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Does Medicare Cover Speech Therapy?

Let’s face it, it’s not fun getting older. Body parts give in to gravity, reflexes and movements get slower, and our vision and hearing weaken. As if that wasn’t enough, stroke risk increases with age and the older you get the more likely you are to develop dementia. While stroke and dementia are 2 conditions that are very complicated, they do have one thing in common: speech and language are affected. The range to which speech is affected varies from case to case but help is available. Luckily there are professionals called Speech-Language Pathologists (SLPs) trained to assess and treat many types of communication and swallowing problems including ones stemming from stroke or dementia and in many instances are covered under Medicare.

seniors toasting — Speech-language pathologists assess, diagnose, treat, and help to prevent communication and swallowing disorders in children and adults.

First let’s discuss two of the more common reasons you are likely to need speech therapy, having dementia and having a stroke.

Stroke

brain xray — A stroke is a life-threatening medical emergency where an individual experiences brain damage caused by a lack of blood supply to parts of the brain.

A stroke is one of the most common reasons adults receive speech therapy. The left hemisphere of the brain houses the language center. If you have a left hemisphere stroke or brain injury, aphasia often occurs. Aphasia is the loss of ability to understand or express speech, caused by brain damage. Meeting with a Speech-Language Pathologist will get you a formal diagnosis as to whether you have aphasia or no. They will set up with a treatment plan to get you on the road to recovery. Post stroke rehabilitation is possible and a Speech-Language Pathologist is an integral part of recovery.

Dementia

Another common reason older adults receive speech therapy is because they suffer from dementia. Dementia is a condition that causes memory loss and other thinking problems that worsen over time. Once diagnosed, the goal of any treatment is to maintain the patients quality of life for as long as possible. This is where a Speech-Language Pathologist is beneficial. A SLP can work on attention, memory, problem-solving, and higher-level thinking skills.

What’s Covered?

Medicare will cover speech therapy services when you meet specific requirements. Speech therapy can improve social communication skills, thinking, and understanding, and even things like swallowing. Doctors may recommend speech-language therapy to patients suffering from a head injury, brain tumor, stroke, or dementia. For Part B to cover speech therapy, your doctor must certify that it’s medically necessary and have a treatment plan ready. Medicare will cover 80% of the cost. You’ll be responsible for the remaining 20% unless you have a Medicare Supplement Plan to cover the rest.

If you or a loved one find yourself in need of speech therapy services, having the right insurance coverage is vital. If there are costs not covered by Medicare, you may find that having a Medicare supplement plan can save you a lot of money and stress,. To find affordable plan options with the coverage you need contact EZ.Insure. To speak directly to a licensed agent call 888-753-7207 or enter your zip code in the bar on the side.

B.E. F.A.S.T When You Spot A Stroke

Strokes are more common than you might think: they are one of the leading causes of death and disability in the US. According to the CDC, each year almost 800,000 people suffer a stroke. Nearly three-quarters of all strokes occur in people over the age of 65, and the risk of having a stroke more than doubles each decade after the age of 55. Strokes can have devastating and long-lasting impacts, but spotting a stroke quickly could mean reducing the damage done. The earlier you can get help, the better, so it is vital to know what to watch out for.

older caucasian man with one side of his face drooping — *Facial weakness or uneven smile is one of the symptoms of a stroke.*

Spotting The Signs Of A Stroke

Strokes happen suddenly when blood flow to the brain is disrupted or cut off. Once this happens, brain cells start dying; the more brain cells that die, the higher the risk of becoming paralyzed or dying. The classic warning signs of a stroke to look out for are simple – use the acronym B.E. F.A.S.T. to remember them:

B – Balance. Sudden dizziness, loss of balance or coordination.
E- Eyes. Sudden trouble seeing out of one or both eyes
F- Face. Facial weakness or uneven smile
A– Arm. Weakness or inability to raise both arms evenly
S– Speech. Impaired, slurred speech, and/or difficulty repeating back simple phrases
T– Time. Every second counts, so call 911 immediately

Additional Symptoms Of A Stroke

Strokes can also cause:

