free instant quotes for plans that cover your current doctors, simply enter your zip code in the bar on the side, or to speak to a licensed agent, call 888-753-7207.
Do you know what one of the perks of getting older is? You have the flexibility and room in your budget to split your time between two homes. Many Medicare beneficiaries spend their time on the move, especially “snowbirds” who are looking to escape the cold in one state, and spend their winters in a warmer, sunnier state. This is a common situation, but if you have homes in different states, you want to know that your Medicare Plan will cover you in both states. Navigating Medicare coverage can be confusing, and adding living in two different states to the mix, can make things even more confusing. Fortunately, though, you will still have access to Medicare in both locations, in what capacity depends on several factors.
Is Medicare The Same In All States?
Original Medicare is accepted in all 50 states; there aren’t any state-specific residency requirements for getting treated with Medicare, so no matter where you are based, you can see a doctor in another state, as long as the doctor accepts Medicare assignment. But it is important to note that there are different categories of Medicare acceptance that might affect how much you will pay:
Practicing provider– A practicing provider accepts Medicare assignments, meaning that they agree to accept Medicare reimbursement as full payment for treating you.
Non-practicing providers– These providers accept Medicare patients but will not accept Medicare reimbursement as full payment. This means that they can charge up to 15% more than the Medicare-approved amount for their services. This extra charge is called an excess charge.
Opt-out provider– These providers choose to opt out of the Medicare program and do not accept Medicare insurance at all. If you see any of these providers, Medicare will not pay anything for the services you receive, leaving you to pay the bill out-of-pocket.
Bridge The Gap
If you’re looking for more coverage, Medicare Supplement Plans are used alongside your Original Medicare coverage to help cover the gaps in Medicare, like the coinsurance that you have to pay out-of-pocket. A Medicare Supplement Plan will provide you with all of your Medicare benefits, no matter what state you are in, as long as you see a doctor or hospital that accepts Medicare assignment. Medicare Supplement Plan G will also cover the excess charges that non-participating providers charge you when you see them.
Any provider who accepts Medicare will accept your Medicare Supplement Plan as well, no matter what state you’re in
Any provider who accepts Medicare will accept your Medicare Supplement Plan as well, no matter what state you’re in. There are currently 10 different Medigap plans: A, B, C, D, F, G, K, L, M, and N. Each is standardized by the federal government so that coverage remains the same between insurance companies, but prices can vary based on your primary residence location and the plan type you choose.
It’s worth looking into a Medicare Supplement Plan to save as much money as you can, so speak to an EZ agent for all of your options. EZ’s agents work with the top-rated insurance companies in the nation and can compare plans in minutes for you at no cost. To get free instant quotes for plans that cover your current doctors, simply enter your zip code in the bar on the side, or to speak to a licensed agent, call 888-753-7207.
March is National Traumatic Brain Injury Awareness Month, so we want to take this time to look at this type of injury, and raise awareness of the risk to older adults. A traumatic brain injury, or TBI, can happen when your head takes a severe blow and your brain hits your skull, causing a concussion or serious brain damage. This type of injury is something that older adults should be especially wary of, because as you get older, falling and hurting your head becomes much more likely to happen than when you were younger. That means it’s important to understand what signs to watch out for, so you can get the appropriate help as soon as possible.
How Common Are Traumatic Brain Injuries?
traumatic brain injuries are more common among people older than 65.
Traumatic brain injuries are a leading cause of disability and death in the United States, contributing to almost 3 million emergency room visits, hospitalizations, and deaths each year. According to the CDC, more than 54,000 adults died from TBI in 2014.
Anyone can experience a traumatic brain injury, but almost 80% of them happen to men, and they are more common among people older than 65, because older adults are more prone to losing their balance, falling, and hitting their heads.
Types of Traumatic Brain Injuries
There are several different types and grades of traumatic brain injuries:
Mild concussion – Also known as mTBI, this is the most common type of TBI, accounting for roughly 3 out of 4 TBIs every year. Symptoms include feeling dazed or losing consciousness for less than 30 minutes, and confusion for a day or so.
Moderate TBI– Symptoms include loss of consciousness for over 30 minutes, but less than one day, and confusion that can last for up to 1 week.
Severe TBI– If you lose consciousness for at least one full day, your TBI is considered severe.
Uncomplicated TBI– Your TBI is considered uncomplicated if you receive a CAT scan or brain MRI, and it comes back normal, regardless of the severity of the brain injury.
