medicare Archives - Page 30 of 44

4 Vaccines That Medicare Covers

When people think of the word vaccines, they often think of babies and young kids. While immunizations are important for children, they are just as important for seniors. Older adults should get vaccines in order to prevent diseases as they get older. Certain diseases can lead to complications in seniors, and possibly death. Luckily, Medicare offers many free preventive care services, including vaccines.

middle aged caucasian woman blowing her nose into a tissue. — *Older adults are more at risk of dying from the flu than any other age group due to weaker immune systems.*

1. Flu Vaccine

Influenza, also known as the flu, is responsible for many deaths every year. Older adults are more at risk of dying from the flu than any other age group due to weaker immune systems. It is especially important for people with asthma, diabetes, or heart disease to receive the flu shot. Studies have shown that vaccinated seniors reduced their risk of flu hospitalization by 50%. There is also a stronger shot that is high-dose, Fluzone High-Dose, if you require more protection.

Medicare Part B covers one flu shot for seniors every fall/winter season.

2. Pneumonia Vaccine

Pneumococcal disease is another disease that seniors are at a higher risk for contracting. It causes severe infections of the bloodstream (bacteremia) and organs, and can result in pneumonia or meningitis. It kills almost 20,000 adults 65+ each year, so it is very important that you get vaccinated against it. It is recommended that people get two different types of vaccines, PCV13 and PPSV23, for more protection.

Medicare Part B covers both pneumococcal vaccines after the age of 65. PCV13 is given first, with the second PPSV23 recommended 6-12 months after.

needle going into a persons upper arm by a medical professional's ahnd with a glove on. — *Medicare Part B covers the tetanus vaccine in specific cases.*

3. Tetanus Vaccine

Tetanus, also known as lockjaw, is an infection that is not common in the U.S. If you contract tetanus, the bacteria gets under your skin, causing muscle spasms and affecting the muscles that control breathing. A person can get tetanus usually when traveling to a different country or from someone who has it.

Medicare Part B covers the tetanus vaccine in specific cases. For example, if a person has diabetes or neuropathy, then they are at greater risk of getting tetanus due to the open sores that can occur. So, you are more likely to get 100% coverage for the shot, as long as the shot is administered as a treatment for either of these illnesses or an injury caused by them.

4. Hepatitis B Vaccine

Hepatitis B, or hep B, is a contagious virus that causes an infection of the liver. There are two types of Hepatitis B: Acute, which mimics the flu, and Chronic, which is a long-term condition with no symptoms that can cause extreme liver damage or even death. If a senior has hemophilia, diabetes, or other conditions that lower resistance to infection, then their risk of getting Hep B is increased.

If a doctor feels like a person is at high or even medium risk of contracting hep B, then Medicare will cover the vaccine.

Getting vaccinated as you age is an important part of staying healthy. If you are at high risk for any of the diseases mentioned, then it would be smart to take advantage of the free vaccinations covered by Medicare.

Medicare Site Has Faulty Tool, Avoid Misinformation With EZ

Looking for Medicare quotes? Did you use Medicare’s Plan Finder Tool on their site, Medicare.gov? If so, you could’ve been given the wrong information, which could be costing you hundreds of dollars. The Medicare Plan Finder tool had some bugs that needed to be fixed, so, in August, the Centers for Medicare and Medicaid Services (CMS) updated it. However, the tool is currently still giving seniors incorrect price estimates, and wrong coverage information. You don’t have to worry about that with EZ. We give you accurate quotes, every time.

caucasian hands holding open an empty wallet. — *The misinformation the tool provides can lead Medicare beneficiaries to lose a lot of money.*

The Problem With The Tool

Even with the August revamp, Medicare beneficiaries have been just as confused as ever. The tool has been showing inaccurate premium estimates, incorrect prescription drug costs, and inaccurate coverage costs. Beneficiaries are at risk of choosing the wrong coverage because of this inaccurate information. They will then be stuck with this plan for the entire year, and will be losing money while they wait for the next open enrollment period.

One Medicare consultant in Wisconsin used the tool to research prescription drug plans for a client, and was shocked by the results. She started checking the plans’ websites, and came across two versions of the same high blood pressure medication. One was covered, while the other was not. The difference in price was $2,700 a month.

