medicare Archives - Page 37 of 44

Medicare Cracks Down on Opioid Problem

Medicare has announced new guidelines for beneficiaries who receive high-dose opioids. Due to the rising deaths from opioids in America, the government and Medicare officials have decided to take action to fix the problem and reduce deaths. The overdose of opioids has been a rising cause of deaths in the USA, killing over 60, 000 people in 2016. The new guideline was designed to crack down on doctors over prescribing opioids, as well as to make sure beneficiaries are not abusing their medications.

*Because some Medicare beneficiaries overuse their prescription opiods, CMS has created new guidelines,*

The Centers for Disease Control and Prevention, CDC, estimated that almost 100 Americans die every day due to an opioid overdose. President Trump decided that it was time to take action and battle the opioid addiction, starting with how much and often they are being prescribed.

Of the estimated 50 million Medicare beneficiaries in America, one in three are prescribed opioids or painkillers. Medicare wants to take part in the opioid addiction problem by putting restrictions/guidelines on the opiods that are given to their beneficiaries.

The New Guideline

The new plan has been finalized in April that will make it harder for Medicare patients to receive high doses of painkillers. The Centers for Medicare and Medicaid Services, CMS, will require all new opioid prescriptions for short term acute pain limited to no more than a weeks worth of supply.

In 2019, morphine prescriptions will be limited to 90mg at a weeks time. If a doctor or patient tried to receive more

If a Medicare patient is prescribed more than the set amount of the guidelines, the pharmasict must talk to the doctor. If they agree with the answer, they will allow the patient to get the prescription.

than this set limit, then it would trigger a “hard safety edit” in which the pharmacist must talk to the prescribing doctor about the dosage. If the pharmacist is happy with the answer then they can override and fill the prescription, and if not then they do not have to fill it and Medicare will not pay for it. If denied, the doctor will have to appeal the decision and show why it is medically necessary for the patient to have the high doses in order for Medicare to reconsider. These guidelines will not apply to those who are suffering from cancer or in hospice.

The new limit is a hopeful tactic to catch doctors who overprescribe, and keep an eye on patients who take more opiates than necessary from different doctors. This way Medicare and the government can try to reduce overprescription that will lead to overdose or patients selling their prescriptions.

Demetrios Kouzoukas, CMS deputy administrator and director of the Center for Medicare, told MedPage Today that if the prescription exceeds the limit, that would act as a “trigger” for a conversation between the physician, patient and insurer about “appropriate opioid use and prescribing.” To get more than the proposed limit, the limit would have to be overridden by the patient’s insurance plan.

The CMS estimates that about 1.6 million Medicare beneficiaries have prescriptions above the set 90mg level. The real battle will be determining that the correct patients that need the dosage required will receive it, while halting the access of addictive drugs to patients who do not need it.

Save A Life, Become a Donor

Over 120,000 people. That’s the number of people in the U.S. that are currently waiting for an organ. This number increases by one more about every 12 minutes. For those who are not able to receive the needed organ, approximately a little over 7,000 people every year, die. Organ donors are something that we are in constant need of. You might be considering becoming an organ donor, if not one already. We will discuss some of the facts and how it all works.

How It Works

When any patient dies, the hospital must contact Gift of Life. The family is notified, and counseled on the process of organ recovery. Once the organs and tissues have been retrieved, they will be evaluated to determine which are

*When a patient dies, if they are a donor, Gift of Life and the family will be notified of organ removal.*

suitable for a transplant. The hospital maintains the health of the organs until they are sent to a matching recipient. After the organ is successfully transplanted, Gift of Life offers post donation services to the families of the organ donor. They can provide letters with information on who received their loved one’s donated organs and tissues.

It is also possible to donate an organ while living. It does not have to necessarily only happen when you die. A person can donate a kidney, part of the pancreas, intestine, lung, or liver while living. Doctors will run a series of tests to make sure the organ or tissue is healthy enough for transplant. They will also determine if donating the organ will put your health at a risk, whether short or long-term. If it does, then you will not be able to donate the organ.

