Many people visit the chiropractor to treat a variety of conditions including back pain and headaches. Chiropractic care may be an alternative to prescription drugs.
The idea is that chiropractic care will treat the root cause of the problem, rather than just treating the symptoms. If you have Medicare insurance, you may want to know, “Does Medicare cover chiropractic care?” Yes, but according to the official notice of Medicare coverage for chiropractic care, Medicare has non-covered, always-covered, and perhaps-covered categories.
So it is only applicable in limited circumstances when chiropractic care treatments meet specific rules.
Medicare Chiropractic Coverage
Medicare will not cover the X-rays, massage therapy, or acupuncture treatments your chiropractor may recommend. However, Medicare does cover chiropractic care (spinal manipulation) to correct subluxations, which describes the condition when one or more spinal vertebrae move out of position.
Original Medicare consists of hospital insurance (Part A) and medical insurance (Part B). Medicare Part B will help pay for chiropractic services if your doctor says they’re medically necessary.
If your chiropractor is Medicare-approved, Part B will pay for 80% of your adjustment. You will still owe 20% coinsurance, and the Part B deductible applies.
Original Medicare does not cover many services people want. Private insurance plans called Medicare Advantage (MA) plans can offer coverage for additional chiropractic services.
MA plans vary by location and carrier, and choosing a plan may seem overwhelming. A licensed agent with Medicare Plan Finder can help you find a health insurance plan in your area that fits your needs.
Here is how Medicare Part A, B, C, and D apply to Chiropractic coverage:
Medicare Part A will not cover a visit to a chiropractor because it only applies to hospital care. Chiropractic care is classified as a non-emergency medical service provided in a chiropractic doctor’s office.
Medicare Part B covers manipulation of the spine if a chiropractor believes treatment of a subluxation, which is a misalignment of the spine, to be medically necessary. Part B also provides coverage for physical therapy, since this is another outpatient treatment.
Medicare Part C, the Medicare Advantage plan part, will also cover medically necessary chiropractic services.
Medicare Part D, the Medicare prescription drug benefit, does not apply to chiropractic care at all because Chiropractors are not typically permitted to prescribe medicines legally.
How Many Chiropractic Treatments Does Medicare Cover?
Medicare provides five paid chiropractic visits annually. This can be arranged by your physician through either the Chronic Disease Management plan (CDM) or the Team Care Arrangement (TCA). Medicare chiropractic coverage will save you more than $250 in your healthcare costs.
How Much Does Chiropractic Care Cost With Medicare?
Medicare beneficiaries are United States residents enrolled in Medicare Part A or Part B benefits, or enrolled in both Part A and Part B. They are entitled to receive most medical services after paying their deductibles and a 20% coinsurance.
As a Medicare beneficiary, several factors affect the exact amount you pay with Medicare, for example:
Your health insurance plan
How much your chiropractor charges
Whether your doctor takes Medicare and accepts the assignment
The type of facility
The location of your test or service
What Leads to the Need for Chiropractic Adjustments?
Many common conditions can lead to spinal subluxations. For example, let’s say you bend over to pick something up, and when you stand up, your back doesn’t feel right. It hurts, feels tight, and you can’t stand up straight.
You visit your doctor right away, and your doctor determines that your spine is out of alignment. Your doctor might refer you to a chiropractor.
Before your chiropractor creates a treatment plan you will have X-rays and tests to assess your range of motion.
Improper lifting is one cause of spinal subluxations. Other common causes include:
A vertebra going out of place due to slips, trips or falls
The entire spine slipping out of place because of poor posture
Damage to intervertebral joints (joints between the vertebrae) resulting in joint swelling
For every inch that your head strays from its natural position, you put an extra 20-30 pounds of pressure on your neck (according to Rene Cailliet, MD, former Director of the Department of Physical Medicine and Rehabilitation at the University of Southern California).
While you sit, don’t slouch. Sit with a straight back and keep your head squarely above your shoulders. If you sit for an extended period of time, be sure to get up and walk around for a while. Develop healthy habits such as stretching your entire body every day.
Benefits of Chiropractic Care for Seniors and Medicare Eligibles
Even though Medicare does not cover chiropractic care unless it’s part of subluxation correction, you may still benefit from chiropractic care. Along with correcting subluxations, chiropractic care may provide relief from headaches, low back and neck pain, and sciatica.
Many people may not want to take prescription drugs for headache relief, and they may want to pursue an approach that doesn’t require an abundance of OTC meds either. Many studies suggest that chiropractic care helps treat both tension and migraine headaches.
Lower Back Pain
Chiropractic treatment may be a cost-effective approach to successfully treating lower back pain. Some patients may find that spinal manipulation is more effective for providing pain relief in the long term.
If your doctor recommends chiropractic care for your lower back pain, then it may be a viable option for relieving pain symptoms.
Sciatica refers to a pinched sciatic nerve. It usually starts with a herniated spinal disk. The pain runs from the base of the spine into your legs, and it can range from a mild ache to severe pain.
Your foot might also go numb or feel weak. According to the European Spine Journal, chiropractic adjustments may be more effective than corticosteroid treatment for sciatica.
Common Chiropractic Care Questions
What chiropractic codes does Medicare cover?
Here are the most common chiropractic codes:
CPT Code 98940 Chiropractic manipulative treatment (CMT); Spinal, 1-2 regions
CPT Code 98941 Chiropractic manipulative treatment (CMT); Spinal, 3-4 regions
CPT Code 98942 Chiropractic manipulative treatment (CMT); Spinal, 5 regions
Does Medicare cover chiropractic care in 2020?
Medicare chiropractic coverage in 2020 continues to cover the Medicare guidelines for chiropractic documentation.
Where can I find the latest Medicare fee schedule for 2020?
Medicare.gov is where you will find all the information you need about Medicare’s chiropractic coverage, including the latest Medicare chiropractic fee schedule.
Does AARP United Healthcare cover chiropractic?
Most plans in the AARP secondary Medicare insurance offer a chiropractic benefit.
Let Us Help You Find Medicare Coverage for Chiropractic Care
If you’re one of the many people who rely on chiropractic care for pain relief, you may want to consider a Medicare Advantage plan to help cover costs.
The licensed agents at Medicare Plan Finder are highly trained and they can help you find a MA plan in your area with additional chiropractic coverage. Call 833-438-3676 or contact us here to learn more.
This post was originally published on June 24, 2019, and updated on April 9, 2020.
Does Medicare Cover the Cost of Hip Replacement Surgery?
An estimated 2.5 million Americans have undergone total hip replacements. Conditions such as osteoarthritis and rheumatoid arthritis can cause the hip joint to wear down so much that a hip replacement may be the only course of action to improve your mobility.
The total cost of hip replacement surgery can be staggering if you don’t have help from insurance. How much does a hip replacement cost with insurance?
A total hip replacement costs anywhere from $32,000 to $45,000, based on general coverage guidance from healthcare.gov. The total cost usually includes everything from the surgeon’s initial evaluation to post-operation hospital care.
Increases in year-to-year costs are small under stable economic conditions. There was only a small increase in hip replacement 2019 costs compared to medicare hip replacement 2018 costs.
If you’re one of the millions of Americans who needs a hip replacement, you may wonder, “Does Medicare cover hip replacements?” Yes, but you have to meet certain eligibility requirements, and you may still have some out-of-pocket costs even with Original Medicare.
You may also be asking, “How much does Medicare pay for hip replacement surgery?” The good news is that it will cover at least some of all types of costs.
How Much Does Medicare Pay for Hip Replacement Surgery?
The likelihood of needing hip replacement surgery increases with age. Seniors 65 and older, people with ALS or ESRD, or people who have received SSDI for at least 25 months qualify for Medicare.
