Understanding Your Medicare Options
May 12, 2020
Email US
Click to Email Us
Original Medicare vs. Medicare Advantage
Original Medicare (Part A and Part B) is the federal plan that provides hospital and medical insurance coverage to those who qualify. For the basics of your health care, it works well. You get easy access to most of the care you need, with minimal paperwork and widespread acceptance by doctors and medical facilities.
But, even though Original Medicare is intended for older adults, it does not cover many of the health issues that become more critical as we age - like prescription drugs, vision, hearing and dental. And it may leave you open to financial burdens that dont fit your budget.
So its no wonder that the Medicare Advantage category is growing rapidly as our country gets older. (Enrollment in Medicare Advantage plans has tripled since 2004*).
Medicare Advantage plans (also known as Medicare Part C) are contracted with the federal government to provide Medicare coverage. These plans must provide all the benefits that Original Medicare offers, and often include additional benefits for more complete health care coverage. And because they operate as managed care programs, Medicare Advantage plans can provide all this coverage, and limit your financial risks as well.
Coverage you cant get from Medicare
Most Medicare Advantage (MA) plans include prescription drug (Medicare Part D) coverage for your medication needs. Look for plans that have low or no copays on widely used generic drugs, and offer additional savings on higher cost prescriptions at in-network or preferred pharmacies.
Dental, vision and hearing issues can become more prevalent as we age, and coverage for these important conditions can be key to maintaining a healthy, functional lifestyle. These benefits are often included in MA plans; the coverage can vary from plan to plan, so try to find one that can help offset the costs of big-ticket items like hearing aids, glasses and dentures.
Protecting your finances
Because incomes often become limited or fixed at the same time health issues increase, Medicare Advantage plans can be a good financial solution as well.
With deductibles, copays and co-insurance, Original Medicare generally covers only 80% of medical expenses. Youd be responsible for the other 20%. Keep in mind there is no limit on this expense, so a chronic health condition or extended hospital stay can be financially devastating.
Medicare Advantage plans cover many of the out-of-pocket costs that Original Medicare does not; you pay little (or nothing) of that remaining 20%. And, while you still must pay your Medicare Part B premium, many MA plans offer coverage with no additional plan premium. In any case, MA plans have maximum out-of-pocket limits, so you know exactly what your potential financial liability looks like.
(In 2019, the average out-of-pocket limit for Medicare Advantage enrollees is $5,059*.)
Make sure that you use doctors, specialists, hospitals and services that are in your plans network to keep your coverage affordable and take the utmost advantage of your Medicare Advantage membership.
Do your research.
Once you become eligible, youll need to enroll in Medicare and choose a health plan. Then, every year, the Annual Election Period (October 15 December 7) allows you to change your coverage, so thats a good time to review your current health, financial situation and Medicare options to make sure that you still have the plan thats right for you. You can find out more at www.medicare.gov.
*Kaiser Family Foundation
https://www.kff.org/medicare/fact-sheet/medicare-advantage/
_______________________________________
Editors Note: This article was contributed by PA Health & Wellness.
Other Articles You May Like
10 Ways to Stay Hydrated
10 Ways to Stay HydratedBeat the Heat with These HacksWe are often dehydrated before we even feel thirsty. We lose water through sweating, urinating, and breathing. According to the U.S. National Academies of Sciences, Engineering, and Medicine, women should drink 11.5 cups a day, and men should drink 15.5 cups a day.Does keeping up with your fluid intake feel daunting? Read on for different ways you can stay on track from Registered Dietitian Lila Cornelio.Start Your Day with a Glass of WaterKickstart your hydration first thing in the morning with a glass of water. This can help replenish fluids lost overnight and set a good hydration habit for the day.Carry a Reusable Water BottleHaving a reusable water bottle on hand makes it easier to sip water throughout the day. Choose one that's easy to carry and holds a good amount of water to encourage regular drinking. Infuse Your Water with Fruits and HerbsAdd a burst of flavor to your water by infusing it with fruits like lemon, lime, berries, or herbs like mint and basil. This can make drinking water more enjoyable and encourage you to drink more.Eat Water-Rich FoodsIncorporate fruits and vegetables with high water content into your diet, such as watermelon, cucumbers, oranges, and strawberries. These can contribute to your overall hydration.Set RemindersUse your phone or a hydration app to set regular reminders to drink water. This can help ensure youre drinking consistently throughout the day.Opt for Hydrating BeveragesWhile water is the best option, other beverages like herbal teas, coconut water, and electrolyte-enhanced drinks can also help maintain hydration levels, especially if youre active.Monitor Your Urine ColorA simple way to check your hydration status is by the color of your urine. Light yellow indicates good hydration, while darker urine suggests you need to drink more fluids.Stay Cool with Ice PopsHomemade ice pops made from water, fruit juice, or blended fruits can be a refreshing way to boost your fluid intake while enjoying a summer treat.Hydrate Before, During, and After ExerciseIf youre engaging in physical activities, especially outdoors, make sure to drink water before, during, and after exercise to replace the fluids lost through sweat.Limit Caffeinated and Alcoholic BeveragesCaffeine and alcohol can have a diuretic effect, leading to increased fluid loss. Balance these with plenty of water to maintain proper hydration.Hydration is crucial during the summer, as higher temperatures increase the risk of dehydration. Staying well-hydrated helps regulate body temperature, supports metabolic functions, and maintains overall health, making it essential for enjoying the season safely and energetically.-Lila Cornelio, MS, RDN, LDN is a Registered Dietitian at our Florida program, Trinity Health PACE of Pensacola. With education and expertise in public health, sports nutrition, and plant based nutrition, her passion lies in educating others how to nourish their body and mind in a fast paced world. Mercy Life of Alabama is a PACE that offers numerous services for Seniors. Learn more by visiting their website at: https://www.trinityhealthpace.org/alabama/mercy-life-of-alabama/.