Accurate Quotes With EZ

red cartoon drawing throwing an arrow at a target towards the center. — *EZ.Insure uses state-of-the-art technology to provide accurate live quotes every time.*

Here at EZ, we make sure we do our research and homework. EZ.Insure uses state-of-the-art technology to provide accurate live quotes. This means that the quotes provided are the prices you would pay for the plan if you signed up today. Getting a live quote is important because as the market and personal situations change, insurance prices will also change.

Avoid all of the work of trying to find an accurate quote. Using the Medicare Plan Finder Tool can leave you with inaccurate quotes, and false information. If you’re not an expert in insurance, then errors, or simple ignorance, can cost you tons of money. It’s your health, and it’s important.

The CMS is currently working on fixing the issues with the Medicare Plan Finder Tool. In the meantime, if you are seeking Medicare advice, it would be best to contact a Medicare agent. An agent who is familiar with plans and the coverage they provide can help guide you in a better, more accurate direction. EZ.Insure has highly trained agents in your region that can offer you accurate quotes on plans available, and help you save. If you would like to speak to an agent, call 888-753-7207. Or if you would like an instant quote, enter your zip code in the bar above.

Changes Are Coming For Medicare Under Trump’s Budget

Before President Trump was elected, one of his campaign promises to Americans was that he would not touch Medicare or Social Security. He has now proposed a budget plan for Medicare, which he claims will make it easier for seniors to opt out of Medicare. Under his plan, Americans would also be able to put more money into HSA accounts. Democratic lawmakers are worried that, if the proposal does go through, the Medicare changes and it’s funding levels will be drastically reduced.

Opting Out Of Medicare

older caucasian hands typing on a laptop keyboard with a silver bracelet on one wrist. — *Trump’s new Medicare budget would allow seniors to opt out of Medicare and add more money to their HSA account.*

Under the current system, as long as you are signed up for Social Security, you will be automatically signed up for Medicare Part A when you turn 65.

One of Trump’s proposals is to allow people to opt out of Medicare Part A (hospital insurance), without their decision interfering with their Social Security benefits.

HSA Changes

Health Savings Accounts (HSAs) are offered to people with high deductible health insurance plans. These accounts come with tax benefits. You can make tax-free contributions, as well as make tax-free qualified withdrawals from the account. Medicare beneficiaries cannot contribute to these accounts, even if they are just on Part A or have a high deductible plan.

However, Trump wants to give Medicare beneficiaries with high deductible health plans the ability to make tax-deductible contributions to HSAs or medical savings accounts (MSAs).

Other Medicare Changes

Further proposals by Trump would not structurally change the Medicare program, reduce the benefits, or limit eligibility for Medicare. Other changes in the proposal are similar to President Obama’s past budgets. They include:

Doctors would be paid the same price for services, regardless if they work for a hospital or private practice
Reduce payments in long-term care hospitals for patients discharged from a regular hospital.
Reduce prices for prescription drugs.
Republicans believe that allowing older adults to opt out of Medicare would help to fund the program.

Republicans believe that some reduction in the growth of the program and/or an increase in funding is necessary, and they believe that allowing older adults to opt out of Medicare would help to fund the program. The trust fund Medicare Part A hospital insurance is projected to be insolvent in 2026, meaning the trust fund would be empty and payroll taxes wouldn’t be enough to cover all of the necessary spending.

“A big boost in the economy could potentially extend the life of the trust fund a bit,” says Tricia Neuman, senior vice president and director of the Program on Medicare Policy at the nonpartisan Kaiser Family Foundation. “But even with a tailwind, policymakers will need to reduce Medicare spending, increase revenues or both to keep the trust fund solvent for an extended period of time. That said, there are a number of policies that could be considered to extend the life of the trust fund beyond those proposed in the Administration’s budget.”

Medicare beneficiaries could also benefit from some proposals. KFF’s Neuman says it is “conceivable” that provider payment changes to hospitals would reduce Medicare spending growth “which could potentially slow the growth in Medicare deductibles.”

Democrats argue that the Trump administration’s budget proposals would cut Medicare beneficiaries’ access to care. They also argue that the proposed HSA changes would only benefit higher income Medicare beneficiaries.

Are Humana & Medicare The Same?