Original Medicare (Parts A and B) will help cover the cost of hip replacement surgery if your doctor determines it’s medically necessary because other treatments have failed. The answer to how much Medicare pays for hip replacement surgery will depend on whether it is medically necessary and what types of coverage you have.
Medicare Hip Replacement Costs With Medicare Part A
Medicare Part A is hospital insurance. This Medicare coverage helps pay for a semi-private room, meals and nursing care during your stay.
Part A will only cover a private room if your doctor says it’s medically necessary or it’s the only room available.
Medicare hip replacement reimbursement includes skilled nursing care after your surgery. Part A helps cover the first 100 days of in-patient care including physical therapy.
The Medicare Part A deductible can apply, and you may be responsible for copays or coinsurance.
Part B Coverage for Hip Replacement Surgery
Medicare Part B will help cover medical expenses such as doctor’s fees for the initial evaluation and post-op visits, surgery in an outpatient surgical facility, and outpatient physical therapy.
You may be responsible for paying the Part B deductible, which was $185 in 2019, and 20% of the Medicare-approved costs. Medicare Part B may also cover your post-operative durable medical equipment (DME) such as a cane or in-home grab bars.
Medicare Part D Coverage
Original Medicare does not cover post-op prescription drugs, but Medicare Part D includes prescription drug coverage. Your doctor may prescribe blood thinners to prevent clotting or painkillers to take during your recovery.
You can use Medicare Part D or private health insurance plans to cover prescription drugs.
Will Medicare Help Pay for a Knee Replacement?
Medicare Part A and Medicare Part B each cover a different aspect of joint replacement surgery. Medicare Part C will cover knee replacement, including both knees at once, only if your doctor considers it necessary.
Medicare Part D prescription drug program will cover the cost of painkillers, antibiotics, and anticoagulants required for the surgery.
What Medicare Advantage and Medicare Supplements Cover
Private insurance plans offer Medicare Advantage (MA) plans, and they are a great way to get all of the Part A and Part B benefits along with some unexpected offerings such as meal delivery, non-emergency transportation, vision and dental insurance.
Certain MA plans even cover prescription drugs! You will pay a monthly premium with MA plans, but some are as low as $0. Coverage varies depending on your location and the plans available, so look for a qualified professional to help you sort through the plans in your area and find the right one.
The difference is that Medigap Plans only cover your financial responsibilities such as coinsurance and deductibles. You cannot have both a Medicare Supplement and a Medicare Advantage plan at the same time, so it’s important to find out which one is best for you.
Medicare Supplement Insurance plans work with Medicare Part A and Medicare Part B to cover out-of-pocket costs for Medicare hip replacements.
Post-Hip Replacement Surgery Costs
Does medicare cover rehab after hip replacement? Yes. Sometimes, after hip replacement surgery, you may need some help.
For example, throughout your recovery, you might need orthotic devices or other equipment to help you get around. Medicare may cover those devices if your doctor says that they are medically necessary.
Some Medicare Advantage plans may provide extra coverage, and Medicare Supplement plans may cover your copayments for devices.
You also might be interested in Medicare Advantage plans that have an OTC or over-the-counter benefit. This can help offset some of your costs related to pain medication and other items you need to pick up from your pharmacy for your recovery.
Additionally, some people may need physical therapy to recover from surgery or other hip injuries. Medicare Part B may cover your physical therapy by as much as 80%, as long as it is deemed medically necessary.
Why You Might Need a Hip Replacement
Several conditions can cause the hip to deteriorate to the point of needing surgery including:
Hip replacement surgery can restore the hip joint and full range of motion. The type of replacement you receive depends on the doctor’s recommendation and your general health.
The surgery may use a cemented or uncemented prosthesis to connect the replacement parts to the healthy bone after the unhealthy cartilage is removed. The entire recovery process can take three to six months.
Understanding the Hip Replacement Procedure (Orthopedic Hip Arthroplasty)
Hip arthroplasty, also known as total hip replacement, is a common orthopedic procedure. During the surgery, your damaged bones and some soft tissue are removed.
The hip joint is replaced with an implant, which can be ceramic, plastic, or metal.
In a traditional replacement, a 10-12 inch incision is made on the side of the hip. In less-invasive procedures, the incision may only be three to six inches.
Some people may not be eligible for a minimally invasive procedure. Be sure to ask your doctor if you aren’t sure what your procedure will be like.
Medicare Hip Replacement Scenario
To better understand how everything works together, let’s take the real-world example of a 75-year-old man who has osteoarthritis.
He’s been working with his doctor to manage his symptoms, and things have been going well. One day, the man takes a nasty fall and breaks his hip. This man’s Medicare hip replacement process involves several steps:
He doesn’t go to the hospital right away because the bruising around his hip looks like one of his routine injuries. The man makes another doctor’s appointment, and his doctor takes X-rays and determines the man will need a hip replacement.
His doctor will determine if the man is healthy enough for surgery, and then the doctor refers the man to an orthopedic surgeon. Until this point, everything falls under Medicare Part B.
The man decides to have his surgery in an outpatient facility. He’s responsible for his deductible if he hasn’t met it, or the out-of-pocket maximum for his plan.
The surgery is successful, so he has physical therapy appointments so he can recover as quickly as possible. The man has a Medicare Advantage Prescription Drug plan, so he collects his blood thinners and painkillers for only a small copayment at the pharmacy.
Along with prescription drugs, the man’s surgeon prescribes a cane and grab bars to help the man perform daily tasks. The man’s MA plan also covers those items, because his doctor determined they are medically necessary.
Contact Us Today
A comprehensive Medicare plan can help cover the cost of hip replacement surgery. If you need help finding coverage, we can help! Call us at 833-438-3676 or contact us here today.
This post was originally published on May 15, 2019, and updated on March 24, 2020.
Does Medicare Cover Cancer Treatment? (Updated for 2020)
The good news is that Medicare does cover cancer treatment, prescriptions, and screenings and might even cover genetic testing, depending on your plan.
Medicare Cancer Coverage: What you Need to Know
Cancer treatment usually involves a combination of treatments that can include chemotherapy, radiation, and surgery. Medicare plans can cover a lot of the costs associated with these treatment options.
What Cancer Treatment Does Medicare Cover?
In order for your treatment to be covered, your doctor must accept Medicare. Outpatient care (including intravenous chemotherapy, certain screenings, and outpatient radiation) falls under Part B.
You may have to pay a copayment, coinsurance and a deductible for each service.
Cancer treatment under Part A (hospital insurance) covers inpatient surgeries and hospital stays. Part A will also cover limited skilled nursing care and home health care services.
Original Medicare Coverage (Medicare Part A and Medicare Part B)
After you qualify at age 65, you’re enrolled in Medicare Part A and Part B, the Original Medicare. Medicare Part A covers inpatient hospital stays, which includes skilled nursing facility care, hospice care, and home health care.
Medicare Part B covers doctor visits, lab tests, and medical equipment and supplies.
Both Part A and Part B cover high-dose radiation treatments to shrink tumors and destroy cancer cells, but in different ways. Part A covers it for inpatients in hospitals.
Part B covers it for outpatients at independent (freestanding) clinics.
Medicare Advantage Plan Coverage
Medicare Advantage Plans are a health care plan offered by private health insurance companies that contract with Medicare and offer the full spectrum of Part A and Part B benefits.
Since these companies are legally expected to provide “equal or better” coverage than the original Medicare, a Medical Advantage Plan is sometimes also known as Medicare Part C.
Medicare Part D Coverage
Medicare Part D Coverage is an optional federal prescription drug plan for Medicare beneficiaries to pay for prescription drug coverage. You can get it as part of your original Medicare (Part A and Part B).
