Select Page

22 Health Care Services You Get Free With Medicare

22 Health Care Services You Get Free With <a href='http://MedicareQuick.com' target='_blank'>Medicare</a>Photo by goodluz / Shutterstock.com

Few senior discounts are worth as much as the savings you get through Medicare health insurance.

The Social Security Administration subsidizes Medicare. So, having a Medicare insurance plan typically is cheaper than buying a health insurance plan on your own.

Medicare is not free — there are premiums, deductibles and copays. But it does entitle policyholders to various “freebies.” By our count, there are at least 22.

These freebies are preventive services ranging from annual wellness visits to flu shots and cancer screenings. So, redeeming them will save you money — and possibly protect you from future medical conditions and costs. They could even save your life.

Medicare freebies

Under Original Medicare, the following services are free to all beneficiaries:

  1. “Welcome to Medicare” preventive visit (includes a review of your medical and social history related to your health and education, and counseling about various preventive services)
  2. Annual “Wellness” visits (includes developing or updating a personalized prevention help plan)
  3. Annual behavioral therapy visit for cardiovascular disease, which is to help you lower your risk for cardiovascular disease (heart-related conditions)
  4. Screening for cardiovascular disease (includes blood tests for cholesterol, lipid and triglyceride levels)
  5. Screening for depression
  6. Vaccination for the flu
  7. Vaccination for pneumococcal infections, which include certain types of pneumonia

Under Original Medicare, the following services are free to eligible beneficiaries. Eligibility varies by test but often involves being within a certain age range or having a higher risk for a medical condition.

  1. Vaccination for hepatitis B
  2. Bone density test
  3. Screening for diabetes
  4. Screening for hepatitis C
  5. Screening for HIV
  6. Screening for lung cancer
  7. Screening for colorectal cancer (can include a colonoscopy or other types of tests)
  8. Screening for prostate cancer (includes a prostate specific antigen, or PSA, blood test)
  9. Screening mammograms
  10. Screening and counseling for alcohol misuse
  11. Screening for abdominal aortic aneurysm (includes an ultrasound)
  12. Screening for cervical and vaginal cancers (includes Pap test, pelvic exam and breast exam)
  13. Screening and counseling for sexually transmitted infections
  14. Medical nutrition therapy
  15. Screening for obesity and counseling

Patients do not owe copays or other out-of-pocket costs for these services. However, before redeeming these freebies, know that they are free:

  • For folks with what’s known as Original Medicare. Costs might differ for people with Medicare Advantage plans, which are offered by private health insurers.
  • When obtained from a health care provider who “accepts assignment.” This is jargon that basically means the provider has signed an agreement accepting Medicare’s payment conditions.
  • When obtained at a certain frequency, which varies. For example, Medicare beneficiaries can get a free flu shot once every flu season but can only get a free screening for heart disease once every five years.
  • For folks who are eligible for them. Some Medicare freebies are available to all beneficiaries, but most freebies are available to folks in certain situations.

Using Medicare’s websites

Note that you can use Medicare.gov’s “Your Medicare Coverage” search tool to determine whether services or supplies are covered by Medicare and get an idea of what they would cost you — including whether they are free.

Logging into your MyMedicare.gov account will give you access to more personalized information, including a calendar of the free tests and screenings for which you are eligible. You’ll find this in the “My Health” section.

Medicare.gov and MyMedicare.gov are official Medicare websites operated by the federal government. Using these websites is free, as is signing up for an account.

What’s your favorite thing about Medicare? Share your thoughts with us below or over on our Facebook page.

Source

https://www.moneytalksnews.com/22-health-care-services-that-are-free-with-medicare/

Malloy vetoes Medicare bill

Gov. Dannel P. Malloy Photo: Brian A. Pounds / Hearst Connecticut Media / Connecticut Post

Photo: Brian A. Pounds / Hearst Connecticut Media

As he promised last week, Gov. Dannel P. Malloy on Tuesday night vetoed legislation aimed at restoring income thresholds for more than 100,000 elderly participants in the Medicare Savings Program.

He called the legislation “wishful thinking” and “double counting” that postpones tough fiscal decisions into the future, which he cannot support.