Many people wonder if Humana and Medicare are the same. Simply put, no. Medicare is a government administered health insurance program, and Humana is one of the largest private insurance companies. People get these two confused because Humana sells Medicare Advantage and Medicare Supplement Plans. Let’s go over what exactly the two are.

a picture of a balancer with green apples on onse side and oranges on the other. — *When comparing Medicare and Humana, it can be like comparing apples and oranges. They are two different things.*

Medicare

Medicare is the nation’s largest health insurance program for adults 65 and older. It is operated by the Centers for Medicare and Medicaid Services (CMS) under the US Department of Health and Human Services (HHS). Medicare is used by over 57 million Americans, and it is not based on income, and it is not free. In order to be eligible for Medicare, you must meet some requirements:

You must be 65 and older.
You must have worked and paid at least 40 qualifying quarters, or 10 years, of Medicare taxes to receive Medicare Part A.
You must be a U.S. citizen.

Medicare benefits are divided into two parts, Part A and Part B.

picture of different medical equipments — *Medicare Part A and Part B covers a number of hospital and medical services.*

Medicare Part A (Hospital Insurance) — covers inpatient hospital care, skilled nursing facility care, short-term nursing home care, hospice care, and some home health care. (100% of your costs for up to 60 days in a hospital or up to 20 days in a skilled nursing facility.)
Medicare Part B (Medical Insurance) — covers annual wellness visits every month, ambulance services, orthotics and prosthetics, medical equipment, and mental health care. (80% of costs covered by Medicare.)

Medicare will cover 80% of your Part B expenses, leaving you with 20% to pay out of pocket. If the expenses get to be too much to budget, you can look into additional coverage to pay for the 20%, such as Medicare Supplement plans. These plans vary by premium, deductible, and coverage. Additionally, they are helpful to those who travel, as some cover international health care costs.

Humana

Humana is a private insurance company that sells Medicare Advantage plans, and Medicare Supplement plans for people looking for secondary insurance to help pay for Original Medicare.

Humana is contracted with the federal government to provide these Medicare plans under the Medicare program.

If you have Medicare and are interested in a Medicare Supplement plan, EZ.Insure can help! There are roughly 10 different types of medicare supplement plans on the market, and they all vary in coverage and cost. Figuring out which plans are best for you can be hard, but we are here to help. If you would like to gather more information on Medicare and Medicare Supplement plans, one or our highly trained agents are ready to help.

You can start by simply entering your zip code in the bar above to get a quote, or you can contact us by email at Replies@Ez.Insure or call 855-220-1144. There is no hassle and no obligation. We will help you answer any questions, go over all of your plan options, find the Medicare Supplement plan most suited for your needs and budget, and even help you sign up if you’re ready.

Congress Considering Bill To Eliminate Gaps In Coverage

If you are turning 65 soon you might be looking for information on your Medicare eligibility, and what exactly having Medicare means. Medicare provides insurance to seniors under plans known as Parts A and B. Part A is hospital insurance, and Part B is medical insurance. While Part A is free, Part B is only covered up to 80% by Medicare, leaving you to pay for the other 20%. Unfortunately, some people are unaware that they must sign up for Part B within a certain timeframe, and can face a Medicare penalty.

white bell insude of a blue circle. — *In order for Medicare beneficiaries to avoid a penalty, Congress will begin notifying them to sign up before they turn 65.*

Currently Medicare does not notify you when it is time to sign up and it is up to you to be aware of the standard enrollment periods. If you do not sign up for Medicare Part B within the specified enrollment period, then you will face a life-long penalty. Luckily, in order to help people avoid this penalty, Congress is considering making revisions to a bill called the BENES Act.

The Medicare Penalty

Medicare Part A normally kicks in when you turn 65 on its own, there is no action required from you. You can enroll in Part B three months before you turn 65, the month you turn 65, and three months after the month you turn 65. While it is mandatory to enroll into Medicare Part A when you turn 65, you do have the option to opt out and put off your enrollment into Part B. Generally this will cause a penalty to be applied to your future Medicare rates unless you qualify for a special enrollment period.

The qualifications for a special enrollment period are:

You have coverage by a group health plan through you or your spouse’s current employment.
During the 8 months following the month your group health plan coverage ends, or when the employment ends (whichever is first).