The annual premium for coverage in 2020 is $435, up from $415 last year.
Medicare Supplement Insurance (Medigap) Coverage
Medicare Supplement Insurance (Medigap) is worth buying to lower out-of-pocket costs if you want lower monthly premiums. Medigap plans cover many original Medicare costs, like copayments, coinsurance, or deductibles.
Does Medicare Cover Chemotherapy?
Medicare Part B covers chemotherapy drugs, radiation, and chemotherapy treatment for cancer patients in a doctor’s office, a clinic, a hospital, or even chemotherapy in a skilled nursing facility.
Immunotherapy is a cancer treatment that triggers your own immune system to fight off cancer cells. If immunotherapy is medically necessary, Medicare may cover many types of specialized treatments, for instance, immunotherapy for lung cancer.
Is CAR T-Cell Cancer Therapy Available to Medicare Beneficiaries?
The Centers for Medicare and Medicaid (CMS) approved Medicare coverage for FDA-approved Chimeric Antigen Receptor T-cell (CAR T-cell) to treat specific types of cancer, such as non-Hodgkin lymphoma and B-cell precursor acute lymphoblastic leukemia.
According to the Leukemia and Lymphoma Society (LLS), CAR T-cell therapy works by re-engineering a patient’s T-cells (disease-fighting cells), multiplying the cells, and re-introducing the “new” cells to the body.
Medicare Cancer Screening
Catching cancer in its early stages can make a huge difference in your treatment’s success.
That’s why Medicare offers coverage for preventive screenings for most cancers, including but not limited to:
Breast cancer: Medicare will cover one annual mammogram, and one clinical breast exam (CBE) every two years for all women 40 and older who have an average risk of developing breast cancer. Women who are at a high risk of developing breast cancer can receive one CBE every year.
Cervical cancer: Medicare pays for one pelvic exam and Pap test every two years. If you have a high risk of cancer, Medicare covers those tests once yearly.
Colorectal cancer: Medicare covers certain colorectal cancer screenings looking for pre-cancer polyps for people 50 and older.
Prostate cancer: Medicare covers one digital rectal exam (DRE) and one prostate-specific antigen (PSA) for men 50 and older. Medicare will cover 80% of the DRE and 100% of the PSA.
Lung cancer: If you’re a smoker or have a long history of tobacco use, Medicare will cover low-dose CT scans for lung cancer.
Does Medicare Cover Wigs for Cancer Patients?
Hair loss is a common side effect of certain cancer treatments. Original Medicare and Medicare Supplements do not cover wigs. However, some Medicare Advantage plans may offer coverage for wigs.
Medicare Genetic Testing
Some people are at a higher genetic risk for cancer than others, meaning that they have specific gene mutations. Medicare will cover BRCA1 and BRCA2 genetic testing to find those mutations if you have a personal history of cancer.
Medicare also covers certain genetic tests for melanoma and colon cancer. Depending on where you live, that coverage extends to multigene testing if the initial test indicates multiple mutations.
Most people have to wait for the Annual Enrollment Period (AEP), which is from October 15 to December 7, to change coverage, but you can take advantage of the SEP.
Medicare Chronic Special Needs Plan (C-SNP)
If you are diagnosed with cancer, you may be eligible for a Chronic Special Needs Plan (C-SNP). C-SNPs are a form of Medicare Advantage designed specifically for those with certain chronic illnesses and conditions.
They go above and beyond the coverage that Original Medicare provides. For example, C-SNPs provide coverage for prescription drugs.
Your C-SNP will involve a network of providers that will communicate with each other about your treatment plan.
When to Enroll in a C-SNP
You can enroll in coverage as soon as you receive your cancer diagnosis, but you must get confirmation from your doctor that you have cancer. While you are allowed to enroll in a C-SNP before your doctor verifies the diagnosis, your doctor must verify the diagnosis before you can keep the coverage.
Does Medicare Cover Cancer Treatment After Age 76?
Medicare covers cancer treatment for those enrolled, including medicare coverage over 70 years of age, but there may be a deductible or a copay. It also covers beneficiaries after they turn 76.
Can You Get Medicare Before 65 If You Have Cancer?
If you’re under 65 and get cancer, you are eligible for Medicare if you’ve been receiving Social Security Disability Insurance (SSDI) checks for 24 months or longer or if you have a diagnosis of End-Stage Renal Disease (ESRD).
How to Find an Oncology Doctor Who Takes Medicare
An oncology doctor, or oncologist, is a doctor who specializes in cancer treatment. Oncologists can have one of three different sub-specialties: medical, surgical, and radiation.
Medicare.gov has a tool for finding local oncologists who accept Medicare.
To get started, click here. First, enter your zip code beside the red arrow. We used 37209, because that’s the zip code for our corporate headquarters in Nashville, TN.
Then enter “oncology” in the box above the green arrow. Once you do that, click “Search” beside the yellow arrow.
The next page will let you select what subspecialty you want your oncologist to have. You can select more than one, but for demonstration purposes, we only chose “Medical oncology” (below beside the red arrow).
Then click “View results” beside the blue arrow.
The next page features a list of medical oncologists complete with contact information. Call the doctors to get an idea of what services they provide and if they can treat you.
You may have to call multiple oncology doctors to find the right one.
We Can Help You Get Covered
A cancer diagnosis can be overwhelming, but the right medical coverage can help give you the chance to get the quality care you need.
If you have cancer and need to enroll in a C-SNP, we will assist you with finding the best insurance plan for you. Call us at 844-431-1832 or contact us here today.
This post was originally published on April 19, 2019, and updated on March 6, 2020.
Does Medicare Cover Alcohol Rehab and Substance Abuse? (Updated for 2020)
Substance abuse costs the US more than $740 billion every year. Those costs are related to crime, healthcare, and lost productivity at work.
Overcoming addiction is a lot of work, and it takes a team of mental health and medical professionals to keep you on the right path. You might know that Medicare will pay for doctor visits for illness and injuries, but what you want to know is, “Does Medicare cover alcohol rehab?”
Medicare does cover many of the costs related to alcohol rehab and treatment if your provider says those services are medically necessary. You must get treatment at a Medicare-approved facility or from a Medicare-approved provider, and that provider must create a care plan.
Addiction Treatment for Seniors and Medicare Eligibles
Treatment for addiction is a lot like treatment for any other disease. It starts small, often with preventive measures, and will progress according to the doctor’s recommendations.
Medicare pays for alcohol and substance abuse treatment for both inpatients and outpatients. Substance use disorders are drug addictions that influence a person’s thoughts, feelings, and behaviors.
These disorders aren’t just limited to illicit drugs, such as Cocaine, Ecstasy, GHB, Hallucinogens, and Heroin, among others. They can also include misuse of legal drugs like nicotine, marijuana, or alcohol as well as legal medications like fentanyl (Duragesic), hydrocodone (Vicodin), or oxycodone (OxyContin).
Level 0.5, Early Intervention Education and prevention for people who are at risk of developing an addiction fall under this level. Medicare can cover a conversation with your doctor about a prescription drug that may be habit-forming.
Level 1, Outpatient Treatment This level of addiction treatment refers to nine hours or less of weekly counseling services or recovery. Outpatient mental health services fall under Medicare Part B and certain Medicare Advantage (MA or Part C) plans.
Level 2, Intensive Outpatient and Partial Hospitalization
These treatment programs are categorized as having more than nine hours of counseling services a week, and/or short inpatient hospital care. Medicare Part A pays for hospital stays of up to 60 days. After 60 days, you will owe coinsurance.