The veto is in the face of overwhelming votes by the House and Senate, who could be prompted to meet for the required two-thirds votes to override, depending on the reaction of legislative leaders. The House first passed the bill by a veto-proof margin of 130-3 and the Senate approved the bill 32-1.

Malloy had continued lower-income thresholds through at least the rest of the fiscal year, which ends June 30. The veto came as the state got word that tax revenue has failed to meet projections by $260 million, adding to the estimated $220 million shortfall in the state budget.

“This bill has essentially done nothing to the state’s budget operations in order to fund restoration of the Medicare Savings Plan by either adding new revenue or reducing state spending levels,” Malloy wrote.

kdixon@ctpost.com Twitter: @KenDixonCT

http://www.ctpost.com/local/article/Malloy-vetoes-Medicare-bill-12502460.php

Source

http://www.ctpost.com/local/article/Malloy-vetoes-Medicare-bill-12502460.php

Some Medicare Patients Eligible And Eager For Home Health Care Aren’t Getting It : Shots

Colin Campbell last month in his home near Los Angeles, Calif. Campbell was diagnosed with Lou Gehrig’s disease — ALS — eight years ago. He gets Medicare because of his disability, but was incorrectly told by several agencies that he couldn’t use it for home care. So, instead, he pays $4,000 a month for those services. Heidi de Marco/Kaiser Health News hide caption

toggle caption

Heidi de Marco/Kaiser Health News

Colin Campbell last month in his home near Los Angeles, Calif. Campbell was diagnosed with Lou Gehrig’s disease — ALS — eight years ago. He gets Medicare because of his disability, but was incorrectly told by several agencies that he couldn’t use it for home care. So, instead, he pays $4,000 a month for those services.

Heidi de Marco/Kaiser Health News

Colin Campbell needs help dressing, bathing and moving between his bed and his wheelchair. He has a feeding tube because his partially paralyzed tongue makes swallowing “almost impossible,” he says.

Campbell, 58, spends $4,000 a month on home health care services so he can continue to live in his home just outside Los Angeles. Eight years ago, he was diagnosed with amyotrophic lateral sclerosis, or “Lou Gehrig’s disease,” which relentlessly attacks the nerve cells in his brain and spinal cord and has no cure.

Because of his disability, he has Medicare coverage, but he can’t use it for home care — as the former computer systems manager has been told by 14 home health care providers.

That’s an incorrect but common belief. Medicare does cover home care services for patients who qualify but, according to advocates for seniors and the homecare industry, incentives intended to combat fraud and reward high quality care are driving some home health agencies to avoid taking on long-term patients, such as Campbell, who have debilitating conditions that won’t get better. Rule changes that took effect this month could make the problem worse.

“We feel Medicare coverage laws are not being enforced and people are not getting the care that they need in order to stay in their homes,” says Kathleen Holt, an attorney and associate director of the Center for Medicare Advocacy, a nonprofit, nonpartisan law firm. The group is considering legal action against the government.

Because of his ALS, Colin Campbell needs to wear a brace, and relies on help from a home health worker to get bathed and dressed every day. Heidi de Marco/Kaiser Health News hide caption

toggle caption

Heidi de Marco/Kaiser Health News

Because of his ALS, Colin Campbell needs to wear a brace, and relies on help from a home health worker to get bathed and dressed every day.

Heidi de Marco/Kaiser Health News

Federal law requires Medicare to pay indefinitely for home care — with no copayments or deductibles — if a doctor ordered it and patients can leave home only with great difficulty. They must need intermittent nursing, physical therapy or other skilled care that only a trained professional can provide. They do not need to show improvement.

Those who qualify can also receive an aide’s help with dressing, bathing and other daily activities. The combined services are limited to 35 hours a week.

Medicare affirmed this policy in 2013 when it settled a key lawsuit brought by the Center for Medicare Advocacy and Vermont Legal Aid. In that case, the government agreed that Medicare covers skilled nursing and therapy services — including those delivered at home —to maintain a patient’s abilities or to prevent or slow decline. It also agreed to inform providers, those who audit bills, and others that a patient’s improvement is not a condition for coverage.