How To Become A Donor

When you renew your license, you can choose to be a donor.
Tell your loved ones your wishes to be an organ donor, whether a designated health care proxy, or in your will.
Register with the National Donate Life Registry at RegisterMe.org

Facts

Almost anyone can become an organ donor, including anyone younger than the age of 18 as long as they have the consent of a parent or guardian.
If you have cancer, HIV, diabetes, kidney disease, or heart disease, you might not be considered healthy enough to be a living donor. This does not mean that once you die, your healthy organs cannot be used.
You can still have an open-casket funeral if you donate your organs. The incisions will all be closed.
Your family will not incur any costs for anything related to organ donations, including tests and the surgery. The recipients insurance usually covers the costs.
Old age does not disqualify you from becoming an organ donor. There may be come organs and tissues that can be used.
Anyone can become an organ donor and help save at least one life.
If you are a living donor, there are risks that may follow surgery such as bleeding, clots, infection, and damage to other organs and tissues. It will take a while for your body to recover.

The decision to become an organ donor is an important one to research, and talk to your doctor and family about. In the end, the decision is yours to make. Becoming an organ donor will help not just cave one life, but as many as 50 lives. At times, it will help a family cope with the loss of their loved one knowing they were able to save other lives. Instead of letting your organs go to waste getting buried with you or burned, you can help save someone’s life who needs it. Every day almost 20 people a day die waiting for an organ that can save their life. Be the person to save a life, or multiple lives- become a donor.

Tips To Help Seniors Manage Holiday Stress

The holidays are supposed to be a joyful time, but in reality it is a stressful time for a lot of people. This is especially true for seniors, because it can accompany grief, as well as depression. Travel plans, party planning, shopping, and entertaining guests are just some of the stressful things seniors may deal with. While on the other hand, some can not be with their families during the happy season. Here are some helpful tips to keep in mind, and exercise in order to reduce the stress of the holidays.

*Create a schedule for when you travel to make it less stressful.*

A Solid Schedule

The holidays can get very hectic. Traveling to see your loved ones is one of those hectic times. It is important to set a schedule and stick to it. Work around your current day to day schedule. This includes taking your medications on time, and eating and sleeping as close to your normal times as you can. It can be a lot to travel, and then try to stay up late with family members. But it is important to take care of yourself too, and get the rest you need.

Be Realistic

If you can not travel during the holidays, it is okay. It can be both physically and mentally exhausting for anyone, especially as we get older. If you do decide to travel, then make sure you get enough time for rest. Try not to put too much pressure on yourself to make it somewhere if you are not capable.

Watch Your Wallet

A lot of seniors live on a fixed income, so if you do, then you are not alone. Because of this, it can be really stressful to buy gifts, food, pay your bills, and pay for travel expenses. Plan ahead and stick to a realistic budget.

Eat Well

*During the holidays, make sure to eat as healthy as possible.*

What else can we expect during the holidays other than good eating, and lots of sugar? As much as you want to indulge in all the delicious and savory sweets, you must be mindful. For seniors, it is especially important to watch what we eat. Try not to eat too many sweets, and stick to nutritious foods such as fruits, proteins, and vegetables. Eating these foods will help your body fight against diseases like the flu. It is important to stay hydrated, and drink plenty of water.

Speak Up

If you are overwhelmed, depressed, or just need help getting around, then speak up. The holidays are a super stressful time, and can bring on depression, especially if you lost a loved one. People do not want to let their family down, or have them worry, so a lot of times they will keep our feelings of stress and overwhelm to themselves. Speak up and notify your family so they are aware and can accomodate you and your needs. Families love and support each other, so do not feel like you have to please everyone. If you can not make it to something, or plan to have family over your house, ask a family member for help. Take some of the stress off yourself. Make sure you are healthy and your energy is up. Your family will help, but only if they are aware.

Taking care of yourself is the most important thing you can do during the holidays, because if you do not, then you will not be around for it. Your family members are there to help when you need them to be, but this can only happen if you talk about it. Tell them what kind of schedule you need to follow, your limitations, and the help you may need. In order to reduce the stress of the holidays, plan wisely with your expenses, and time. It is okay to indulge during the holidays, but be mindful of your health. If you plan to travel, stick to your schedule and rest. Do things in moderation if you need to. The holidays are about being happy, feeling loved, and enjoying your family. The only way to do this is to be prepared, and minimize stress as much as possible.