Sudden confusion, trouble speaking, or understanding others when they speak
Chest pain is also a sign of a stroke.
Hiccups
Sudden severe headache with no known cause
Chest pain
Feeling weak all over
Rapid heartbeat
Shortness of breath

What To Do If You Suspect a Stroke

A stroke victim needs treatment right away. If any of the common warning signs are present, use the F.A.S.T test to help determine whether someone is having a stroke:

F (Face) – Ask the person to smile, and if one side of their face droops or the smile is uneven, that’s a sign of weakness or numbness in the face, which could indicate a stroke.
A (Arms) – Ask the person to raise both arms, and if one arm drifts downwards, that’s a sign of weakness on one side of their body.
S (Speech) – Ask the person to repeat a simple phrase. Slurring, sounding strange, or being unable to repeat the phrase are tell-tale signs of a stroke.
T (Time) – If the person shows any of these symptoms, get help immediately by calling 911. Let the operator know what time the test was given so they can estimate when the stroke occurred.

Even if symptoms go away, that doesn’t mean that the person is in the clear; a mini-stroke can last up to 24 hours. Any sign of a stroke could mean lasting damage, because these symptoms indicate that brain cells have begun to die. It is better to be on the safe side, so even if symptoms seem to pass, go to the emergency room or call 911. A health professional can administer tests, and can help to get the condition under control in order to reduce the risk of a stroke in the future. Every minute counts!

What Medicare Covers After A Stroke

According to the National Institute of Neurological Disorders and Stroke, over half a million people over the age of 65 suffer from a stroke every year. A stroke can be very serious, and can have long lasting effects on balance, hearing, and vision. It can also cause decreased mobility or even paralysis. Recovery after a stroke can be a long and difficult process, especially if you don’t have the proper insurance coverage. Thankfully, Medicare covers a lot of the aftercare related to recovery from a stroke, including both inpatient and outpatient care, as well as some medical equipment. There are gaps, however, which can be filled by a Medicare Supplement Plan.

Medicare Part A Coverage

If you suffer a stroke, you might need to go to an Inpatient Rehab Facility afterwards to recover and get the therapy that you need. As long as your doctor deems your stay medically necessary, Medicare Part A will cover this inpatient rehabilitation. Medicare will cover the cost of treatment in an inpatient facility for a limited time; if you need to stay longer than 60 days you will have to pay $352 per day for days 61-90. For days 91 and beyond, you will pay $704 in coinsurance per “lifetime reserve day.” You have 60 reserve days over your whole lifetime; after that, you will need to pay the full cost of your stay.

Medicare Part B Coverage

Medicare Part B will cover any outpatient rehabilitation needed, such as physical therapy, at 80%. You will be responsible for the other 20% coinsurance. As with any service, your doctor must deem your rehab medically necessary in order for it to be covered. If there is any durable medical equipment that is medically necessary, then Part B will also cover the cost of that at 80%. This includes equipment such as wheelchairs, walkers, or canes. Any of this equipment will need a prescription from your doctor.

Skilled Nursing Facilities

If you are moved into a skilled nursing facility from the hospital or from an inpatient rehab facility, Medicare will only pay for your stay if you have satisfied the “3-day rule.” This means that you need to have been admitted as an inpatient into the hospital for three days, and not classified as an “observation care” patient. With Medicare, staying at one of these facilities is free to you for the first 20 days, and $176 per day for the next 80 days after that.

Long-Term Care Facilities

Medicare does not cover any long-term care facilities, even if your doctor deems it medically necessary. These services are not covered because care at these facilities includes things like bathing, feeding, and assisting with the bathroom, which Medicare does not consider medical care services.

Medicare Supplement Plans

There are obviously gaps in what Parts A and B cover when it comes to recovery from a stroke. A Medicare Supplement Plan can help to fill those gaps. Most plans will cover your Part A coinsurance and allow you to extend hospitalization days up to 365 days over your lifetime. A Medicare Supplement Plan will cover part or all of your Part A deductible, and approximately 8 out of 10 plans will cover the skilled nursing facilities coinsurance. Some also provide coverage for long-term care. There are 10 different types of plans to choose from, with different coverage and different price points. EZ’s highly trained, licensed agents can help you compare these plans, and can provide quotes to you within minutes.