Campbell is able to move around his house with the help of a walker. Heidi de Marco/Kaiser Health News hide caption

toggle caption

Heidi de Marco/Kaiser Health News

Campbell is able to move around his house with the help of a walker.

Heidi de Marco/Kaiser Health News

Campbell says some home health care agencies told him Medicare would pay only for rehabilitation, “with the idea of getting you better and then leaving,” he says. They told him that Medicare would not pay them if he didn’t improve, he says. Other agencies told him Medicare simply did not cover home health care.

Securing Medicare coverage for home health services requires persistence, says John Gillespie, whose mother has gone through five home care agencies since she was diagnosed with ALS in 2014. He successfully appealed Medicare’s decision denying coverage, and afterward Medicare paid for his mother’s visiting nurse as well as speech and physical therapy.

“You have to have a good doctor and people who will help fight for you to get the right company,” says Gillespie, of Orlando, Fla. “Do not take no for an answer.”

Yet a Medicare official did not acknowledge any access problems. “A patient can continue to receive Medicare home health services as long as he/she remains eligible for the benefit,” says spokesman Johnathan Monroe.

But a leading industry group contends that Medicare’s home health care policies are often misconstrued. “One of the myths in Medicare is that chronically ill individuals are not qualified for coverage,” says William Dombi, president of the National Association for Home Care and Hospice, which represents nearly half of the nation’s 12,000 home care providers.

Part of the problem is that some agencies fear they won’t be paid if they take on patients who need their services for a long time, Dombi says. Such cases can attract the attention of Medicare auditors who can deny payments if they believe the patient is not eligible, or they suspect billing fraud. Rather than risk not getting paid, some home health agencies “stay under the radar” by taking on fewer Medicare patients who need long-term care, Dombi says.

And those companies may have a good reason to be concerned. Medicare officials have found that about a third of the agency’s payments to home health firms in the fiscal year ending last September were improper.

Shortages of home health aides in some areas might also lead an overburdened agency to focus on those who need care for only a short time, Dombi says.

Another factor that may have a negative effect on chronically ill patients is Medicare’s Home Health Compare ratings website. It includes grades on patient improvement, such as whether a client got better at walking with an agency’s help. That effectively tells agencies who want top ratings “to go to patients who are susceptible to improvement,” Dombi says.

This year, some home care agencies will earn more than just ratings. Under a Medicare pilot program, home health firms in nine states will start receiving payment bonuses for providing good care and those who don’t will pay penalties. Some criteria used to measure performance depend on patient improvement, Holt says.

Another new rule, which took effect last Saturday, prohibits agencies from discontinuing services for Medicare and Medicaid patients without a doctor’s order. But that, too, could backfire.

“This is good,” Holt says. “But our concern is that some agencies might hesitate to take patients if they don’t think they can easily discharge them.”

This article was written with the support of a journalism fellowship from New America Media, the Gerontological Society of America and the Silver Century Foundation. (KHN) is a nonprofit news service. It’s an editorially independent program of the , and not affiliated with Kaiser Permanente. You can find Susan Jaffe on Twitter @susanjaffe.

Home Care Agencies Often Wrongly Deny Medicare Help To The Chronically Ill

Source

https://www.npr.org/sections/health-shots/2018/01/17/578423012/home-care-agencies-often-wrongly-deny-medicare-help-to-the-chronically-ill

Home Care Agencies Often Wrongly Deny Medicare Help To The Chronically Ill

Colin Campbell needs help dressing, bathing and moving between his bed and his wheelchair. He has a feeding tube because his partially paralyzed tongue makes swallowing “almost impossible,” he says.

Campbell, 58, spends $4,000 a month on home health care services so he can continue to live in his home just outside Los Angeles. Eight years ago, he was diagnosed with amyotrophic lateral sclerosis, or “Lou Gehrig’s disease,” which relentlessly attacks the nerve cells in his brain and spinal cord and has no cure.

Because of his disability, he has Medicare coverage, but he can’t use it for home care — as the former computer systems manager has been told by 14 home health care providers.

