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Does Medicare Cover Life Alert?

Medical life alert systems were created to help older adults in the unfortunate event of a fall, or a medical emergency. Generally, these alert devices are worn around the neck or on the wrist, so that seniors can have easy access to help 24/7. This can be life saving in dire situations. So how much do these life alerts cost? And does Medicare cover the cost?

different emergency vehicles parked next to each other. — *Medical alert systems can help direct emergency respondents when and where they need to go to help you.*

Is A Medical Alert System Necessary?

According to the Center for Disease Control and Prevention, CDC, approximately 1 in 4 Americans over the age of 65 experience a fall every year. These falls result in broken hips, bones, and more. If you are living alone, then these devices would be extremely beneficial. Especially if you experience physical weakness, poor vision or balance, medication side effects, or chronic conditions.

The Different Types

There are all kinds of medical life alert systems. If you do not want to wear one, you can have one on your phone, or activity tracker. You have the ability to choose the one that best suits your lifestyle.

Bracelets, lanyards, or pendant– These are the usual alert systems that have an emergency button to push. You can wear it around your neck, and wrist. With some you have to push a button, while others sense a fall and call help for you.
Cell phone alert system– These systems are self explanatory. You can contact your alert monitoring center through the push of a button on your phone. They can use GPS on your phone with these systems so medical assistance will know exactly where you are when needed.
Activity tracker– These kinds of systems track your daily activity. If something is off, then the company will raise a red flag and check on you to make sure you are okay. These kinds of systems will help you improve your overall health by tracking sleep cycles, and more.

The Cost

The cost of an alert system is different among companies. For some, you will have to pay a one-time fee for rental, and then a monthly monitoring fee. Other companies will have you just pay the monitoring services, and ship the device for free. The monthly fees range for these systems range from $50 to $90.

So, Is It Covered By Medicare?

Unfortunately Medicare does not cover medical life alert systems. But don’t worry, there are some ways to get a discount on them. Some Medicare Supplement Plans might provide discounts, as well as organizations like AARP, AMAC, and USAA.

calculator and paper with hands pointing at both — *Unfortunately Medicare does not cover medical life alert systems, but there are some ways to get a discount.*

If you are not a part of any of these organizations, don’t lose hope. You can contact the local Department of Human Resources, or Department of Aging Services in your area, and they can help. Also, consider looking into Medicare Supplement Plans, since they can offer discounts towards alert systems.

If you need assistance searching and comparing Medicare Supplement plans, 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. We will offer you a personal agent who will go over all the different kinds, and which one will suit you best, and offers a discount on alert systems. 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.

Medicare Isn’t Mandatory, But There Is A Penalty

Medicare normally kicks in when you turn 65. You can enroll 3 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 when you turn 65, you do have the option to opt out and push your enrollment into the program. However, when you do this, you are at risk of facing a penalty.

caucasian hand holding a bubble with a stethescope in it — *There are some ways to avoid the Medicare penatly, such as if you have employer’s health insurance.*

Having Coverage

If you are still employed, or have coverage, then you can opt out of signing up for Medicare. As long as your employer has 20 or more employees, then you can hold off on Medicare, and will not have to worry about the penalty. You can still sign up for Medicare Part A. It does not cost you anything and will cover hospital visits, and can act as a secondary insurance to your employer’s insurance.

Collecting Social Security

If you are collecting Social Security, then you will automatically be enrolled into Medicare Parts A and B. You have the option to cancel or opt out of Part B if you have coverage through an employer. However, if you opt out, then you will face a penalty. Medicare Part B covers doctors’ services, outpatient care, and medical equipment.

The Penalty

Opting out of Medicare Part B without a valid reason, such as being on an employer’s insurance, then you will pay a penalty fee. When you decide to finally sign up for Medicare Part B, then you will have to pay 10% to your monthly premiums. This penalty can remain as part of your monthly premiums for a long time.

