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...

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...

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 ...

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  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...

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...

There are  90 days of  inpatient  hospital care coverage on Original Medicare for each  benefit period , In addition, you also have an additional 60 days of coverag e , called LIFETIME RESERVE DAYS .   These Lifetime Reserved Days  can be used only ONCE, and you will pay a  coinsurance  for each of it. To have a better understanding of it, let’s imagine an individual who had a 120-day  Medicare -covered inpatient stay, this means that they used 30 lifetime reserve days. After they have been out of the hospital for 60 days in a row, they will be eligible for another 90 days of hospital coverage because they will be in a new  benefit period . However, if they need  inpatient care  beyond the benefit period maximum, they will only have 30 of their 60 lifetime reserve days remaining. The above example illustrates that lifetime reserve days do not have to be applied to the same hospital stay. If you need to stay in the hosp...

The benefit period is the length of time during which a benefit is paid. It   measures your use of  inpatient  hospital and  skilled nursing facility (SNF)  services. This  begins the day you are admitted as an inpatient, or to an SNF, and ends the day you have been out of the hospital or SNF for 60 days in a row. After you meet your  deductible ,  Original  Medicare  will pay in full for days 1 to 60 that you are in a hospital. The remaining days, 61-90 , you will have to pay a  daily coinsurance. If your 90 days of hospital coverage has been consumed but you need to stay longer, Medicare covers up to 60 additional lifetime reserve days and yo u will also have to pay a daily  coinsurance . These days are nonrenewable , meaning you will not get them back when you become eligible for another benefit period. If you run out of days during your benefit period, Medicare will stop paying for your in-patient related ho...

If you are in a  nursing home  or another qualified institution  and receive   long-term care , you should know how your   prescription  drug   coverage may be affected. Different rules will apply as to when you can switch plans and how you can access drugs. Note: During a  Part A -covered nursing home stay, prescription drugs are covered by Part A, not  Part D . The information below is only applicable to Part D coverage of drugs in a nursing home setting. Nursing homes work with specific pharmacies , thus you should choose your plan wisely. If your plan does not work with your nursing home’s pharmacy because it is out of  network  or not preferred , you may end up paying higher costs for prescriptions. If you are in a nursing home, you can switch your drug coverage outside regular  enrollment  periods.  Specifically, you  can make plan changes when; You enter a nursing home Once a month while ...

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 ...