That’s an incorrect but common belief. Medicare does cover home care services for patients who qualify but, according to advocates for seniors and the homecare industry, incentives intended to combat fraud and reward high quality care are driving some home health agencies to avoid taking on long-term patients, such as Campbell, who have debilitating conditions that won’t get better. Rule changes that took effect this month could make the problem worse.

“We feel Medicare coverage laws are not being enforced and people are not getting the care that they need in order to stay in their homes,” says Kathleen Holt, an attorney and associate director of the Center for Medicare Advocacy, a nonprofit, nonpartisan law firm. The group is considering legal action against the government.

Federal law requires Medicare to pay indefinitely for home care — with no copayments or deductibles — if a doctor ordered it and patients can leave home only with great difficulty. They must need intermittent nursing, physical therapy or other skilled care that only a trained professional can provide. They do not need to show improvement.

Those who qualify can also receive an aide’s help with dressing, bathing and other daily activities. The combined services are limited to 35 hours a week.

Medicare affirmed this policy in 2013 when it settled a key lawsuit brought by the Center for Medicare Advocacy and Vermont Legal Aid. In that case, the government agreed that Medicare covers skilled nursing and therapy services — including those delivered at home —to maintain a patient’s abilities or to prevent or slow decline. It also agreed to inform providers, those who audit bills, and others that a patient’s improvement is not a condition for coverage.

Campbell says some home health care agencies told him Medicare would pay only for rehabilitation, “with the idea of getting you better and then leaving,” he says. They told him that Medicare would not pay them if he didn’t improve, he says. Other agencies told him Medicare simply did not cover home health care.

Securing Medicare coverage for home health services requires persistence, says John Gillespie, whose mother has gone through five home care agencies since she was diagnosed with ALS in 2014. He successfully appealed Medicare’s decision denying coverage, and afterward Medicare paid for his mother’s visiting nurse as well as speech and physical therapy.

“You have to have a good doctor and people who will help fight for you to get the right company,” says Gillespie, of Orlando, Fla. “Do not take no for an answer.”

Yet a Medicare official did not acknowledge any access problems. “A patient can continue to receive Medicare home health services as long as he/she remains eligible for the benefit,” says spokesman Johnathan Monroe.

But a leading industry group contends that Medicare’s home health care policies are often misconstrued. “One of the myths in Medicare is that chronically ill individuals are not qualified for coverage,” says William Dombi, president of the National Association for Home Care and Hospice, which represents nearly half of the nation’s 12,000 home care providers.

Part of the problem is that some agencies fear they won’t be paid if they take on patients who need their services for a long time, Dombi says. Such cases can attract the attention of Medicare auditors who can deny payments if they believe the patient is not eligible, or they suspect billing fraud. Rather than risk not getting paid, some home health agencies “stay under the radar” by taking on fewer Medicare patients who need long-term care, Dombi says.

And those companies may have a good reason to be concerned. Medicare officials have found that about a third of the agency’s payments to home health firms in the fiscal year ending last September were improper.

Shortages of home health aides in some areas might also lead an overburdened agency to focus on those who need care for only a short time, Dombi says.

Another factor that may have a negative effect on chronically ill patients is Medicare’s Home Health Compare ratings website. It includes grades on patient improvement, such as whether a client got better at walking with an agency’s help. That effectively tells agencies who want top ratings “to go to patients who are susceptible to improvement,” Dombi says.

This year, some home care agencies will earn more than just ratings. Under a Medicare pilot program, home health firms in nine states will start receiving payment bonuses for providing good care and those who don’t will pay penalties. Some criteria used to measure performance depend on patient improvement, Holt says.

Another new rule, which took effect last Saturday, prohibits agencies from discontinuing services for Medicare and Medicaid patients without a doctor’s order. But that, too, could backfire.

“This is good,” Holt says. “But our concern is that some agencies might hesitate to take patients if they don’t think they can easily discharge them.”

This article was written with the support of a journalism fellowship from New America Media, the Gerontological Society of America and the Silver Century Foundation. (KHN) is a nonprofit news service. It’s an editorially independent program of the , and not affiliated with Kaiser Permanente. You can find Susan Jaffe on Twitter @susanjaffe.