The PAWsitive Power of Pet Therapy
Lifes most tender moments often involve the companionship of our beloved pets. How many of us giggle with delight when we get to pet a rabbit or a horse or hold a bird? From morning walks with our faithful dogs to the comforting purr of a cat in our lap, these interactions bring immeasurable joy. But why should these cherished experiences fade as we age or transition to senior living? At Grand Living, we recognize the importance of preserving these connections, valuing the unique individuals we serve, and their desire for pet experiences.Fostering Bonds Between Seniors and Their PetsRemember the exhilaration of a playful romp with your dog or the contentment of your cat nestled in your lap? These feelings are timeless and transcend age. At Grand Living, we celebrate the magic of pet companionship, whether residents bring their pets or wish to experience the joys of pet interaction.A Profound Impact on Physical and Mental Well-beingThe positive rewards of pet companionship extend far beyond the surface. Studies have revealed the benefits of having a furry friend by your side. Lowered blood pressure, improved mood, reduced depression, enhanced mobility, and increased physical fitness are just a few of the positive outcomes. Remarkably, these effects linger even after the interaction ends. A single daily interaction with a pet can have lasting benefits for hours and days.Grand Living at Tower Place residents enjoy pet therapy.One of the most profound advantages of pet companionship is the sense of purpose it brings. Caring for a pet offers a continuous source of affection and attention, infusing life with meaning. At Grand Living, we understand the significance of this bond in promoting emotional well-being. The simple act of nurturing a pet fosters immeasurable positivity in a persons life.Maintaining Pet Companionship in Memory CareMemory loss can pose challenges to pet care, but at Grand Living, were dedicated to overcoming obstacles. In our LUMINATIONS Memory Care program, we strive to enrich residents minds, bodies, and spirits. Recognizing the benefits of pet companionship, we make many adaptations to penetrate through memory loss to recreate the benefits of owning a pet.Innovative Pet Therapy ProgramsLLamas visit Grand Living at Indian Creek.Our Pet Therapy programs are both diverse and heartwarming. Within our communities, dedicated staff members bring therapy dogs to interact with residents. Beyond traditional cats and dogs, we introduce residents to llamas, therapy horses, and petting zoos featuring adorable baby lambs, goats, and rabbits. Additionally, other Grand Living residents and families bring their dogs to the LUMINATIONS neighborhood for daily visits.In a creative leap, weve introduced animatronic cats and dogs to our neighborhoods. These lifelike companions purr, yap, and play, captivating residents with the same joy as real pets. These interactions create a bridge to the past, allowing residents to relive the joy of caring for and playing with pets.A Life Enriched: Championing the Joys of Senior LivingAs we grow older, life can sometimes feel like a succession of losses. At Grand Living, we meet this challenge head-on, striving to fill the lives of our residents with warmth, happiness, and fulfillment. The power of pet companionship cannot be underestimated its a connection that transcends time and infuses our days with purpose and delight.Age is no barrier to the profound joys of pet companionship. At Grand Living, we celebrate the uniqueness of each individual and their desire for pet experiences. Through our innovative programs, we ensure that the benefits of pet companionship are accessible to all, even in the face of challenges like memory loss. The warmth, love, and purpose that pets bring to our lives are boundless, and were committed to keeping that spirit alive in every step of our residents journey.
Long Term Care Insurance? Dont wait too long to use your benefits
Under most long-term care policies, you are eligible for benefits when you cant do at least 2 out of six Activities of daily living, called ADLs on your own or suffer from Dementia or other cognitive impairment.Many policyholders delay utilizing benefits for many reasons: fear of the unknown, wanting to maintain control over their lives, concern for losing their independence, or appearing needy or weak.EVERYONE ages and needs some assistance. Individuals who require long-term care are generally NOT sick in the traditional sense, but instead are unable to perform the basic ADLs without support.When a loved one needs support at home to continue to live independently, long-term care insurance can be a big help in making that care more affordable.If you know your loved one has long-term care insurance and is struggling with ADLs encourage them to utilize their policy benefits as there is no refund of premiums to the family if benefits are not utilized.To better serve clients with long-term care insurance, we accept a wide variety of policies including:American PioneerBankers LifeConseco (SHIO)John HancockGuarantee TrustKanawhaMetlifePenn TreatyTransamericaUNUMWashington NationalThe Certified Nursing Assistants (CNAs) and Home Health Aides (HHAs) referred by Granny NANNIES are understanding and specialize in providing companionship, mobility assistance, and transportation services that keep seniors independent. They can also help relieve daily stress and keep our loved ones active and social. We carefully screen CNAs and HHAs for not only the essential legal requirements but also the kindness and compassion needed to care for others. Founded in 1990, Granny NANNIES offers services that can be personalized to meet the requirements of any individual, regardless of age or need. Available 24 hours a day, 7 days a week, we provide quality, trustworthy, reliable, and affordable in-home care.