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Mga Post

Ipinapakita ang mga post mula sa Abril, 2020

Health Savings Accounts and Medicare

Health Savings Accounts (HSAs) are accounted for individuals with high- deductible  health plans. As long as these will be  used to pay for qualified medical expenses,  these funds contributed to an HSA will   not be taxed when you put it into the HSA or when it is taken out.  Your employer may oversee your HSA, or you may have an individual HSA that is overseen by a bank, credit union, or insurance company. Also, if you have an HSA and will soon be eligible for  Medicare , it is important to understand how enrolling in Medicare will affect your HSA. High-deductible health plans In order to qualify to put money into an HSA, you must be enrolled in a high-deductible health plan . These high-deductible health plans have large deductibles that members must meet before receiving coverage which means they have to pay in full for most health care services until they reach their deductible for the year. Afterward, the plan covers all the member’s costs for the remainder of the year

Traveling and Medicare

Wondering if your Medicare coverage can be used outside your state or even outside the country, let's say during a business trip or a vacation perhaps? Your Medicare  coverage and how you will receive your benefits will depend on where you travel. Travel within the U.S. You have coverage anywhere in the U.S. and its territories if you have  Original Medicare.  This includes all 50 states , the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Most doctors and hospitals take  Original Medicare . If you have a  Medicare Advantage Plan , your plan may or may not cover care outside of its  service area . Some plans may cover providers that are  out of your service area, but with higher cost-sharing (copayments, coinsurances) . Your plan may also impose other rules or restrictions like  prior authorization . Contact your plan to see what rules and costs apply when you travel within the U.S. Note:  Medicare Advan

Hepatitis B and Hepatitis C Medicare Coverage

Hepatitis B Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic diseases.  The virus is most commonly transmitted from mother to child during birth and delivery, as well as through contact with blood or other body fluids.  It can be prevented by vaccines that are safe, available, and effective. Eligibility Medicare   Part B   covers the hepatitis B vaccine if you are at medium or high risk for hepatitis B. Medicare considers you at medium or high risk if you: Have  End-Stage Renal Disease (ESRD) Have hemophilia Live in the same household as a hepatitis B  carrier Have unprotected sex with multiple partners or with someone who has hepatitis B Use certain federally prohibited substances Are health care professional in frequent contact with blood or other body fluids during routine work Note: If you are at low risk for hepatitis B, the shot will be covered under  Part D . Hepatitis C Hepatitis C is a liver disease caused

More Information about Home Health Care

Home health care for Chronic Condition Once you meet   Medicare’s home health eligibility requirements ,   Medicare  will cover your care regardless of whether your condition is temporary or chronic .  Medicare covers skilled nursing and therapy services as long as they: Help you maintain your ability to function Help you regain function or improve Or, prevent or slow the worsening of your condition Providers and agencies may worry that Medicare will not cover skilled home care if you are no longer showing signs of improvement. However, Medicare will not deny your home care because your condition is chronic or unchanging, or when additional care will not improve your ability to function, as long as the care is  medically necessary  to maintain your condition or to prevent or slow deterioration. If you have chronic care needs, it may be hard to find a  home health agency  (HHA) willing to provide you with services. If you have  Original Medicare , call 1-800-MEDICAR

Home health care and Medicare Advantage

All  Medicare Advantage Plans   must provide at least the same level of  home health care  coverage as   Original  Medicare , but they may impose  different rules, restrictions, and costs.   Depending on your plan, you may need to: Get care from a  home health agency  (HHA) that contracts with your plan Request  prior authorization  or a  referral  before receiving home health care Pay a  copayment  for your care (Original Medicare fully covers home health) For your information, HHAs can choose who to accept as a patient or refuse to provide you with home health services if they do not believe they can ensure your safety. If no HHA in your plan’s  network  will take you as a patient, call your plan.   Your plan must provide you with home health care if your doctor says it is  medically necessary . If no  in-network  HHA will provide you with care, but an  out-of-network  HHA will, your plan must provide coverage for your out-of-network home health care. If no HHA in your are

What are the Home health covered services?

Medicare   covers the following i f you qualify for th e  home health benefit; Skilled nursing services :   Services performed by or under the supervision of a licensed or certified nurse to treat your injury or illness. You may receive services that include injections - teaching you to self-inject, tube feedings, catheter changes, observation and assessment of your condition, management, and evaluation of your care plan, and wound care. Services are given seven days per week for generally no more than eight hours per day and 28 hours per week. In some cases, Medicare can cover up to 35 hours per week. Skilled therapy services :   Physical, speech, and  occupational therapy  services that are reasonable and necessary for treating your illness or injury , and performed by or under the supervision of a licensed therapist. Physical therapy  includes gait training and supervision of and training for exercises to regain movement and strength in a body area. Speech-la

The Basics of Home Health

Home health care   includes a wide range of health and social services delivered in your home to treat illness or injury. Services covered  include intermittent skilled nursing care, therapy, and care provided by a  home health aide . Home health care will still depend on the circumstances, thus, it will be covered by  either Part A or Part B. Medicare will cover your home health care if: You are  homebound , which means that it is extremely difficult for you to leave your home and you need help in doing so. You need  skilled nursing services  and/or skilled therapy care on an intermittent basis.  You have a face-to-face meeting with a doctor within the 90 days before you start home health care, or the 30 days after the first day you receive care. This can be an office visit, hospital visit, or in certain circumstances a face-to-face visit facilitated by technology (such as video conferencing).  And, you receive care from a   Medicare-certified   hom

What is an EQUITABLE RELIEF?

Equitable relief    It is a process which allows you to request the following from the  Social Security Administration (SSA), either: Immediate or retroactive  Medicare   enrollment Elimination of the Medicare  Part B  late enrollment penalty (LEP) In order for you to be eligible for a request, you must have failed to enroll in Medicare due to the error, misrepresentation, or inaction of a federal employee, such as a Social Security or 1-800-MEDICARE representative . It will  not apply if you were misinformed about your Medicare rights and options by non-federal employees , such as an employer. Example:   Let’s say you did not enroll in Part B because a Social Security representative said you did not need to sign up. Because of misinformation from a federal employee, you failed to sign up for Medicare. Now, you may have  grounds for receiving equitable relief. How to request for an Equitable Relief? To request, you or your representative should write a le