Copyright 2018 Kaiser Health News. To see more, visit Kaiser Health News.

Source

http://kasu.org/post/home-care-agencies-often-wrongly-deny-medicare-help-chronically-ill

On Medicare Advantage? This Key Deadline Is a Month Away

Most people understand the benefits of signing up for Medicare. Yet once they’ve signed up, a lot of retirees don’t realize that they have the option to make changes to their Medicare coverage each and every year. The regular Medicare open enrollment period for 2018 coverage has already passed, having started in mid-October and ended in early December.

For those who are on Medicare Advantage, there’s a potential second bite at the apple. A more limited set of options is still available for another month. If you’re not happy with your current coverage, you have some options — but you need to act quickly, because after Feb. 14, you’ll lose your final chance to make this change for 2018.

How to go back to original Medicare

The current opportunity for Medicare Advantage participants is called the Medicare Advantage Disenrollment Period. Starting on Jan. 1, those who are part of a Medicare Advantage plan have the ability to leave their plan and switch back to traditional Medicare. If you do so, then you’ll get your hospital coverage under Medicare Part A and your medical coverage under Medicare Part B, giving up your private insurer-provided healthcare coverage under Medicare Advantage.

Many Medicare Advantage participants also get prescription drug coverage as an integrated offering within their plans. Therefore, Medicare also allows you to enroll in a Part D prescription drug plan if you disenroll from Medicare Advantage, so that you’ll be able to replace your old drug coverage with a substitute.

Why the Medicare Advantage Disenrollment Period isn’t as good as open enrollment

The problem with the Medicare Advantage Disenrollment Period is that there’s not very much that you can do. Open enrollment lets you make all sorts of moves, such as moving from traditional Medicare to Medicare Advantage, switching between Part D drug plans, or making a change from one Medicare Advantage private insurer to another.

With the disenrollment period, the only thing you can do is what the name says: disenroll from Medicare Advantage and go back to original Medicare. You can’t go in the reverse direction, nor can you switch to a different Medicare Advantage plan provider. You also can’t make a switch between drug plans.

Moreover, some plans aren’t eligible for the disenrollment period. Those who have special Medicare Advantage plans known as a Medicare Medical Savings Account plan, you’re not allowed to shift out of those plans back to original Medicare at this time. Again, only the regular open enrollment between mid-October and early December gives you that level of flexibility.

What else you need to know

If you decide to disenroll from Medicare Advantage, the change takes effect as of the first day of the month after you make the move. That gives you a limited time to make changes to become effective as of Feb. 1, and those who put off a move until closer to the Feb. 14 deadline will have to wait until March 1 for their original Medicare coverage to become effective. Changes to prescription drug coverage also go into effect as of the first day of the following month.

Also, the way that original Medicare, Medicare Advantage, and supplemental Medigap policies interact can be tricky. Ordinarily, if you sign up for traditional Medicare when you first become eligible, you’re guaranteed the right to sign up for a Medigap policy. However, those who use the disenrollment period to go back to original Medicare don’t necessarily have the same guarantee. There’s a lot at stake, including coverage for unpaid coinsurance, copays, and other expenses that traditional Medicare doesn’t cover. You’ll therefore need to be careful not to create a gap in coverage that you can’t fill later on.

If you find that Medicare Advantage isn’t meeting your needs and would prefer what traditional Medicare gives you, then the Medicare Advantage Disenrollment Period can be a great time to make a move. But if you’re interested, don’t let the clock run out on this limited-time opportunity.

The $16,122 Social Security bonus most retirees completely overlook
If you’re like most Americans, you’re a few years (or more) behind on your retirement savings. But a handful of little-known “Social Security secrets” could help ensure a boost in your retirement income. For example: one easy trick could pay you as much as $16,122 more… each year! Once you learn how to maximize your Social Security benefits, we think you could retire confidently with the peace of mind we’re all after. Simply click here to discover how to learn more about these strategies.

Source

http://foxbusiness.com/markets/2018/01/14/on-medicare-advantage-this-key-deadline-is-month-away.html