There are many confusing rules and regulations for our seniors to follow when signing up for Medicare and/or the private plans, and the process can be overwhelming. It’s important for Medicare beneficiaries to understand all their options, what Medicare covers and, most importantly, what it doesn’t.
Original Medicare covers two parts; Part A is hospital coverage and Part B is medical coverage. Part A can be $0 premium if the beneficiary has worked for 10 years paying into Medicare taxes. It covers four things; inpatient hospital stays, skilled nursing, home health, and hospice. For 2019, if an individual goes in the hospital as an inpatient, they will have a $1,408 deductible for days 1-60. If the stay is past 60 days, now the beneficiary will look at $352 each day until day 90. Day 91 it goes up to $704 per day. It’s important to remember that the deductible is per benefit period, not per calendar year. For example, if an individual is admitted into the hospital at the beginning of the year, they will have to pay the $1,408 deductible. For example, if they go back six months later they will have to pay that deducible again.
Skilled nursing is covered for the first 20 days, but they are first required to be in the hospital for three nights. After 20 days, there’s a $176 copay per day in skilled nursing until day 100.
Home health care services that are deemed medically necessary such as therapy and skilled nursing, administration of medications, wound care, medical tests, etc. are covered 100% by Medicare. A doctor’s prescription is required, Medicare will not, however, cover help with cooking meals, cleaning your house, transportation, bathing, etc.
Hospice is covered 100% but can be subject to small copays for prescription medications and may charge 5% of the Medicare approved amount for inpatient respite care.
Original Medicare Part B has a monthly premium that reflects an individual’s income they reported two years ago. Anything medical is covered under Part B such as; doctor visits, outpatient surgery, emergency visits, urgent care, ambulance rides, blood tests, durable medical equipment, etc. Part B does have a yearly deductible, which is $198 for 2020. Once a beneficiary reaches the deductible, Medicare will cover 80% and the consumer is left with paying 20% of medical expenses.
Medicare does not have coverage for prescription medication, so it is always best to sign up for a separate plan to avoid a penalty. The penalty would be charged for each month that they didn’t have coverage from when they were first eligible. It wouldn’t affect them until they signed up for prescription drug coverage. At that point, they would pay the penalties on top of the plan’s premium for the rest of their life.
Medicare does not have a ceiling for out-of-pocket expenses. If the beneficiary had a catastrophic health year, the expenses could be life alternating. That is why it is important to speak with someone to go over their options to help elevate out-of-pocket expenses. With so many options out there today, it can be confusing which plan is best for you. At Informed Choice Insurance Agency, we are an independent company that can show all the options available. We are a salary-based agency that does not receive commissions. This gives our clients peace of mind when exploring options with an unbiased agent. If you ever have questions about your current plan or what other possibilities are out there, we are more than happy to assist you.
Andrea Munao, Sales Associate, Informed Choice Insurance Agency. Andrea lives in sunny Florida where she specializes in educating individuals who are Medicare eligible on plans including Medicare Supplements, Medicare Advantage plans and Prescription Drug plans. Andrea thrives on helping her clients understand the basics of Medicare and finding the best options available to them. Andrea can be reached at 239-208-7090 or amunao@informedchoice.com.Each of the five senses connects us to our world in different ways, but as we age they begin to change. The staff and caregivers at The Preserve understand that sensory loss has a great impact on older adults and also can be difficult to grasp for those who are not experiencing the same.
A 2016 study by the University of Chicago Medical Center found that 94 percent of older adults in the United States have at least one sensory deficit, 38 percent have two, and 28 percent have three, four or five. This is the first study to measure the full-spectrum of impairment to all five senses and the findings show a strong association to age, gender and race.
When we think of sensory loss, oftentimes age-related hearing loss comes to mind first, but what about the other 4 senses? Let’s take a look at common challenges our aging loved ones face each day and learn more about what to expect as we grow older, including ways to protect our senses.
Vision
Imagine not being able to see the beauty around us with clear vision. Studies show that by the age of 65, 1 person in three will have some form of vision-reducing eye disease, which can produce blind spots, blurred or cloudy vision or loss of peripheral vision.
Hearing
The sound of laughter and to hear the voice of a loved one or friend in conversation can be frustrating for the one in three people in the United States between the ages of 65 and 74 who have difficulty hearing. Hearing loss can increase loneliness and cause an aging family member to engage in conversation less often, especially in larger groups or loud rooms, and become more isolated.
Feeling
Peripheral neuropathy affects more than 20 million Americans, leaving them with nerve damage to the hands and feet. Peripheral neuropathy refers to the various conditions, including a tingling feeling and/or numbness, that involve damage to the body’s communication network (peripheral nervous system).
Taste
Did you know that by the age of 65, the average adult has lost 50 percent of their taste buds? The foods we love, the textures and tastes, and for some the ability to chew, when no longer there can have a profound effect on a person’s daily life and can even become serious when the loss of taste changes a senior’s eating habits.
Smell
A scent that brings back a fond memory might be a favorite family recipe. Working hand-in-hand with the sense of taste, thirty percent of Americans between 70 and 80 years of age notice a change in their sense of smell. A sense of smell that declines with age is not preventable.
At The Preserve, we do what we can to make things a little easier for our residents. One resident was having trouble reading buttons on the remote control, so a staff member took a picture and labeled them. Here are a few more examples:
- Closed Captioning is activated on all the televisions throughout the community
- Meditation Mondays for the Memory Support residents
- Hand massages with lotion which provides the physical touch the seniors desperately need
- Increase the font size of TV guides to make reading easier
Although we can’t go back in time, we can begin doing things now to protect our senses and minimize the effects of aging:
- Regular visits to doctors and specialists you trust
- Eat a well-balanced diet
- Kick bad habits, including smoking and excessive drinking
- Wear sunglasses and control exposure to the sun
- Turn down the volume
- Train your sense of smell with distinctly different odors
- Move your body
- Hug someone
There are many more tips to live by that will lead to overall mental and physical health and help reduce the impact of sensory loss.
Supporting an older adult with sensory loss in turn will help to improve their safety, enjoyment and quality of life. Our staff at The Preserve takes this information seriously and uses it to help empathize with an aging loved one’s changing senses.