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Ipinapakita ang mga post mula sa Mayo, 2020

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...

Medicare and its Savings Program

Medicare  Savings Programs  is also known as Medicare Buy-In programs or Medicare  Premium  Payment Programs ,  this helps you pay your Medicare costs if you have limited income and savings.  There are three main programs each with different benefits and eligibility requirements: Qualified Medicare  Beneficiary  (QMB) : Pays for Medicare Parts A and B  premiums. If you have QMB, typically   you should not be billed   for Medicare-covered services when seeing Medicare providers or providers in your   Medicare Advantage   Plan’s   network . Specified Low-income Medicare Beneficiary (SLMB) : Pays for Medicare  Part B  premium. Qualifying Individual (QI) Program : also pays for Medicare Part B premium. If you will enroll, you will also automatically get  Extra Help.   To qualify for an MSP, you must have Medicare  Part A  and meet income and asset guidelines.  If you do not have Pa...

Medicare and Living Abroad

Medicare   enrollment  can be complicated if you live outside the United States. This means that you do not live inside the  50 states of the U.S, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, or the Northern Mariana Islands. Although Medicare does not typically cover medical costs you receive when you live abroad, you still need to choose whether to enroll in Medicare when you become eligible or to turn down enrollment.  This is subject to consideration as well; Whether you plan to return to the U.S. Whether you are working or volunteering outside the U.S. The potential costs of delayed enrollment If you are  65 or older and qualify for Medicare , you can enroll in Medicare Parts A and B, also known as  Original Medicare , either before or after you leave the U.S . However, you must remember that Medicare will typically not cover medical care you receive outside the U.S.  Part A coverage is the best to keep eve...

Medicare and Hospital Discharged Planning

Hospital  discharge  planning is a process that determines what kind of care you will need after you leave the hospital. This discharge plans can help prevent future readmissions , and they should make your move from the hospital to your home or another facility as safe as possible. Medicare  requires hospitals to screen  inpatients  and provide discharge p lanning for those who need it. But this  is only mandatory for hospital inpatients, if you are an  outpatient, possibly  on  observation status,   Medicare will not require screening or discharge planning. However, there are some states that provide outpatients with rights to discharge planning services. For more information on discharge planning in your state, please contact your  State Health Insurance Assistance Program (SHIP) . Your  discharge plan  should include information about where you will be discharged to, the types of care you need, and who will provi...

Medicare and Rehabilitation Care

Rehabilitation hospitals are specialty hospitals or parts of acute care hospitals that offer intensive  inpatient  rehabilitation therapy . This kind of care is intended for patients  recovering from a serious illness, surgery, or injury and requires a high level of specialized care that generally cannot be provided in another setting. Common conditions which may qualify for care in a rehabilitation hospital include ; stroke spinal cord injury brain injury.  Hip or knee replacement is not covered by Medicare, especially if you  have no other complicating condition. Medicare -covered services offered by rehabilitation hospitals include: Medical care and rehabilitation nursing Physical, occupational, and  speech therapy Social worker assistance Psychological services Orthotic and prosthetic services To qualify for a Medicare-covered stay in a rehabilitation hospital, your doctor must state that this care is  medic...