We hope you never need to test the limits of Medicare’s coverage for stroke care. Speak to your doctor about your risk factors, such as high blood pressure, high cholesterol, diabetes, smoking, and drinking, and see if there are ways you might be able to lower your risk through healthy lifestyle changes. Suffering a stroke can be scary and life-changing, but if it does happen to you, Medicare will cover the majority of your costs for treatment and rehabilitation. And whatever it does not cover, you can always count on a Medicare Supplement Plan to help you pay your medical bills. To be better prepared and to save money, compare Medicare Supplement Plan quotes by entering your zip code in the bar above, or to speak directly to an agent call 888-753-7207.

Coronavirus Update: Week 3

As of April 14, total global deaths from Coronavirus have surpassed 100,000, with the U.S. accounting for about 31,000. Also on April 14, President Trump decided to halt funding to the World Health Organization (WHO), claiming that they mismanaged the response to the coronavirus, and that they covered up information about its spread. At the same time, scientists, physicians, funders and drug manufacturers from around the world have pledged to collaborate with the WHO to help find a vaccine against COVID-19. The U.S. economy continues to suffer, with unemployment claims climbing to 22 million and one-time stimulus checks being issued to help Americans. Trump, meanwhile, is hopeful that some business will be able to reopen sooner than May 1.

Coronavirus & The Brain

There is now some evidence that COVID-19 may not only affect the respiratory system, but also the brain. Doctors at Mount Sinai hospital in New York have noticed a spike in the number of strokes suffered by coronavirus patients. There were around 45 strokes in a 4 week period, which is nearly triple the normal number. Half of these patients had coronavirus, and were on average 12 years younger than typical stroke victims. Some coronavirus patients are now receiving blood thinners. A limited study of COVID-19 patients in China also found that more than a third suffered from neurological symptoms, including loss of taste and smell, dizziness, headaches, and strokes.

Trump Halts Funding To WHO

On Tuesday, April 14, Trump announced that he was halting funding to the WHO due to what he claims was mismanagement of the coronavirus. The U.S. provides $400 million-$500 million in funding to the WHO each year.

“Had the WHO done its job to get medical experts into China to objectively assess the situation on the ground and to call out China’s lack of transparency, the outbreak could have been contained at its source with very little death,” Trump said.

Reopening America

The US Captiol building. — *Trump told the nation’s governors that they could begin reopening businesses by May 1 or earlier.*

The Paycheck Protection Program, a federal loan program that was created to help small businesses keep workers on their payrolls during the pandemic, has run out of money. $349 billion had been allocated for the program, but that money quickly ran out, leaving millions of businesses unable to even apply for the loans.

Instead of announcing plans to reup the funding for the loans, President Trump revealed federal guidelines on Thursday, April 16, to restart the economy by “reopening” the U.S. Under his three phase “Opening Up America Again” plan, states would not begin to relax stay at home orders until they had 14 consecutive days of decreases in coronavirus cases. He told the nation’s governors that they could begin reopening businesses by May 1 or earlier.

“Some states will open sooner than others,” Trump said. “Some states are not in the kind of trouble that others are in. Now that we have passed the peak in new cases, we’re starting our life again. We’re starting rejuvenation of our economy again in a safe and structured and very responsible fashion.”

Ideas To Make The Most Of Your Stimulus Check

Caucasian hand holding a pen on an open checkbook. — *The stimulus check will be a one-time payment, and can be incorporated into your budget in multiple ways.*

This week people have started receiving their stimulus checks, which are valued at $1,200 or more, depending on family size. This check will be a one-time payment to help ease financial burdens during the pandemic, and can be incorporated into your budget in multiple ways.

For the millions of Americans who have lost their job, this check can help pay some of their bills. If you are one of these Americans and are able to get a bill deferment for a couple of months, then the money will help families buy groceries and other necessities in the interim.

For people who are financially secure, they may be in the position to use the funds towards their savings, a child’s education, or retirement. If you still have a job, or are financially secure, then you should consider using the money to pay off debts such as credit cards and student loans. If you are well off, then consider donating to those in need. You can do this by donating to a charity, a local food bank, or the CDC to help find a cure for the disease.

Tag: stroke