Every full 12-month period (year) that you could’ve had Part B, but did not take 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 2 years, then you will face a 20% penalty fee added onto your monthly Part B premiums forever. If you opt out for 4 years, then you will face a 40% penalty, as so forth.

caucasian hands holding open an empty wallet — *The Medicare penalty you will face is 10% for every year you opted out of Medicare.*

When You Are Safe From Penalties

If you miss your enrollment date, you have a General Enrollment Period, GEP, in which you can sign up if you missed signing up when you were eligible. It is a make-up time for Medicare enrollment and us January 1-March 31 every year. If fewer than 12 months have elapsed, then you will not pay a penalty fee. Other situations you can avoid the penalties are:

If you have Medicaid and Medicare. The state pays the Part B premiums.
If you qualify for assistance from your state in paying Medicare costs under a Medicare Savings Program.

It is not mandatory to sign up for Medicare when you turn 65, depending on your situation. If you do not sign up when you are supposed to, then you will be penalized, unless you have employer coverage or are in the aforementioned situations. It is best to go over your situation and make sure you are making the best decision. Talk to a Medicare agent beforehand so that you are aware of all of your options, and how you can avoid any extra fees.

EZ.Insure can help you with these kinds of situations. We offer specialized Medicare agents within your area that can go over all of your options and make sure you are in the best situation. If you would like to speak to an agent, call 888-753-7207 or email us at replies@ez.insure. Or if you would like an instant quote, enter your zip code in the bar above. Our services are free, because our goal is to help you, and make sure you are taken care of.

Beware This Faulty Medicare Tool!

The federal government designed a tool to help seniors navigate through all their possible Medicare choices. This was created for them to be able to choose their best option. There have been some bugs that needed to be fixed, so the Centers for Medicare and Medicaid Services, CMS, updated the Medicare Plan Finder tool in August. However, the tool is still currently giving seniors incorrect price estimates, and wrong coverage information.

older caucasian hands on the keyboard of a leptop — *The Medicare Plan Finder Tool is a tool on the Medicare.gov site that helps consumers navigate through Medicare plans and prices*

The Medicare Finder Tool

The Medicare Plan Finder Tool is a tool on the Medicare.gov site that helps consumers navigate through Medicare plans and prices before signing up. The tool was developed in 2005, but in August of 2019, it was revamped and redesigned.

The Issue With The Tool

Even with the 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. If a beneficiary chooses the wrong coverage due to the inaccurate information provided, it can cost them a lot of money for the whole year they are stuck with the plan until the next open enrollment.

Per ProPublica, a Medicare consultant in Wisconsin used the tool to research prescription drug plans for a client, and was shocked by the results. The consultant stated that when she searched for them, the comparison page showed all but one of her client’s medications would be covered. So the consultant dug deeper by clicking on “plan details” to find out which medication was left out. She then saw that the plan finder said all of the medications were covered.

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.

In Nebraska, an insurance administrator flagged about 100 errors since she began working with the tool in October.

“Millions of people are going to be absolutely affected,” said Ann Kayrish, senior program manager for Medicare at the National Council on Aging. “And you hate to think about millions of people having the wrong plan. That’s kind of crazy.”

red sign with the words "wrong way" on it — *The Medicare Tool has been giving seniors the wrong information on coverage and prices.*

“It’s not like there’s one consistent problem that you can fix and then be addressed,” said David Lipschutz, associate director of the Center for Medicare Advocacy. “It’s really like a game of whack-a-mole.”

What You Can Do

CMS has spent $11 million dollars in order to revamp the tool. But the misinformation it gives is alarming, especially when seniors are struggling as it is to pay for Medicare costs and prescription drugs. Using the tool and enrolling into a plan that ends up costing a medicare beneficiary too much, they will struggle, and possibly end up with major financial issues.

The CMS is currently working on fixing the issues. In the meantime, if you are seeking Medicare advice, it would be best to contact a Medicare agent. A Medicare agent who is familiar with plans and their coverage can help guide you in a better, more accurate direction. EZ.Insure offers highly trained agents in your region that can offer you accurate quotes on plans available. If you would like to speak to an agent, call 888-753-7207 or email us at replies@ez.insure. Or if you would like an instant quote, enter your zip code in the bar above.

