Lumaktaw sa pangunahing content

Mga Post

Durable Medical Equipment and Medicare

Medicare   Part B  covers the D urable Medical Equipment (DME).   These are equipment that serves a medical purpose, able to withstand repeated use, and is appropriate for use in at home.  There are many important things to know about Medicare’s coverage for DME. Below are pieces of information that will help you know whether/how you are covered. Eligible equipment Medicare’s DME benefit does not cover all medical equipment.  Medicare only covers DME if your  provider  says it is  medically necessary for use in the home . You also must order your DME from suppliers who contract with  Original Medicare  or your  Medicare Advantage  Plan . However, Medicare Advantage Plans may have additional requirements you need to meet before your DME is covered. DME coverage Depending on what type of equipment you need, Medicare will require that you either rent or buy DME. There are also special rules when you need oxygen equipment...
Mga kamakailang post

Medicare on Heart Disease Screening

Heart disease ,   describes a range of conditions that affect your heart. Diseases under the heart disease umbrella include blood vessel diseases, such as coronary artery disease; heart rhythm problems (arrhythmias); and heart defects you're born with (congenital heart defects), among others. This is often used interchangeably with the term cardiovascular disease . Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke . Other heart conditions, such as those that affect your heart's muscle, valves, or rhythm, also are considered forms of heart disease .  Screening blood tests for cholesterol, lipid, and triglyceride levels can detect conditions that may lead to heart disease . Eligibility Medicare   Part B  covers blood tests for heart disease once every five years when ordered by your  provider . You do not need to show signs of heart disease or have a...

Cardiovascular Disease Risk Reduction

Cardiovascular disease generally refers to conditions that can lead to a heart attack or stroke. Cardiovascular disease risk reduction visits can help detect and prevent this disease. How to know if I am Eligible? Medicare   Part B  covers an annual cardiovascular disease risk reduction visit with your primary care  provider . You do not need to show any signs or symptoms of cardiovascular disease to qualify for screening, but you must be considered competent and alert when counseling is provided.  During the screening, your provider may; Encourage aspirin use if the benefits outweigh the risks You are a man  of age 45-79 Or a woman of age 55-79 Screen for high blood pressure if you are age 18+ Provide behavioral counseling and tips to encourage a healthy diet Note: Men under 45 and women under 55 are not encouraged to use aspirin as a tool to reduce cardiovascular disease. How much will it cost? If you are eligible,  Original Medicare  will cover yo...

Medicare and Preventive Visit

Medicare  Preventive Visit is a one-time appointment you can choose to receive when you are new to Medicare. Its aim is to promote general health and help prevent diseases. Eligibility Medicare  Part B  covers your one-time Welcome to Medicare preventive visit. Remember that you must receive this visit within the first 12 months of your Part B  enrollment . Covered services During the course of your Medicare preventive visit, your  provider  should: Check your height, weight, blood pressure, body mass index (BMI), and vision Review your medical and social history Review your potential for depression and other mental health conditions Review your ability to function safely in the home and community Provide you with education, counseling, and referrals related to your risk factors and other health needs Give you a checklist and/or written plan with information about other preventive services you may need The Medicare preventive visit is not a head-to-toe phy...

The Phases of your Medicare Part D Coverage

Your Medicare   Part D -covered drug costs may change throughout the year. If you notice that the price has changed, it may be because you are in a different phase of your Part D coverage. Four different phases of Part D coverage: Deductible  period Until you meet your Part D deductible, you will pay the full negotiated price for your covered  prescription  drugs. After this, the plan will begin to cover the cost of your drugs. While deductibles can vary from plan to plan, it can't be higher than $435 in 2020, and some plans have no deductible. Initial coverage period   After you meet your deductible, your plan will help pay for your covered prescription drugs. They will pay some of the cost, and you will pay a   copayment   or   coinsurance . How long you stay in the initial coverage period depends on your drug costs and your plan’s benefits structure. For most plans in 2020, the initial coverage period ends after you have accumulated a total ...

Medicare and Heart Health

Medicare   Part B  covers both general cardiac rehabilitation and intensive cardiac rehabilitation (ICR) programs. These provide various services if you have a heart condition, including exercise, education, and counseling. These programs are designed to help improve your cardiac health and reduce risk factors. How can I be eligible? Medicare Part B will cover a cardiac rehabilitation program and the ICR programs if you were referred by your doctor and have had any of the following conditions or procedures: Heart attack in the last 12 months Coronary bypass surgery Stable angina pectoris (chest pain or discomfort due to heart disease) Heart valve repair or heart valve replacement Coronary angioplasty or coronary stent (opening or widening of an artery) Heart or combined heart-lung transplant Stable chronic heart failure It also covers ICR programs if your doctor prescribes the program and you have any of the conditions above except for stable chronic heart failure. You can ...

Medicare Coverage on Observation Services

Observation services are short-term  outpatient  services you received when you are in the hospital. You usually have this for monitoring purposes and/or to determine whether you should be admitted as an  inpatient .  It is important to know that if you are receiving observation services, you haven't been formally admitted to the hospital as an inpatient, even if you are given a room or to stay overnight.  You can always ask the hospital staff about your status. Also, the hospital must provide you with a notice if you receive observation services for more than 24 hours. This is called the  Medicare  Outpatient Observation Notice (MOON) . This notifies you that you are receiving observation services. This explains why you are an outpatient and your doctor should explain this notice to you in person. Since this kind of service often involves an overnight stay in the hospital, they may look no different than inpatient services. However, it is very impor...