Complicated TBI– This means that your head CT scan or brain MRI shows changes, such as bleeding in the brain.
Closed TBI– This means that an outside force caused the blow to the head, but it did not penetrate the skull. A closed TBI can still cause swelling of the brain.
Open TBI– Also known as a penetrating TBI, this occurs when a bullet, knife, or something else goes through the skull, damaging brain tissue.
Top Cause of Traumatic Brain Injuries
For older adults, the top cause of a traumatic brain injury is a fall: in fact, falls account for almost half of all emergency room visits, mainly for people 65 and older. These falls generally happen when someone loses their balance or trips over something; if they hit their head when they fall, their brain will experience chemical changes to compensate for the injury.
It is important to do everything you can to prevent falls and protect yourself from traumatic brain injury, which can result in damage to your brain cells. To do this, you should make sure that your home is as safe as possible; fortunately, Medicare will cover a home assessment for you to make sure that you are safe from falls and traumatic brain injuries.
Warning Signs of TBI
As we laid out above, there are different levels and grades of traumatic brain injuries. But whatever the grade of your injury, one of the key signs of a TBI is loss of consciousness after receiving a blow to the head, or feeling dizzy for a couple of minutes. You can experience several different symptoms, and if you do, it is very important that you seek help immediately. Some of the warning signs of TBI include:
Confusion or memory problems
Dilated pupils or blurred vision
Headaches
Behavioral or mood changes
Slurred speech
Sensitivity to light and smell
Nausea and vomiting
Restlessness
Dizziness
Fatigue
Agitation
Sleeping too little or too much
Treatment/Management of TBI
If you suspect you have had a traumatic brain injury, go to the emergency room, or speak to your healthcare provider, who will examine you. You might have to undergo a neurological evaluation, imaging testing, and/or a blood test to look for protein in your blood that would indicate concussion or mild traumatic brain injury.
After identifying a TBI, your doctor will treat you based on the type and severity of the injury. If you have a mild traumatic brain injury, you will only need minimal treatment, which will typically include relaxing and taking a rest from any work or strenuous activity for a couple of weeks. However, if you have a severe traumatic brain injury, you will need hospital care and more intensive treatment such as:
Counseling for emotional support
Surgery to stop any bleeding in the brain
Physical, occupational, and speech therapy, if necessary
It is important to note that the older you are, the slower your recovery will be. And if you have had any prior traumatic brain injuries, it will also take a little longer to recover from your current traumatic brain injury.
Complications Accompanying Traumatic Brain Injury
Unfortunately for some people, there can be complications that accompany a traumatic brain injury. People with traumatic brain injuries have a higher risk of developing anxiety, depression, post-traumatic stress disorder, seizures, and epilepsy. Moderate or severe traumatic brain injury can cause permanent brain damage and disabilities, and in some rare cases, can lead to Alzheimer’s disease, dementia, or movement disorders.
Preventing TBI
A walking assistance can help you with your balance when walking to prevent falls.
Traumatic brain injuries are not always preventable, but there are some things you can do to try to prevent falls :
Assess your medications– Some medications can cause dizziness, which can lead to falls, so it is important to monitor your medications to know which ones make you dizzy or sleepy. Speak to your doctor to find out if it is possible to change your medications to ones that don’t cause dizziness or sleepiness.
Stay active- One of the best ways to prevent falls is to remain active. Keeping your body moving by doing things like yoga or Tai Chi helps build muscle and improve your balance.
Use walking assistance– Walkers and canes can help you to be steadier on your feet if you have issues walking or with your balance.
Fall proof your home– As we mentioned earlier, Medicare will cover a home assessment to make sure that you are safe. They will suggest things like removing any rugs that can trip you, and installing stair handrails and bathtub grab bars. Medicare Part B can also cover any durable medical equipment needed such as walkers or canes, as well as any modifications to your home, such as a ramp for a wheelchair or grab bars.
The older you are, the more likely you are to experience a traumatic brain injury caused by a fall. Some falls can even lead to death if the blow to your head is hard enough, which is why it is really important to make sure that you are safe in your home and when walking. And if you do experience any type of head injury, have your healthcare provider check it out no matter how minor the injury seems at the time.
And in the meantime, take the proper steps to prevent falls by utilizing Medicare and what they offer to make sure that you are safe at home. And while Medicare Part B covers a lot, it will only cover 80% of expenses, leaving you the remaining 20% to pay out-of-pocket. This can be quite expensive, especially if you are living on a fixed income, as many Medicare beneficiaries are. Fortunately, though, you can save money on medical expenses and get extra coverage by purchasing a Medicare Supplement Plan.