How To Report Medicare Fraud Or Abuse

Medicare is a federal health insurance program for people who are 65 and older. Medicare works within a network of doctors to provide beneficiaries, like yourself, with proper care. However, sometimes people will abuse their power and take advantage of the program. When this happens, it is considered Medicare fraud, or Medicare abuse. This is a serious issue that needs to be reported.

womans hands on a calculator in front of an open laptop — *Billing mistakes can happen with Medicare sometimes.*

Billing Errors

Everyone has been there, opening up a bill only to notice an extra charge, or a couple of charges that are unidentifiable. Unfortunately, at times these billing mistakes can happen with Medicare.

Accidents happen. Just be sure to keep an eye on your bills and contact Medicare, or your doctor if you see a charge you do not recognize. They can explain why the bill has extra charges, or realize it was a mistake and correct it. These kinds of mistakes are not considered fraud or abuse.

Fraud

Medicare fraud does not just affect you, it affects taxpayers financially, and affects the availability of services for Medicare beneficiaries. An act is considered fraud when it is done intentionally, or abusing the Medicare system for personal gain. For example, it is one thing if your doctor bills you accidentally for services not provided, but for it to happen multiple times is a clear case of Medicare fraud.

Medicare fraud is when a doctor or health care provider sends a bill for services or products that were not medically necessary, more than once. If it is a pattern, or recurring issue, then it is fraudulent and considered Medicare Abuse. Some things a doctor might say or do that you should report are:

cartoon of a person sitting in front of a laptop with "fraud alert" on the screen — *Beware when a doctor states the following:*

Saying “the more tests performed, then the less you pay out of pocket.”
Offering you a gift to get you to use their services
Waives a copayment
Saying the copayment is higher on a no-coplay plan
Telling you they know how to get Medicare to pay for something that isn’t covered on your plan. (Tells you that you can receive coverage on a non-covered service).
Claiming that Medicare endorses their products or services

Reporting It

Pay attention to your bill and look through your Medicare Summary Notice often. This will give you a clear understanding as to what is covered through your insurance, and how much things are. If you are overcharged for services, or products, then you are a victim of Medicare Abuse. When you report fraud or abuse, your name will be kept anonymous, so your doctor will not know it was you. Be

cause odds are if he or she is doing it with you, then they are doing it with others.

Report Medicare fraud or abuse by:

Call the Medicare fraud tip line at 1-800-HHS-TIPS (1-800-447-8477). The TTY number is 1-800-377-4950.
Email: You can also send up to 10 pages describing the incident to HHSTips@oig.hhs.gov.
Fax your report (up to 10 pages) to 1-800-223-8164.
Mail the report (up to 10 pages) to the Office of the Inspector General HHS Tips Hotline, P.O. Box 23489, Washington, DC 20026-3489.

As stated, billing errors can occur, but if it keeps happening, then fraudulent activity is happening. Make sure to always stay on top of your bills, and know what is covered and what is not.

How Medicaid & Medicare Are Different

Medicare and Medicaid are two government-run health care programs. The two programs sound similar, but they are far from it. They serve different people, and are both operated and funded by different parts within the government. It’s easy to confuse the two; they even sound similar, but there are different requirements for each program, and who they cover.

This is a big decision, so make sure you talk it over with family and trusted advisors!

Medicare

Medicare is a federal insurance program that provides health coverage for people 65 and older. 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 Part A covers hospitalization, and is free as long as you have paid 10 years of necessary Medicare taxes. Medicare Part B covers doctor visits and outpatient care.

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.

Medicaid

Medicaid is a government assistance program that is available in every state and is for individuals and families with low income. The income must be below 100% of the poverty line. Medicaid is typically free since most people receiving it have little to no assets. In rare cases, individuals are expected to copay.

Medicaid covers:

Hospitalizations
home health care
doctor visits
labs
x-rays
preventive services
maternity and pediatric services

It will cover individuals and families, and if you have a disability, you might be eligible.

