medicare Archives - Page 34 of 44

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.

You’ve Retired, Now What? Go Travel!

Now that you have retired, you are probably sitting around wondering what you should do with all of your free time. Save up some money, and go travel! Traveling has so many positive health benefits that promote social, mental, and physical well being. It’s a large world out there, go explore it! First, here are some tips, and ideas you can use before you hop on a plane!

*Traveling boosts your mood, mental health, cognitive health, and physical health.*

Boost Your Brain & Mood

When you travel, whether alone or with a group, you will meet new people. Talking and socializing with people has been proven to actually lower your blood pressure, and minimize serious health risks like Alzheimer’s, cancers, mental health issues, and so much more! Experiencing new places allows your brain to challenge itself, which boosts your cognitive health. Your physical health obviously improves because you are up, moving around, such as walking, or hiking while sightseeing in a new place. Just be careful when hiking, so that you do not get injured. Traveling boosts your mental mood, making you feel happier and even offer better sleep at night.

Plan Ahead

Packing

If you are like me, then you tend to pack a lot of outfits and clothes for a short trip. It would be wise to sit down and plan it all out before you start packing. All that extra luggage can be annoying to lug around, and you may not have room for the essentials. Plan ahead, and make a list of medications you need and any other medical necessities. Have your doctor fill out a letter regarding your medications and why they are needed, just in case there is an issue with the airport. Once you have all of the important essentials packed, then you can worry about which outfits to pack, depending on the climate you are traveling to, of course.

Make sure to optimize your travels with doing a lot of research on prices, and best time to travel to places.

Research, research, research!

Research is the most important thing you must do when you consider traveling, especially if you are going outside of the country. Research costs and the best time to go to your desired destination. Make sure it is not peak times during the year so that it is not overly crowded.

Better To Be Insured Than Not

It is easy to accidentally get hurt when hiking or exploring a new place. Accidents happen. This is why it is important to be insured while traveling. If not, it can end up costing you hundreds, if not thousands of dollars in medical bills. Some Medicare Supplement Plans offer coverage while traveling outside of the U.S. Something to consider if you do not have it already.

Estimate Costs

Budgeting can be hard. Once you do all your research on the places you want to go, with hotels, flights, cruises, etc. then you can create a budget. The budget will have to focus on spending money on food, souvenirs (if you want), and extra just in case costs are higher than expected.

Go RVing!

Ever wanted to travel across the U.S. visiting all the national parks? Then an RV is the perfect choice for you. Visit all the towns, cities, and parks that you want to in an RV. In the beginning, renting out one may sound expensive, but it is less expensive as the trip goes on. Nothing but you, your spouse or a group of friends going on a cross-country journey together. Road trip!

Make sure to optimize your travels with doing a lot of research on prices, and best time to travel to places. — *You can travel by train, and enjoy the scenic routes to different destinations.*

Travel By Train

If you enjoy the scenic route, then train travel is the way to go. There are trains that travel cross country, and around the world. Other countries such as Europe offer journeys via train travel. You can go to different cities around and see all their beauty, both scenic and cultural.

Make Memories

After all the important safety, planning, and budgeting tips are out of the way, the next significant thing to do is have fun and make some valuable memories. Go visit the Taj Mahal in India, the Great Pyramid of Giza, the Colosseum in Rome, or even Christ the Redeemer statue in Brazil. The possibilities are endless. You have the time, so start saving (if you haven’t been already), and make the most out of it!

Make sure you are covered when traveling outside of the U.S. with a Medicare Supplement Plan. If you would like help on how to get started, and which plan will work best for you, contact EZ.Insure. We offer Medicare agents that can explain your options and sign you up with a plan for free. Simple enter your zip code in the bar above, or speak with an agent through email at replies@ez.insure, or phone at 888-753-7207.

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 replies@ez.insure. Or if you would like an instant quote, just enter your zip code in the bar above.

Glaucoma: How You Get It, How To Prevent It!

Did you know that glaucoma is the second leading cause for blindness in the world? While everyone is at risk for developing glaucoma, people over the age of 60 have a higher risk. Statistics show that over 3 million Americans have it, but only half know they actually have it. There are no known cures for the disease yet. However, there are precautions you can take to prevent glaucoma.

What Is Glaucoma?

*Glaucoma is a serious eye disease that develops in millions of Americans. Damage to the optic nerve causes vision loss over time.*

The optic nerve has over 1 million nerve fibers, connecting the retina to the brain. Glaucoma is a disease in which the optic nerve is damaged, causing vision loss, and blindness. There are 3 main types of glaucoma diseases, open-angle glaucoma, angle-closure glaucoma, and low-pressure glaucoma. Most cases develop slowly over time, but if it is detected early on, you can significantly slow down the loss of vision.

The Causes

As mentioned, when there is damage to the optic nerve, then glaucoma begins. Fluid constantly flows to nearby tissues, and whenever the liquid cannot drain, it adds pressure to the optic nerve, causing damage. Family history, and your ethnicity can increase your risk of glaucoma. If your parents or siblings have it, have diabetes, or if you are African American or Latino, then you have a greater chance of the disease. The three main types/causes of glaucoma are:

Open-angle (Chronic) Glaucoma– This is the most common type of glaucoma. There are no early warning signs for this type of glaucoma, because it develops slowly and is not noticeable. Most people feel fine and like nothing is wrong, because it is so unnoticeable. By the time a person notices vision loss, the disease is in its advanced stages, making the vision loss untreatable. Open-angle refers to the angle in your eye where the iris meets the cornea. The drainage canals become clogged causing eye pressure.
Angle-closure (Acute) Glaucoma– This type of glaucoma is less common, and occurs when there are blocked drainage canals. Because of the blockage, the angle between the iris and cornea is closed or narrowed. Symptoms and damage are usually noticeable when it occurs, and needs immediate attention.
Low-Pressure (Normal-Tension) Glaucoma– This occurs when the optic nerve is damaged, possibly due to poor blood flow to the nerve. even though the eye pressure is not very high.