According to the American Addiction Centers, “Part B covers partial hospitalization (PHP), which is an outpatient treatment” that a hospital or mental health center provides. A PHP provides more intensive treatment than standard outpatient programs.
A doctor must say that PHP is medically necessary, and your treatment plan must include at least 20 hours of treatment per week.
PHP services can include:
Individual and group therapy
Activity therapies that are not chiefly recreational
Therapeutic drugs that can’t be self-administered
Medically necessary diagnostic services for mental health
Level 3, Inpatient Treatment
The next level involves up to 90 days in a rehab facility with a focus on behavioral therapy and staying away from substances. Medicare Part A covers the first 60 days of psychiatric hospital stays.
Days 61-90 will cost most people $335/day.
According to the American Addiction Centers, you can receive up to 190 days of treatment at a specialty psychiatric hospital, but no more. That is a lifetime limit. You may be able to receive treatment under Medicare Part A at:
Acute care hospitals
Critical access hospitals
Inpatient rehab centers
Long-term care hospitals
Inpatient care as part of a qualifying research study
People whose long-term addictions have caused them physical harm need this level of care. It not only involves drug and alcohol counseling but also access to nursing care, prescription drugs, and other medical services
In the event that you or someone you love suffers an overdose, Medicare covers some treatments. For example, most Medicare Part D plans cover Narcan, the drug used to reverse the effects of an opioid overdose.
Typical co-pays for most people with Part D and certain Part C plans for Narcan range from $19-$144.
Medicare Part A is hospital insurance, and it will cover your hospital stay, but not all services fall under Part A. Ambulance transportation is under Part B, and so is doctor observation until you are “officially admitted” into the hospital.
The Centers for Medicare & Medicaid Services (CMS) cover mental health treatment. Medicaid is a federal and state program to help you with your medical costs if you have limited income.
Mental health treatment services are based on screening, brief intervention, and referral to treatment (SBIRT). This is an evidence-based approach used in public health for early interventions and treatment services.
It’s designed to help someone at risk for a substance abuse disorder or who already has a substance abuse disorder.
For instance, after this comprehensive evaluation protocol, someone addicted to heroin might be administered methadone to reduce the intensity of withdrawal symptoms. If this patient does not benefit from outpatient treatment, then inpatient psychiatric care is another option. Such residential treatments provide a space for treatment, sleeping, bathing, recreation, and dining.
Addiction is a disease, and with the right treatment plan, it can be managed. A qualified professional can guide you through the thousands of Medicare plans out there and help you find one that will suit your needs.
Does Medicare Cover Opioid Treatment?
In 2020, the Medicare program includes paying for Opioid Treatment Programs (OTP). The Medicare-enrolled opioid treatment program is comprehensive, consisting of periodic assessments, intake procedures, toxicology testing, individual therapy, group therapy, and counseling for substance use.
It also includes FDA approved opioid treatments and medication-assisted treatment (MAT) medications as well as the dispensation and management of MAT medications. A search for “opioid treatment programs near me” will show you a map of addiction treatment centers in your neighborhood.
SAMHSA Helpline to Find Treatment
The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline is a free, confidential service you can use 24 hours a day, seven days a week to find treatment for substance abuse disorders. You reach the helpline at 1-800-662-HELP (4357) or use SAMHSA’s online treatment finder tools.
What Is the SAMHSA Helpline?
The SAMHSA National Helpline offers assistance in finding local treatment facilities, support groups, and community-based organizations. You can also request free publications and other information.
Will My Medicare Plan Cover This Service?
The referral service is free. When you call, ask the representative to refer you to a facility that accepts Medicare. If you have a Medicare Advantage plan, ask your health insurance carrier for a list of participating healthcare providers.
How to Find Approved Medicare Alcohol Treatment and Drug Rehab Providers
Medicare’s Physician Compare website is a great resource for finding addiction treatment in your area. Click here to get started.
You’ll reach a page that allows you to enter your zip code and what type of medical practice you want to find. We chose 37209, which is the zip code for our corporate offices in Nashville, TN.
For the practice type, we chose “addiction medicine.” Once you’ve entered that information, click “search.”
That will lead you to a list of local practices that specialize in addiction treatment. You can use the contact information to call the facilities and compare their services, or you can use Medicare.gov’s tool.
To use the tool, click on the practices you want to compare. For our purposes, we only chose the top three practices on the list.
Then click “Compare” at the bottom of the page.
Then you will come to a page that allows you to view practice contact information on one screen. You can also look at the practices’ full profiles and get directions to each location.
Prevalence of Substance Abuse in Older Adults
Older adults (defined as 65 and older in the United States) most commonly abuse alcohol, but many also abuse prescription and illegal drugs. The percentage of older adults who met the criteria for having an addiction problem was 11.7 percent.
Drug abuse in adults older than 65 years is mainly limited to alcohol despite the prevalence of so many illicit drugs and mood-altering prescription drugs.
Substance Abuse in the Elderly: Unique Issues and Concerns
The elderly population accounts for 25% of the prescription drugs sold in the US, and this population faces unique issues when it comes to substance abuse. Because addiction symptoms look like other common senior health disorders such as dementia, diabetes, and depression, addiction often goes ignored.
If you or someone you love struggles with drug or alcohol addiction, you don’t have to face it alone. A licensed agent with Medicare Plan Finder may be able to help you find a Medicare plan with the right care team to lead your or your loved one’s recovery.
To set up a no-cost, no-obligation appointment with an agent call 844-431-1832 or contact us here today.
This post was originally published on April 22, 2019, and updated on March 6, 2020.
Seniors Staying Active: How Do You Like to Exercise?
According to USA Today, “seniors need to stay active to be healthy and avert loneliness.” It’s no secret that physical activity has a host of health benefits, but many people simply won’t exercise if it feels like a chore. So how do you keep a routine? Find something you enjoy.
We polled 1,420 people about their fitness routines and what types of exercise they enjoy. Read on to learn our poll results, the benefits of different types of exercise, and how you can get started with your own exercise routine.
Poll Results: How Do You Exercise?
The clear favorite in our poll was cardiovascular activity (walking, running, or biking), which received 748 votes (28.6 percent).
“Other” exercises followed with 296 votes (11.3 percent.)
Exercising with a personal trainer was the least popular with 142 votes (5.4 percent).
Seniors Staying Active With Cardiovascular Exercise
Cardiovascular exercise is the most popular activity with the people we polled. Walking, running, or cycling may be the easiest to start. All you need is the right equipment such as comfortable shoes and clothes or a bicycle.
You can walk pretty much anywhere, and cold weather is oftentimes no excuse to get moving — many shopping malls allow people to walk around before the stores open.
All you need is a good pair of shoes and comfortable clothes and you can start reaping the benefits of cardio exercise. Running may be a bit more high-impact on your joints, but it still has a ton of benefits* for heart and lung health. Bicycling requires more equipment than the other two, but it can be a great way to get outside and explore your neighborhood, provided it’s safe to do so.
*Always consult with your healthcare provider before starting any exercise program.
Benefits of Cardiovascular Exercise for Seniors
Cardio exercise offers a host of benefits that reach from your head to your toes. For example, it increases blood flow to your brain, which decreases your chance of stroke. Cardio can also improve your blood sugar control, which helps relieve stress on the pancreas and reduces your chance of developing type 2 diabetes. Additionally, cardio can aid in weight loss, help fight osteoporosis, reduce chances for a hip fracture, and help manage arthritis pain.
Seniors Staying Active at the Gym
Gyms are a great place for anyone looking to stay active. Many of them have the most up-to-date equipment and they can provide a great atmosphere for like-minded people to meet. Many gyms have staff on hand to answer questions and some even have saunas and hot tubs to help you relax after a workout!