The Differences

Eligibility:

Medicare is typically for seniors 65 and older, and cannot be used for families. Medicaid is based on income, while Medicare is based on age and how many years you paid taxes in the U.S. while working.

Enrollment:

In order to enroll into Medicare, you must be within 3 months of your 65th birthday, and 3 months after your 65th birthday. It totals to 7 months when you include your birthday month. Medicare’s annual enrollment is from October 15 to December 7 and is when you can make changes to your plan.

Medicaid does not have an open enrollment period, you can just sign up anytime you are eligible (meaning below the poverty line).

Options:

woman happy with both Medicare and Medicaid — *Your health and happiness are priorities. Talk with our experts if you have any questions!*

Medicare has many options you can choose from. For example, you can choose a Supplement plan to help pay for Part B expenses. There are about 10 different Supplement Plans to choose from, making it easier to cover more of what you need, and gives you more control of how much you spend. There are different premiums, out-of-pocket costs, and deductibles for each plan.

Medicaid, on the other hand, has very few options to choose from.

If you are in the market for a Medicare Supplement plan, we can help. EZ.Insure has trained agents in the industry that will provide you with quotes on all the different plans, and which suits your needs and budget mist. The agent will go over each plan, and even sign you up when you are ready- for free. We can help you get started when you are ready to sign up for Medicare, or just have questions on how to save money, or how to get more coverage. To get started, contact an agent at 888-350-1890, or email us at replies@ez.insure. You can also get instant quotes by entering your zip code in the bar above, it’s that simple. No hassle, no obligation.

Dental & Vision Coming to Medicare–If Congress Approves

If you have Medicare, you probably already know that you aren’t covered for dental or vision under the program. That is unless you purchase additional coverage through Advantage or standalone policies.

medicare in congress building — *Pay attention to the people we have in office. It’s important for our healthcare system.*

There’s tentative good news coming; Congress might be allowing Medicare to negotiate prices for prescription drugs, and the pharmaceutical companies that produce them. With these talks, they’re seeking a cap for out-of-pocket expenses people have been expected to pay for with their medication.

Members of the House Ways & Means Committee passed three Medicare benefits expansion bills that would add dental, vision, and hearing care insurance benefits to the program. Although these committees passed the bills, they must be adopted and implemented.

David Lipschutz, the Center for Medicare Advocacy’s associate director, says “There have been proposals over the years that would do this, but in the past, they haven’t gone anywhere. It looks like this time something could get passed in at least one chamber of Congress.”

The proposed bills are:

H.R. 4650 (the Medicare Dental Act of 2019 bill): This bill would add preventive and screening coverage for basic and major dental services, such as coverage for bridges, crowns, root canals, and dental implants, to the definition of “medical and other health services” covered by Medicare, in Section 1862(s) of the Social Security Act of 1935.
H.R. 4665 (the Medicare Vision Act of 2019 bill): This bill would add coverage for routine eye exams to coverage through Part B, with beneficiaries paying 20% of the cost. It would provide coverage for eyeglasses, basic eyeglass frames and contact lenses to the Medicare definition of “medical and other health services.”
H.R. 4618 (the Medicare Hearing Act of 2019 bill): This bill would add coverage for hearing exams and hearing aids to the Medicare “medical and other health services” definition under Part B. Beneficiaries would have to contribute 20% as they would normally under Part B costs.

These bills include provisions for cost-sharing among the patients, and includes limits on the number of products and services, such as hearing aids, adding relief to those who couldn’t afford these services before.

person holding glasses paid for with Medicare — *Both our eyes and teeth play important parts of health. We really need coverage to help take care of them.*

Members of the House Energy and Commerce Committee have also approved the bills, but it still needs further support before it is fully implemented. There is no exact estimate as to how these bills would impact Medicare’s budget.

While we’re not sure about the costs incurred from these changes, Medicare’s overall costs are expected to rise, and there is more work to be done if an accurate assessment is to be presented. But one thing is for sure, if Medicare offers hearing, dental, and vision, then it would make a lot of people’s lives a little easier.

Tag: medicare