If you do not qualify for a special enrollment period, then you will only be able to join during The General Enrollment Period, or GEP.

The GEP, which falls between January 1 and March 31 of every year, is the period of time when you can enroll in Medicare Part B for the first time. Coverage will then begin the following July. However, if you skipped the initial enrollment period when you turned 65 and waited for a GEP, you will be at risk of facing a penalty.

dollar bills piled on top of each other. — *If you miss the opportunity to sign up for Part B when you are eligible, you will face a 20% penalty for every year you did not sign up.*

When you do decide to finally sign up for Medicare Part B, you will then have to pay an additional 10% on top of your monthly premiums. For every full 12-month period (calendar year) that you were eligible for Part B, but did not enroll in it, you will pay a 10% penalty for as long as you have Part B. For example, if you opt out of signing up for Part B benefits for two years, then you will face a 20% penalty fee added onto your monthly Part B premiums forever.

The Problem

Unfortunately, some seniors mistakenly assume they can skip Part B because they have a former employer’s insurance through the ACA, or for other reasons. This leads to the beneficiaries facing a monthly Part B penalty for the rest of their lives. According to research, in 2018, about 760,000 people were paying a late penalty onto their monthly Part B premium, increasing their costs an average of nearly 30%. Congress thankfully is stepping in to try and end the Medicare penalty by notifying the beneficiaries before they turn 65.

Congress’ Approach

Congress hopes to revise the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, so that Medicare & Medicaid Services are required to notify people before their 65th birthday about their Medicare eligibility. Currently, the government only contacts people who are receiving Social Security benefits to notify them when it is time to sign up for Medicare.

The hope is that this would lead to beneficiaries avoiding the Part B penalty when they do not sign up for 12 or more months after they become eligible.

If passed, the revision would be the first one in five decades. This would move the GEP (January through March) window to the fall, which would coincide with the enrollment period for drug coverage and Medicare Advantage. It would also do away with the July effective date, and move it to January.

Does Medicare Cover Adjustable Beds?

When dealing with an illness or disability that leads to the assistance of durable medical equipment such as an adjustable bed. Questions come up, mainly how much they are, and if the costs of these beds are covered by Medicare Insurance.

black and white picture of a hospital bed — *Adjustable beds will be covered under Medicare if they are deemed medically necessary.*

Doctors can prescribe these beds for many conditions, such as sleep disorders, respiratory problems, restless leg syndrome, and more. If you do require an adjustable bed, then it must be deemed “medically necessary” by your doctor in order to be covered. Will it be completely covered? Well, it depends.

What Is Durable Medical Equipment (DME)?

Durable medical equipment is medical equipment that is reusable, such as crutches, wheelchairs, and adjustable beds. In order for a DME to be covered, it has to be used for medical reasons, durable, andused at home.

If you are staying in a nursing home, that does not qualify as your home. Therefore, it will not be covered. However, a long term care facility can give you DME, because they are responsible for your health.

Is it Medically Necessary?

Even though your doctor might determine that there is a medical purpose for DME, it does not mean it will be approved by Medicare. Once the doctor recommends it, it must be considered and reviewed by Medicare before it will pay. Not all DME is created equal. In other words, there might be a specific type of bed that is approved, while others are not.

Adjustable beds are usually prescribed to patients to help cure, relieve, and minimize circulatory and respiratory health issues. These beds help people get in and out of bed with more comfort and ease.

"20%" written in silver and enlarged — *Medicare Part B will cover 80% of the adjustable bed expense, leaving you to pay the rest (20%).*

Will Medicare Cover Adjustable Beds?

Under Medicare Part B, in the DME section, it states that they might cover adjustable beds. But there are some requirements that a person must meet first before qualifying. First, a doctor must prescribe the bed for use at home. Afterwards, the bed must be sourced by an accredited Medicare supplier. Then, Medicare Part B will cover 80% of the expense, leaving you to pay the rest (20%).

Thankfully, if you are in need of an adjustable bed in your home due to chronic pain, or certain conditions, Medicare will cover it. As long as the bed is prescribed as medically necessary, and acquired from an accredited supplier, then you will be good to go. Make sure you contact Medicare to make sure the bed is accredited before purchasing it, because some bed suppliers will mislead patients into buying unaccredited beds.

Tag: medicare