You may even be able to find help paying for gym membership! Some Medicare plans include a fitness benefit that gives you free gym and/or group fitness access! Original Medicare does not offer coverage for fitness services, however, certain private plans called Medicare Advantage plans can. Some Medicare Advantage plans have low $0 premiums, so you’d get benefits such as gym memberships, meal delivery, hearing, dental, and vision for little or no extra cost to you*.
*You still owe the Medicare Part B premium even if you have a Medicare Advantage Plan.
Benefits of Weight Training at a Gym
According to the New York TImes, “In multiple experiments, older people who start to lift weights typically gain muscle mass and strength, as well as better mobility, mental sharpness and metabolic health.” Gyms also usually have cardio equipment, too, so you can develop a well-rounded fitness program.
Seniors Staying Active With Home Gym Equipment
Working out at home can be a great way to stay in shape. You don’t need a lot of equipment to get started, either. You can have a safe and effective workout using dumbbells or resistance bands, and you can modify your routine to accommodate your needs.
For example, some people may not be able to stand up and do shoulder presses. You can do exercises from a chair and still get an effective workout. The key is to know which exercises to perform, how many sets, and how many repetitions.
Home Gym Benefits
You don’t have many excuses to not exercise if your gym is at home. Even people homebound people can reap the benefits of exercise for older adults. You can find equipment at Amazon, Target, Walmart, or even used! Craigslist is a great source to find people who want to get rid of gym equipment they don’t use.
Another benefit is that you get to control what equipment goes into your gym. Sometimes a fitness center will have what seems like an endless amount of machines, but you only use a handful of them. Don’t want a treadmill? Don’t buy one. You can have only the equipment you want. The best part? You likely won’t have to wait in line for any of it.
Group fitness classes have an added social component, which is extremely important for seniors and brain health. Also, many times group fitness classes can help you attend more regularly with the “positive peer pressure” that can result.
If you start attending classes at certain times every week and you skip, your classmates will ask you where you were. That adds an accountability component that just exercising on your own doesn’t have.
Some Medicare fitness programs* can cover this benefit, too! Programs such as SilverSneakers®, Silver & Fit®, and RenewActive™ are included with certain plans. Some Medicare Advantage plans have low $0 premiums*, which would mean that your gym membership would have no additional cost.
*Medicare Advantage fitness benefits are not administered or necessarily endorsed by Medicare or any other government agency.
**You still owe the Medicare Part B premium even if you have a Medicare Advantage plan.
Seniors Staying Active With the Help of Personal Trainers
Following a personal trainer’s plan is a great way to get in shape, especially if you’re new to working out. Your trainer will give you exercises to perform and a routine to follow. They’ll even watch you and make sure you’re maintaining the proper form so you don’t hurt yourself.
However, personal trainers can be expensive. You may owe trainer fees on top of your gym dues. However, some gyms allow you to have a certain number of personal training sessions for free so you can see if the one-on-one fitness coaching is the path you want to take.
Other Ways for Seniors to Stay Active
The exercise methods in our poll aren’t the only ways for older adults to stay active. There are many other safe ways to exercise including, yoga, swimming, hiking, and playing sports. You have seemingly endless options as long as your healthcare provider approves your activity. The most important thing is that you enjoy the activity. Otherwise, you won’t stick with it and you won’t receive the many rewards that exercising can offer.
How to Get Fitness Coverage
Working out at the gym, your local senior center, or taking group fitness classes may be too expensive for some people. Fortunately, you may be able to find help if you have the right Medicare plan.
Every location has different plans with different benefits. If you want to learn more about Medicare Advantage and what benefits (including fitness programs) are in your area, a licensed agent with Medicare Plan Finder can help.
Our agents are highly trained and they can talk to you about your needs and they may be able to find a local plan that fits your budget and lifestyle. Call 1-844-431-1832 or contact us here to arrange a no-cost, no-obligation appointment today.
Have you voted on our poll yet? How do you like to exercise?
Does Medicare Cover Dental Implants?
Sometimes plaque and tartar can build up to the point where the accumulation irritates the gums and cause damage to your teeth. The irritation and damage can even result in tooth loss. A dentist might recommend a dental implant to solve the problem.
If you’re one of the many people who need dental implants and you have Medicare insurance, you probably have a lot of questions such as, “What are dental implants,” and, “Does Medicare cover dental implants?”
What Are Dental Implants?
A dental implant is an artificial tooth with a titanium post that’s surgically attached to your jaw. About 450,000 people have dental implants every year.
Original Medicare and Medicare Advantage Dental Coverage
Are dental implants covered by Medicare advantage plans?
Sometimes. This means some plans do and some plans don’t.
Private insurance policies called Medicare Advantage (MA) plans can offer coverage for additional services Original Medicare does not, including dental services. Sometimes the dental services offered include implants and sometimes they only include routine cleanings and x-rays.
If you need dental insurance, an agent with Medicare Plan Finder can work with you to find a Medicare Advantage plan in your area that offers dental implants. Some plans also offer coverage for vision, hearing and even fitness classes along with all of the services that Original Medicare covers.
Some people may find that their Medicare Advantage plan does not cover all of their dental needs. Those people may need additional dental coverage from private policies called commercial dental insurance plans to cover major procedures such as dental implants.
How to check if your Medicare Advantage plan covers dental implants.
In order to determine if your current plans covers dental implants, you’ll need to check the summary of benefits you received when you first enrolled in your plan.
There should be a section in your summary of benefits that will specifically address the dental benefits included as well as specifically covered benefits such as implants, dentures, cleanings, and x-rays.
As mentioned, every plan offers different benefits, so you should always verify with your plan summary benefits to be sure. If you do not know how to find your summary of benefits, you should call your insurance company or speak to a licensed agent.
Does Medicare Supplement Cover Dental Implants?
No. Medicare supplement plans do not cover dental implants.
Medicare Supplement (Medigap) plans can help pay for financial items such as copays and coinsurance that can come with Original Medicare.
Unlike Medicare Advantage plans, Medigap policies do not offer additional benefits. That means that a Medicare Supplement plan will not pay for routine dental care or dental implants. You cannot have both a Medicare Advantage policy and a Medigap plan at the same time, so it’s a great choice to learn the difference between the two.
Medicaid is both federally and state-funded. The program helps people who qualify to pay for their health insurance. Every state has different rules about dental coverage. While most states provide at least emergency dental services for adults, not all states provide comprehensive dental coverage.
If you qualify for Medicaid and have questions about what services your state covers, contact your local Medicaid office.
Elderly Dental Problems and Their Solutions
Tooth loss is not an inevitable part of aging, but many seniors can develop diseases which can make dental implants or other solutions a necessity. Conditions that affect older adults include dry mouth, gum disease, and oral cancer.
Many medications that treat common senior conditions have dry mouth as a side effect. Dry mouth can lead to cavities, which ultimately lead to gum disease. If you have dry mouth as a medication side effect, talk to your doctor about what drugs you take and the dosages.
Your doctor may change your prescriptions or recommend over-the-counter oral moisturizers or drinking more water. In order to further prevent cavities, your dentist may apply fluoride treatments.
Periodontal, or gum disease results from bacteria in plaque irritating the gums. The gums become swollen and are more likely to bleed. Periodontal disease is widespread among older adults because it’s often painless until it becomes severe and many people don’t have regular dental exams.
If gum disease goes untreated, the gums can recede from the teeth and form spaces that can collect food particles and more plaque. Advanced periodontal disease can destroy the gums and the bones and ligaments that support the teeth. Your dentist can treat or help you prevent gum disease, so it’s important that you have regular check-ups.