The Early Signs

There are many early signs of glaucoma. It is very important that if you notice or suspect glaucoma, or any of the following symptoms to see your doctor immediately. Symptoms include:

Vision loss, especially around the peripheral (side) vision.
Seeing halos around lights
The inability to adjust to darkened rooms
Foggy or blurred vision
Pain or pressure in the eye
Nausea or vomiting
Tunnel vision (narrowing of vision)
Frequently switching glasses

If you are able to catch glaucoma early, then you have a higher chance of treating it. This usually occurs with eye drops, pills, laser surgery, and/or traditional surgery. The earlier you can prevent vision less, the better, because once you lose vision, you can not reverse it.

Prevention

In order to prevent glaucoma, there are some simple steps to take recommended by medical experts. A healthy lifestyle is the best way to prevent vision loss, and this includes:

*Regular eye exams can catch early signs of glaucoma, or any damage to the eye. This gives you a better chance of fighting it and preventing it.*

Regular eye exams- Early detection from frequent eye exams are one of the main ways to prevent vision loss and glaucoma. It is recommended that people age 55-64 go to the eye doctor every 1-2 years, and people 64 and older go every 6-12 months.

Exercise– Moderate exercise can lower your intraocular pressure, which is the pressure that causes optic nerve damage. Walking or jogging can help lower the pressure.

Prevent Eye Injuries– Always wear protective eyewear when you are in the sun. Make sure you are not straining to read or watch something. Wear eyewear when you are dealing with construction, or sports to prevent any injury.

Keep Insulin Levels Low- Diabetes creates a higher chance of developing glaucoma. This is because diabetes can increase blood pressure, which includes eye pressure as well. Avoid sugar and high-carb foods in order to keep your insulin levels low.

Eye-Healthy Foods– Some foods to consider eating for healthy vision are foods rich in vitamins A,C,D, E, zinc, and omega-3 fatty acids. A lot of these vitamins are found in leafy greens, vegetables, and fruits.

Once you have vision loss due to glaucoma, then the harder it is to go back to regular vision. More often, when vision loss happens, it becomes irreversible. So the main thing to do is to stay on top of your eye health. Visit the eye doctor regularly, eat healthy, exercise, and if you exhibit any symptoms, then seek immediate medical attention.

Instant Access To Everything: Why Seniors Should Use YouTube

Seniors being unable to use the computer has been a longstanding stereotype. However, people over the age of 60 access the internet more than ever. YouTube is a free website that provides people the ability to share videos and watch others videos. There is a lot of misconception about who uses YouTube, mainly that it is for Millenials, or

Seniors can take advantage of YouTube just as much as any other generation. There are many benefits to using it. — *Seniors can take advantage of YouTube just as much as any other generation.*

younger. Even seniors can find resourceful content on Youtube. Let’s take a look at what you can search for.

Learn New Skills

With all the free time you have while retired, you can take on a new hobby. With Youtube, you can find the perfect tutorial to get started, whether it be to make crafts with your grandkids, learn new recipes, or cook some delicious meals. (Don’t forget desserts!). There are endless videos that teach you practically anything in simple, easy steps.

Stay On Top Of Trends

On YouTube, there is a “Trending” section, which has currently popular topics. Watching these videos arms you with conversation topics so you can connect with your grandkids. These topics can be celebrity news, movie trailers, sports, or even reviews. It ranges from celebrity news, and movie trailers, to sports and reviews. Surprise everyone with your trendy knowledge. Maybe you will want to post something yourself.

Health Related Topics

Have questions about your health, or what is going on with Medicare? Go to YouTube! It offers information on diseases and numerous health topics. There’s content explaining health warning signs, cancer prevention, plus other issues such as dementia. Some people are visual learners; YouTube is the perfect tool.

*If you are considering buying a new product, look up reviews by people who used it, on YouTube.*

Research Product Reviews

Are you about to purchase cosmetics, an appliance, electronics, or a vehicle? It’s important to research their reviews. Whatever you need, Youtube has you covered. You can research the reviews of whatever you are considering purchasing on YouTube. You can find specific channels where people have bought products, used them, and reviewed them for you. You can even research retirement communities! Watch other’s reviews and other products/alternatives before making a decision.

Exercise Tips

Do you find yourself scratching your head when it comes to exercise? Let Youtube’s content help with simple techniques to get you off the couch. Yoga is the most popular, and it’s easy to do at home. Is that pesky arthritis pain getting you down? Not for long!

Funny Videos

Some of the best videos hosted are the funny ones. Do you need a mood boost? I bet you’ll remember “America’s Funniest Home Videos” from TV. Guess what? It’s on Youtube now! Similar shows appear as well. If you know a particular show, look it up. Enjoy the memories.

There are many benefits with becoming familiar and using YouTube. You can create your own channel, post your own reviews, talk about your passions, or create a funny skit. Go ahead and explore Youtube. What are you waiting for?

Tag: medicare