When Can You Sign Up For Medicare Supplement

Medicare Supplement plans do not have annual enrollment periods, so it is important to know when to apply for one. The Medicare Supplement initial enrollment period is the time to sign up for a plan. It is important to utilize this period if you need help paying Part B costs, or if you have pre-existing conditions you need covered. During this time, you have guaranteed issue rights. This is your guarantee that companies will cover your pre-existing conditions without extra charge. What most people do not know is that you can also obtain guaranteed issue rights during a special enrollment period.

Must be 65 and already be enrolled in the original Medicare Parts A and B to qualify
Th best time to sign up for a Medicare Supplement plan is during the 7 month period of your 65th birthday. 3 months before your birth month, and the 3 months after.

Best time to enroll

The best time to enroll in a Medicare Supplement plan is during your Medicare Supplement Initial Enrollment period. This six-month period starts on first day of the month that you are both 65 or older and enrolled in Medicare Part B. Throughout this period, you can enroll in any Medicare Supplement plan offered in your service area with guaranteed issue. This means that insurance companies are not allowed to deny you or charge you more due to pre-existing conditions. If you have medical issues or disabilities, it’s especially important to take advantage of this period.

Special Enrollment Period

Guaranteed issue right means that companies must sell you a policy at the best available rate, regardless of your health status and cannot deny you coverage. If you miss your initial enrollment period, you can apply for a Medicare Supplement plan with guaranteed issue rights during a special enrollment period. The situations to be eligible for a special enrollment are:

Your Medicare Supplement insurance company goes bankrupt and you lose your coverage, or your Medicare Supplement policy coverage ends through no fault of your own.
You’re enrolled in Original Medicare and your employer coverage is ending.
You drop a Medicare Supplement policy or leave a Medicare Advantage Plan because the company did not follow the contractual obligations, commits fraud, or misled you.
You have Original Medicare and a Medicare SELECT plan and you move out of your plan’s service area.
You’re enrolled in a Medicare Advantage plan or PACE organization and move out of the plan’s service area, or your Medicare Advantage plan leaves the Medicare program.
You joined a Medicare Advantage plan, and within the first year of joining you want to switch to Original Medicare and Medicare Supplement.

You will run into problems if you try to buy a Medicare Supplement policy outside of your protected enrollment periods. Companies can refuse to sell you a policy, or will only let you buy one if you meet certain medical requirements. If an insurance company does agree to sell you a policy you will need to pay a higher monthly premium. You will also need to wait six months before the plan will cover pre-existing conditions.

A Medicare Supplement plan will help save you money. — *A Medicare Supplement plan will help save you money by offering more coverage than Original Medicare.*

What it covers:

All Medicare Supplement plans cover at least part of:

Your Medicare Part A and Part B deductibles
Skilled nursing facility costs after you run out of Medicare-covered days
Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
Medicare Part B coinsurance or copayment
Part B excess charges
Part A hospice care coinsurance or copayment
Blood (first 3 pints)

Additional Information:

After January 1, 2006, Medicare Supplement plans are not allowed to include prescription drug coverage. If you would like prescription drug coverage, you can join a Medicare Prescription Part D plan.

The cost of your Medicare Supplement policy depends on the type of plan you buy, the insurance company, your location, and your age.

A standardized Medicare Supplement policy is guaranteed renewable even if you have health problems, as long as you pay your premiums on time.
People who have a Medicare Advantage plan cannot get a Medicare Supplement plan.
A Medicare Supplement policy only covers one person. If you and your spouse both want Medicare Supplement, then you must each purchase separate policies.
You can buy a Medicare Supplement policy from any insurance company that is licensed to sell one in your state.

Need help deciding if and when you can sign up for a Medicare Supplement plan? Here at EZ.Insure we are dedicated to helping you find the plan that is right for you. You will speak directly with one of our trained agents at any time by calling 888-753-7207, or emailing us at Replies@EZ.insure. If you want to see quotes now you can put your zip in the bar above to get started. We will help you with any questions or concerns you have, free of charge!

All Seniors Want For Christmas, Is Time With You!