There are 10 different Medicare Supplement Plans to choose from, each offering different coverage options and rates. It’s worth looking into a Medicare Supplement Plan to save as much money as you can, so speak to an EZ agent for all of your options. EZ’s agents work with the top-rated insurance companies in the nation and can compare plans in minutes for you at no cost. To get free instant quotes for plans that cover your current doctors, simply enter your zip code in the bar on the side, or to speak to a licensed agent, call 888-753-7207.
With age comes the need to take some extra precautions, especially in your home to keep you safe from falls and other dangers. Falls are a big risk when you’re older, and they can happen in your home if you’re not careful with common hazards like wires or other obstacles. Not only that, but you also need to make sure your home is safe from floods, fires, or potential intruders. Making sure that your home is safe can be expensive, and most people don’t know where to start. Fortunately, Medicare can cover the costs of home safety assessments, with certain conditions.
Different Types of Medicare Home Safety Assessments
There are multiple categories of home assessments that you should consider to ensure that your home is safe for you and your loved ones. These include:
Part of the assessment is to make sure you have a fire extinguisher available in your home in case of a fire.
Fire hazard assessment – Did you know that older adults over age 65 are twice as likely to die in home fires, and people aged 85 and older are four times as likely to die as compared to the general public? This might be because older adults are less able to react quickly to emergencies, and many live alone, and when accidents happen, there might not be others around to help. But whatever the reason, it is important to ensure your home is as safe as possible by keeping it free of electrical and fire hazards. Don’t smoke in your home, and make sure your electrical system can handle the amount of electricity you use. For example, if you have a ventilator or oxygen machine that requires a lot of power, check to see if your home’s electrical system can handle it, so it does not overheat and cause a fire. In addition, be mindful of how you use power strips, and the state of your electrical wiring.
Fire response assessment – In addition to assessing your home for fire risks, you should also assess if you will be able to respond quickly and safely should there be a fire in your home. This means having a clear exit in case of fire so that you will not be stuck inside. If anyone in your home uses a wheelchair, doors need to be wide enough to accommodate them, so you don’t lose any time when fleeing a fire. You also need to check that your smoke detectors have batteries and are in good working order. Finally, you should have fire extinguishers in easily accessible areas; these extinguishers should also be checked and serviced regularly so they will work when you need them.
Home fall risk assessment – 1 in 4 Americans over the age of 65 falls each year, leading to broken hips, and sometimes death, so this is a very important assessment. Make sure there is no loose carpeting in your home, and that rugs have non-slip pads beneath them and their corners lie flat. You should also ensure that your walkways are clutter-free, any electrical/extension cords are tucked securely away, and your stairs are in good shape, with no loose boards.
Will Medicare Pay For Your Assessments?
Medicare will cover treatment for any injuries if you fall in your home, but it can also cover home safety assessments to help prevent falls. Medicare covers a fall risk assessment as part of your Welcome to Medicare visit; in addition, you might be eligible for a home safety assessment if your doctor orders one after a hospitalization due to a fall.
Medicare will also cover fire risk and response, as well as other home assessments, if you are receiving home health care to make sure you are as safe as possible. It is important to know that Medicare will not cover the bill if a first responder, such as the fire department or an ambulance, comes to your aid unless they transport you to a hospital.
Medicare might also cover durable medical equipment (DME) and possibly some home modifications, such as walk-in tubs and wheelchair ramps: it depends on the DME and the reason for the modifications.
Extra Coverage
While Medicare might help cover the cost of your home assessments, they will only cover them at 80%, leaving you to pay for the other 20% out-of-pocket. This can be quite expensive, especially if you are living on a fixed income, as many Medicare beneficiaries are. Fortunately, though, you can save money on any medical expenses and get extra coverage by purchasing a Medicare Supplement Plan.
There are 10 different Medicare Supplement Plans to choose from, each offering different coverage options and rates. It’s worth looking into a Medicare Supplement Plan to save as much money as you can, so speak to an EZ agent for all of your options. EZ’s agents work with the top-rated insurance companies in the nation and can compare plans in minutes for you at no cost. To get free instant quotes for plans that cover your current doctors, simply enter your zip code in the bar on the side, or to speak to a licensed agent, call 888-753-7207.