Oral cancer is an uncontrollable growth of invasive cells that causes damage to the mouth, tongue, and throat. It can be life-threatening if it’s not treated early. Along with regular dental visits, you can prevent oral cancer by avoiding tobacco or heavy alcohol use.
Other risk factors include a family history of cancer, excessive sun exposure and having HPV. About 25 percent of oral cancer cases are people who don’t smoke or who only drink occasionally. Treatment for oral cancer involves surgery to remove the cancerous cells, or radiation and chemotherapy.
Does Medicare Cover Dentures or Other Alternatives to Traditional Dental Implants?
Some people may not be able to receive dental implants. For example, if your jaw cannot support a dental implant, a dental specialist will have to find an alternative.
Dental Implant Alternatives
Bridges: This alternative uses artificial teeth supported by crowns that attach to the natural teeth to solve the dental issue.
Full or Partial Dentures: Full dentures are a dental implant alternative for people who have lost most of their natural teeth. They are removable artificial teeth secured to a support piece in the mouth. Partial dentures are for people who have most of their natural teeth still, and they attach to natural teeth with metal clasps.
“Teeth in a Day”: Traditional dental implants require a lengthy recovery period that can last up to two years. “Teeth in a Day” is a procedure that uses computer-guided technology to find the best placement for implants and accurately insert new posts in an hour.
If you take care of your teeth, you can avoid many of the issues that contribute to tooth decay, gum disease, tooth loss, and ultimately avoid needing assistance with dental implants. A strong oral hygiene routine includes:
Brushing twice daily with fluoride toothpaste
Flossing between your teeth every day to remove plaque
Limiting alcoholic beverages
Refraining from smoking or chewing tobacco
Regular dental visits even if you have no natural teeth or you have dentures
Visiting your doctor or dentist if you experience abrupt changes in taste or smell
Working to control diabetes, which will decrease the risk of gum disease and other conditions
Many older adults will need assistance with everyday grooming and self-care. If you’re a caregiver, you can help the people you care for avoid gum disease by flossing and brushing their teeth every day and bringing them to their dentist visits.
Let Us Help You Find Dental Plans That Cover Dental Implants
Even though Medicare does not cover dental implants, the right Medicare Advantage plan or commercial dental insurance plan can help pay for the treatments your dentist recommends. Call 833-438-3676 or contact us here to arrange an appointment with a licensed agent.
This post was originally published on June 12, 2019, and updated on January 7, 2020.
7 Popular Senior Instagram Accounts You Need to Follow
Seniors on Instagram are helping to change age-related stereotypes and they’re having fun doing it. Are you on Instagram? All you need to join these influencers is a smartphone and to download the Instagram app. The best part? The app is free, and you can use it to connect with your grandkids.
Social media influencers over 50 have become style icons, entrepreneurs, and they’ve even shown up at events such as music festivals and red carpets. Check out this list of popular senior Instagram accounts and give them a follow. Use these accounts as ideas for your own posts. Who knows? You might end up going viral just like some of the people below!
Magda Llohis de Gutierrez, 76, is living her best life and documenting it for everyone to see. She smiles in almost every photo she posts.
Llohis de Gutierrez’s Instagram initiation was about as free-spirited and spontaneous as her approach to life. According to the BBC, fashion blogger Ari Seth Cohen took photographs of Llohis de Guttierez and told her she “had to have an Instagram account.” She had “no clue what she was talking about.” She must’ve figured it out quickly — the self-proclaimed artist now has more than 20 thousand followers.
Helen Ruth Elam Van Winkle worked in a factory for 28 years before rising to Instagram fame. The 91-year-old woman’s daughter posted a photo in cut-off denim shorts and a tie-dyed T-shirt while holding up a peace sign. Van Winkle told NPR that she thought people “saw a great-grandmother that didn’t care what anybody thought about her.”
Those rebellious vibes quickly went viral. Van Winkle now has nearly 4 million followers. “Being age-appropriate” is not a concern for the Insta-famous star — she’s often posting selfies from music festivals and red carpet events. She’s even been photographed lip-syncing with the rapper Drake.
Van Winkle also talks candidly about her challenges in life like her hip replacement surgery and the loss of her husband and son. She appreciates her Instagram community. “Thank you guys for always wanting to support me. I’m so undeniably grateful,” she wrote in one post.
Irvin Randle, 57, is an elementary school teacher from Houston, TX. He is a self-described “sharp-dresser,” and his Instagram posts back up his claims. Randle is a grandfather of two, and he even inspired his own hashtag — #MrStealYourGrandma. However, Randle was upset at the hashtag at first. “I don’t want anybody’s grandma,” he said.
Randle’s daughter sparked his Insta-fame flame. He became a social media celebrity seemingly overnight when his daughter took photos of him wearing a stylish outfit in 2016. He told Voyage Houston that he thought he was in trouble when his daughter told him he was trending.
Sarah Jane Adams, 63, started her Instagram account to promote her jewelry business. Now her feed features an age-positive and feminist message. For example, she hashtags most of her posts with #MyWrinklesAreMyStripes. She said, “I have no desire to get rid of them,” after a makeup artist asked if Adams wanted to cover her wrinkles. “It’s ridiculous that we’re living in a world where showing an unfilled, make-up free face is considered ‘brave!’”
Adams was born in the United Kingdom and now lives in Sydney, Australia. She is on a mission to create diversity. “I don’t think people are following me because of my clothes or my jewelry,” she said. “It’s my attitude.”
Kimiko Nishimoto, 90, shows her followers that you’re never too old to learn something new. She joined her son for a photography class when she was 72, and she’s been snapping humorous photos ever since.
“I just want to do something funny,” Nishimoto explained to the Japan Times. “Life is all about being playful.” Nishimoto’s sense of humor skews toward slapstick or physical comedy. She’s also a skilled photo editor. Her Instagram feed shows edited photos of her flying on a broomstick, crashing scooters, and slamming doors on people.
Nishimoto credits photography with helping her cope with the loss of her husband in 2012. “Taking photos is my happiness,” she said. “I’ll keep doing it for as long as I’m alive.”
Lance Walsh, 58, sells fruit in London, England. He’s best-known for his streetwear fashion sense on social media, however. Walsh has dressed in colorful clothing and worked his fruit stand for more than 30 years. One day, a photographer named Ben Awin noticed him, posted photos on the internet, and later Walsh started an Instagram account.
Walsh can often be seen wearing hoodies, colorful T-shirts, camouflage pants, or colored shorts. His Instagram feed has caught the attention of followers all over the world. According to Walsh, some fans from Asia even “cry” when they see him.
Linzhuang Yueli, also known as Moon Lin, is 91 years old and from Taiwan. Lin is another Instagrammer who’s known for her streetwear style. She has more than 100 thousand fans, and it doesn’t seem like she’ll be slowing down any time soon.
Her feed shows her wearing colorful hats, sports gear, and even wearing a bunny costume as she goes on with her day-to-day life.
Find Your Next Favorite Social Media Influencers Over 50
We hope these senior social media influencers give you some ideas about what popular senior Instagram accounts to follow. This list is not exhaustive, and it doesn’t cover everyone. Do some exploring to find more inspiration and and accounts to follow!
Pro tip: After you’ve “liked” or commented on a few posts, click on the magnifying glass at the bottom of your app. Instagram will start suggesting accounts and posts similar to the ones you’ve engaged with. In other words, the more you use Instagram, the more likely you are to find your next favorite influencer.
Signs of Depression in Older Adults
Depression is more than just feeling sad from time to time. It’s a serious mental health issue that can be treated. It can cause severe symptoms that affect your entire life including how you think, feel, and handle day-to-day activities such as sleeping and eating.
