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Medicare Open Enrollment starts on November 15th and runs through December 31st. CareAll has partnered with MedAssurance, a not-for-profit organization, to help Medicare recipients make an informed decision about their Medicare choices. We are also launching a public service television campaign that will be seen throughout the state of Tennessee.
Click here to learn more about MedAssurance
Click here to visit the Medicare.gov Open Enrollment Page
If you would like more information about Medicare Open Enrollment, call us at 888-401-CARE(2273).
Congress is proposing to drastically reduce Medicare reimbursement for home health services to the chronically sick and elderly. They plan on cutting $57 billion out of the Medicare home health benefit over 10 years. Home health represents only 4.5% of the total Medicare budget, but 11% of the proposed total cuts.
Home health is a key solution for lowering the cost of health care. It is the most cost effective way to care for the sick and elderly. More importantly, the sick and elderly want to stay in their home. They recover more quickly at home with family and friends. Without home health care, seniors will be readmitted into hospitals and transferred to nursing homes, both of which will put a greater financial burden on our Medicare system.
Click here to Read More and Sign the Petition.
Although Medicare covers the majority of healthcare costs, it does not cover 100% of these expenses. Patients are responsible for deductibles and copayments on medical services and prescription drugs. Sometimes meeting these obligations can be very difficult, and for some, even impossible.
There are extra help programs that could help. I’d like to tell you about them.
First, the State Medicaid programs are available for qualified individuals who meet certain income and asset limits. If your income as a single person is $902.50 per month or less, or as a couple $1,214.17 per month or less, and you have limited resources, you could be eligible for a program that can pay your Medicare premium, deductibles, and copayments. In addition, this would automatically qualify you for assistance with your prescription plan premiums, deductibles, and copayments as well.
Even if you do not qualify for this program, you still may be eligible for others. If your income as a single person is $1,353.75 per month or less, or as a couple $1,821.25 per month or less, and you have limited resources, you could qualify for extra help with your Medicare healthcare or prescription costs.
To apply for these programs, you should contact your local Social Security office, visit social security online at www.ssa.gov, or call your local Medicare counseling program State Health Insurance Assistance program, or SHIP. The number for TN is 1-877-801-0044.
If your income does not meet the requirements and you are still having difficulty paying for your medications, talk with your physician about patient assistance programs and generic medicines that can also help you save money.
Whatever you do, don’t go without proper healthcare because you think you can’t afford it. There is help available; you just have to ask for it.
Article provided by Mary Beth Best, Medicare advocate with Voice, Inc.
The Medicare prescription benefit, or Medicare Part D, was added to the program in 2003 under the Medicare Modernization Act. Since then, there has been lots of confusion and misconceptions about the benefit.
There are 3 important parts of the prescription benefit:
1) Initial Coverage Period
2) Coverage Gap (donut hole)
3) Catastrophic Benefit
The Initial Coverage Period of part D may include a deductible of no more than $295 in 2009. A plan can offer a deductible less than that and as little as $0, but not any more than $295. After the deductible has been met, the plan will cover at least 75% of the cost of prescription medications; the beneficiary will pay 25% copayment. The plan could arrange this in a “flat fee”, such as $20 on generics or $35 on name brand prescriptions, but it cannot exceed 25%. The Initial Coverage Period continues this way until the total cost of medications reach $2,700.
At this point, the Coverage Gap, or the donut hole, begins. This is a period of time that the beneficiary must pay 100% of the medication costs, but also must continue to pay the Part D premium, until the out of pocket costs reach $4,350. This is the TROOP, or “true out of pocket” for the beneficiary, not the total cost of medications.
If a beneficiary pays more than $4,350 out of pocket, then the Catastrophic Benefit will begin. During this time, the government pays 95% of the cost of the medications for the remainder of the year. This process restarts every year in January.
For some, there is extra help. Those with low income and limited resources can apply for financial assistance through Social Security or state Medicaid office.
Annual Enrollment Period is each year November 15th – December 31st. During this time, you can re-evaluate your current coverage and switch plans. You can apply for Extra Help any time during the year.
This is video was produced in cooperation with Mary Beth Best, Medicare Advocate with Voice, Inc.
Home health care is often the last thing on someones mind until the very moment they need it. Because of this, the decision of which agency to use is often made under a cloud of stress and uncertainty. These conditions are not the best to screen a home care agency. How can this be avoided? Make a plan for the care of a loved one before you are faced with the immediate need for home care services.
The best way to begin would be to call your insurance provider to check your coverage and ask who are the agencies participating in their plan. Also, look in the phone book or online to find the listing of all home care agencies in your area. Remember that there are many companies in Tennessee that provide home care services. Do not pick one and go with them. Make sure you weigh all of your options. If you are being discharged from the hospital, they are required to provide you with a list of home health care providers as part of your discharge. This list should make clear the agencies that are associated with the hospital and also which agencies are providers of Medicare and Medicaid services.
After identifying the providers in your area of Tennessee, there are many things to consider. First, you need to find out the reputation of the agencies you are interested in. This can be done by research on the internet and by asking a trusted physician or friend. Look for testimonials from patients who have used their services in the past. Also you will need to be clear on what services are provided by each agency. You may need skilled nursing care, physical therapy or speech therapy. Most companies provide a wide range of services from in home nursing care all the way to companionship and home making. Be sure to check and see how long the company has been in business and if they are licensed and insured.
Next you want to check the quality of the caregivers. Ask about the hiring process of the nurses or caregivers. Things like background checks, reference verification and bonded employees are important to know. You may also want to ask how often the caregivers are supervised while giving care and whether or not care is available 24 hours a day.
After obtaining all of the information you can, sit down with your family and make the best decision for you and your loved ones. Who you choose for home health care is a big decision and should be made with the help of your doctor, family and insurance company to make sure that all of your bases are covered.
If you are in Tennessee and would like to find out more information about CareAll, click here to find the office closest to you.