We are taught at a young age that giving presents are how we express our love. But as we get older, we realize that it is not the materialistic presents that matter. What truly matters is the present of being present, showing love, and giving our time. This is especially true for the parents, grandparents, and older adults in our lives. The holidays can be loney for older adults who do not live near their families. The isolation brings up feelings of loneliness and sadness. People want to feel loved and appreciated, so instead of taking a trip to the mall, take a trip to your loved one’s house and spend more time with them. There is no better present you can give them.

*The best gift you can give seniors during the hoidays is your time.*

It can be hard for some seniors to travel and join the holiday festivities with their family. If they can not make it, or have a hard time getting around, then take the time to go to them. You can make them feel like a part of the festivities. There are many things you can do together to enjoy each other’s time and have some fun.

Decorate Together

Helping put up decorations for the holidays is a thoughtful gesture, especially if your loved one has mobility issues or lives alone. Who wouldn’t love to see all the lights and decorations that brings joyfulness? Speaking of lights, you and your elderly loved one can take a care ride through the neighborhood to see all the holiday decorations. You can take the tour, enjoy each other’s company, and stop for some tea or hot chocolate.

Create A Tradition

*You can start a family tradition such as game night every week.*

Family game night anyone? Have a family game night once a week, or once a month with your loved one. If family game night is not your thing, then watch a holiday movie, sing some songs, or bake together. Share what is going on in your lives, and take pictures so the memory can last forever. Whatever tradition you choose to create, you can carry it on beyond the holidays with each other.

Paint The Town

A lot of times, your elderly loved one can not go out as often to enjoy the simple things, such as shopping. Either they are immobile, or just lonely. Go out and paint the town together if your loved one can manage! You can go out to eat, shop, volunteer, or just to take a stroll together. This will have a huge impact on your loved one’s mental health. The holidays are a time when some people get depressed, and overwhelmed. It is no different, or even worse for seniors who lost a spouse or friend, and are alone. Include them as much as you can, because this means more to them than you know. Your presence and showing you care can make a whirlwind of difference in their life.

St. Francis of Assisi said “for it is in giving that we receive.” Giving is one of the greatest acts we can perform. It brings others happiness, and it makes us feel good. In a world where people seek to get more than they give, be a giver. Offer your love and support to those who need it. The gift of our love and quality time is worth so much more than any material gift you give.

The Annual Open Enrollment Period Is Almost Over!

The end of the Medicare Annual Enrollment Period is right around the corner. From October 15 through December 7, Medicare beneficiaries have the ability to decide if they like what they have, or if they would like to switch. If you have what you want then great, but if you are not satisfied with it, or looking to save more, it is best to do your research and make a decision soon. After December 7, you will not be able to make any changes, or add a Medicare Supplement or Advantage plan.

*During Medicare Annual Open Enrollment, you have different routes to choose that best fits your needs.*

Review Your Coverage

You will be provided with a handbook for next year’s coverage for Medicare. Take a look at the coverage, prices, and benefits. If you are not happy, or think you may need more benefits, then looking into a Medicare Supplement of Advantage plan is important. You can compare the different plans and see which one will help you the most. But you can only add these plans during the annual enrollment period.

The same goes for your Medicare Advantage or Supplement plans, you will receive an Annual Notice of Change for your plan.

Changes You Can Make

Once you make any change to your current insurance, it will take effect on January 1st. So what can you do during this period? You can:

Join a new Medicare Advantage Plan or Part D Plan
Switch between Original Medicare and Medicare Advantage.
Buy a Medicare Supplement Plan depending on where you live.

Research Your Options

Researching the different plans, and comparing the coverage and prices is a lot of work. You do not want to miss out on a great deal by overlooking or not doing enough research. Overlooking plans will cost you, but we will avoid that from happening. EZ.Insure compares plans of over 20 insurance carriers in your region. We compare all the plans and prices for you within seconds, and provide you with the information so you can choose the best option.

To receive instant quotes, you can enter your zip code in the bar above, or you can contact one of our highly trained agents. You will be given your own personal agent to work with, and not have to worry about jumping around agents. Your advisor will gather information and provide you with all of the plans available to you within your area. No obligation or fee. It is all done at no cost to you. Call 855-220-1144, or email us at replies@ez.insure to get started. Let us take care of you, the research, and the sign up process, for free!

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