Depression is a legitimate illness. It’s not something you can just “shake off” one day, and it doesn’t mean that you’re weak or that you lack willpower. It’s important to know the signs of depression in older adults so you can find the treatment you need.
Types of Depression
According to the National Institute on Aging (NIA), there are several types of depression. The most common types of depression are major depression and persistent depressive disorder.
Major depression involves severe symptoms that affect your ability to work, sleep, study, eat, and find joy in life. A person may experience an episode of major depression only once, however, multiple episodes are more common.
Persistent depressive disorder is a depressed mood that lasts for two years or more. A person diagnosed with persistent depressive disorder may have episodes of major depression with periods of less severe symptoms in between.
It might be difficult to recognize depression in older adults because they may show different symptoms than younger adults. For example, sadness is not the main symptom for some older adults. They may have less obvious symptoms of depression like restlessness, or they may not be willing to talk about their feelings. Doctors may be less likely to recognize that you have depression.
Sometimes older people who are depressed feel tired, have trouble sleeping, or seem irritable. Sometimes the attention problems that depression can cause look like Alzheimer’s disease or other brain disorders. Older adults may have medical conditions such as heart disease, stroke, or cancer, which may cause symptoms of depression. Certain medications can also have side effects that contribute to depression.
There are many symptoms associated with depression, and they can vary from person to person. If you have any of the following symptoms for more than two weeks, you may have depression. Symptoms of depression can include:
Persistent sad, anxious, or “empty” mood
Feelings of hopelessness, guilt, worthlessness, or helplessness
Loss of interest in activities you once enjoyed
Fatigue or a lack of energy
Talking or moving slower
Difficulty focusing, remembering, and/or making decisions
Difficulty sleeping, waking up in the early morning, or oversleeping
Unplanned weight gain or loss
Suicidal thoughts, suicide attempts, or thoughts of death
Aches or pains including headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease with treatment
Depression Risk Factors
Several factors can contribute to depression including:
Genetic factors: People who have a family history of depression may be more likely to develop it than people whose families do not have a history of the disease.
Personal history: Older adults who had depression when they were younger are more at risk for developing depression later in life than people who did not have the illness earlier in life.
Brain chemistry: People with depression may have different brain chemistry than people who do not have the disease.
Stress: Situations such as the loss of a loved one or a difficult relationship can trigger depression.
Age: Depression can occur because of the changes that happen as you age. For example, some older adults have a condition called ischemia, which means restricted blood flow. With ischemia, the brain may not get the blood it needs to function. A condition called vascular depression can result, which also puts the person at risk for heart attack, stroke, or other hematologic disorders.
Depression can co-occur with other serious medical conditions such as diabetes, cancer, heart disease, and Parkinson’s disease. Depression can make these conditions worse. Sometimes medications taken for these physical illnesses can cause side effects that contribute to depression. Your doctor may be able to help find the best course of treatment with the fewest side effects.
What Caregivers Need to Know About Depression
It can be difficult to detect depression in your loved one. For example, grieving after the loss of a loved one is normal, and it oftentimes doesn’t require professional mental health treatment according to the National Institutes of Health.
If you notice that your loved one has signs and symptoms of depression, make an appointment with the doctor. Know what questions to ask your loved one’s doctor and go into your doctor prepared with notes about:
Any symptoms your loved one has even if they unrelated to the reason for your appointment. Write down when their symptoms started, the severity of symptoms, if they’ve occurred before, and the treatment for the symptoms.
Key personal information such as any major stresses or recent life changes
All medications, vitamins, or other supplements that your loved one takes. Be sure to include the medication’s dosage and the frequency at which your loved one takes them
Caregivers Can Also Experience Depression
It may be easy to forget about yourself when you spend so much time and energy on your loved one. Caregivers can experience depression, too. According to the Family Caregiver Alliance, many people with symptoms of depression don’t think they’re depressed. Caregivers may have unique concerns when it comes to their own depression including:
Dementia caregivers experience depression at higher rates. People who care for loved ones with dementia are twice as likely to suffer from depression than other caregivers. Dementia caregivers spend more time with their loved ones than other caregivers, and they may experience the following issues:
Physical and mental health issues
Less time to do the things they enjoy
Less time with other family members
Increased family conflict
Women experience depression at higher rates than men: According to the Family Caregiver Alliance, about 12 million women experience major depression each year, which is double the rate of men. Physical factors such as iron, vitamin D, and Omega-3 fatty acid deficiencies along with menopause and thyroid disease can contribute to depression.
Men experience depression differently than women. Men are less likely to report feelings of depression to their doctor, and they’re more likely to “self-medicate” with alcohol or other substances.
Depression can persist even after you place your loved one in a care facility. It can be stressful to move your loved one into a long-term care facility. Even though you may get some much-needed rest, you may feel guilty or lonely, which may contribute to major depression.
You can also look for online and in-person support groups that focus on the needs of specific caregivers. For example, some support groups are only for dementia caregivers.
Other caregiver resources include educational materials and respite care, which is when your loved one stays at a hospital or long-term care facility to give you a break. Medicare will cover respite care only if it’s a part of hospice care.
How to Prevent Depression
According to WebMD, doctors don’t know if it’s possible to “prevent depression altogether.” However, you may be able to keep it from returning if you’ve already had an episode. Some therapists use a treatment called mindfulness-based cognitive therapy (MBCT), which combines cognitive therapy with mindfulness.
According to the Mayo Clinic, cognitive therapy is a type of psychotherapy that helps the patient change negative thinking patterns that can come with depression. Mindfulness is the “self-regulation of attention with an attitude of curiosity, openness, and acceptance, according to Psychology Today.
Other ways to help prevent depression include changes to your lifestyle and nutrition habits. Even though there’s no guaranteed way to prevent depression, you can:
Find ways to improve your self-esteem and manage stress.
Reach out to friends and family during difficult times
Get regular medical check-ups and make a doctor’s appointment if you don’t feel right.
Treatment for Depression in Older Adults and Medicare Coverage
Even the most severe depression can be treated, according to NIA. Treatments often include therapy — usually talk therapy — and prescription drugs.
Depression can get a lot worse if you wait to seek help, so it’s important to talk to your doctor as soon as you notice something is wrong.
You can receive Medicare coverage for depression treatment if you are 65 or older, have ALS or ESRD, or have received SSDI for at least 25 months.
Medicare Part B may cover behavioral health services like psychiatrist or psychologist appointments. Counseling or therapy sessions may be limited because they are only covered under Medicare if your doctor accepts Medicare assignment. Behavioral health services can include:
One-on-one and group therapy
Substance abuse treatment
Active therapy (art, dance, music therapy)
Annual depression screening
Prescription drugs you cannot administer yourself
Original Medicare will cover these services at 80 percent of the Medicare-approved amount. This means you may pay 20 percent coinsurance after you meet the Part B deductible. For example, if your psychologist bills Medicare for $200, you’ll pay $40.
Other treatments for depression can include antidepressants, which are prescription drugs that can help ease symptoms of depression. Original Medicare does not cover prescription drugs. However, Medicare Part D or certain Medicare Advantage plans do.
Medicare Advantage policies are private insurance plans that can offer additional benefits to help treat and prevent depression such as depression screening, possible reduced therapy costs*, and fitness classes!
*A Medicare Advantage plan may offer coverage for therapy services. You may still owe a copay.
**You are still responsible for the Medicare Part B premium even if you have a Medicare Advantage or a Medicare Supplement plan.
Get Medicare Mental Health Coverage Today
Whether you need a Medigap plan, a Medicare Advantage plan, and/or a standalone Medicare Part D plan, a licensed agent with Medicare Plan Finder may be able to help.
Our agents are highly trained and they can help you assess your needs. Your agent can see what plans are available in your area and help you determine what’s right for you. Call 844-431-1832 or contact us here to set up a no-cost, no-obligation appointment.
The 9 Best Christmas Gifts for Seniors in 2020
Finding Christmas gifts for seniors may seem difficult. You may not know what to get, and you may run into the seniors in your life saying, “I don’t want anything.” That doesn’t make matters easier. We’ve put together a list of fun and useful gifts that the seniors in your life are sure to love.
1. Electric Tea Kettle
Electric tea kettles are easy-to-use and they can come with safety features such as automatic shut-off and cool handles. Automatic shut-off makes it so your favorite senior doesn’t need to remember to turn the kettle off after the water boils — the kettle does that for you. A cool handle means that you don’t have to worry about using hot pads when you’re pouring a cup.
Pro tip: Arthritic hands will do better with a small tea kettle. Large tea kettles are too heavy when they’re full of hot water.
2. Autobiographical Journals
Journals are a great way to preserve memories. With some journals, your loved one doesn’t have to worry about formatting. Some journals have questions that are organized into life sections such as past, present, and family history. The questions serve as a way to jog your loved one’s memory.
A journal is also a gift for you because you get to learn about your loved one’s experiences if they choose to share.
3. Book of the Month Subscriptions
This is the perfect gift for bookworms. With subscription services like bookofthemonth.com, your loved one gets to choose what books they want to read, and how often they want to receive new reading material.
When you log onto the website, you can browse the books of the month, which are separated by genre. The best part? You don’t have to ask a bookstore employee or browse online reviews for recommendations. The subscription service puts it all together and gives a synopsis of each title.
4. Smart Speakers
A smart speaker is a voice-activated device that can play music, answer questions, and give recipes. Many smart speakers such as the Amazon Echo, Apple HomePod, and Sonos One are easy-to-use and your loved one may enjoy the added sense of security that a smart speaker can bring. You can also use many smart speakers to make emergency calls.
5. Phone Case
According to PEW Research, 42 percent of seniors 65 and older have smartphones, and it makes sense. Smartphones are a great way to communicate with your friends and family, navigate to new locations, and take pictures & videos of grandchildren.
With all of the great features smartphones have, you’ll probably want to keep it in good shape. It can be extremely expensive to replace damaged parts if you drop your phone. For example, it can cost $279 to replace an iPhone 11 screen. A durable, protective case can help protect your loved one’s phone from damage. Look for a case with your loved one’s favorite pattern (camouflage, hound’s tooth, etc.) or their favorite sports team for a personalized touch.
6. Supplies for Your Loved One’s Favorite Hobby
Whether your loved one loves gardening, painting, or yoga, you can find supplies so they can keep up with their favorite activities. If your loved one enjoys spending time in the garden, look for gardening tool kits with trowels, spades, and clippers in a sturdy carrying case. See if you can locate brushes and paints for the artist in your life or a yoga mat for your favorite senior yogi.
An e-reader is a device that allows you to have an entire library of reading material in one spot. When you give your loved one an e-reader, you give them the opportunity to subscribe to their favorite periodicals and purchase new books from the comfort of their home.
Some seniors will want more features than e-readers provide such as browsing the internet, playing games, and watching videos. Those people will be better off with a tablet like an iPad. You can still purchase and store books and periodicals with a tablet, but you also get additional features.
Your loved one may enjoy the challenge of completing a daily puzzle from a book or they might want to frame their favorite 1000-piece jigsaw puzzle. You can even buy a custom photo puzzle with pictures of their grandkids or pets!
9. Great Experiences
Your favorite senior may have every material thing they could ever want or need. If that’s the case, get them tickets to a show, a sporting event, or a gift certificate to their favorite restaurant.
Alternatively, you can book a spa day so your loved one can relax. Some spas even offer geriatric massages! If you live close, go to the event with your loved one. Quality time can be worth much more than the price of admission.
The Best Christmas Gifts for Seniors Come From the Heart
Sometimes it really is the thought behind a gift that means the most. Your loved one will appreciate the time and effort you spent making sure that their Christmas is special. Check out our blog for more holiday health tips including healthy recipes and meal tips.
Does Medicare Cover Orthotics?
When you have foot problems, it may seem like every little movement you make causes excruciating pain. Even standing still can be difficult. Orthotics can provide relief for people experiencing orthopedic problems such as osteoarthritis, foot pain, or back pain.
Medicare is a great resource for eligible beneficiaries to help pay for medical expenses. Orthopedic care can come with a hefty cost, and you may want to know, “Does Medicare cover orthotics?” Yes, but only if your condition meets certain requirements.
Does Medicare Cover Orthotic Shoes or Inserts?
Orthotic shoes are custom-fitted footwear designed to reduce the patient’s pain for a variety of health conditions including:
Metatarsalgia: chronic pain in the ball of the foot
Plantar fasciitis: chronic breakdown of soft tissue around the heel
Bunions: a painful, bony bump on the outside of the big toe
For the most part, Medicare does not cover orthopedic or inserts or shoes, however, Medicare will make exceptions for certain diabetic patients because of the poor circulation or neuropathy that goes with diabetes.
Medicare may cover the fit and cost of one pair of custom-fitted orthopedic shoes and inserts once per year for those patients.
How Much Does Medicare Pay for Orthotic Services?
Podiatrists are doctors who specialize in the feet and ankles, and they prescribe and design medically orthotic devices. Orthopedic devices as part of a leg brace fall under Medicare’s guidelines for durable medical equipment (DME).
In order for Medicare to cover orthotics, your doctor must first determine that orthopedic care is medically necessary. Medicare Part B may cover about 80 percent of the Medicare-approved cost, and you may have to pay the remaining co-insurance. The company that supplies your DME must be Medicare-approved.
Does Medicare Cover Orthotics for Plantar Fasciitis?
Plantar fasciitis, also called “Policeman’s Heel,” is an often self-treatable and diagnosable ailment involving inflamed tissue on the bottom of the foot. You may feel stabbing pain near your heel. It can usually be treated with physical therapy, shoe inserts, steroid injections, and surgery in some cases.
Podiatrists often prescribe treatment for plantar fasciitis. If your doctor is able to prove that it is medically necessary and the prescription is required, you may be able to get coverage at the Medicare-approved amount. Additionally, there may be some Medicare Advantage plans in your area that provide coverage for orthotics for plantar fasciitis.
Does Medicare Cover Orthotics for Weight Loss?
According to the Hospital for Special Surgery (HSS), orthotics can help ease the extra stress on the feet for overweight people. Medicare does not cover orthotics for people who are overweight just because they are overweight.
Medicare may cover weight loss services such as surgery and/or nutrition counseling for people who qualify. Some Medicare Advantage plans even cover fitness programs!
You may also be able to get over-the-counter benefits with some Medicare Advantage plans. So, even though you may not qualify for prescription orthotic coverage, you may be able to find coverage for over-the-counter products you can find at your local drugstore or mail-order pharmacy.
Does Medicare Cover Orthotics After Hip Replacement Surgery
Sometimes doctors prescribe hip braces as a part of hip replacement surgery recovery. However, hip braces oftentimes don’t include a foot orthotic device. Medicare may help pay for the hip brace as part of your DME coverage, but coverage may not include an orthotic device.
According to Dr. James P. Ioli, DPM, a podiatrist with the Harvard Medical School, you should have a physical therapist assess your “pelvic, hip, knee, ankle, and foot movement” to examine how your “soft tissue restrictions [muscle and cartilage stiffness]” and flexibility contributes to your pain. The physical therapist can address your pain and make recommendations to manage it.
Does Medicare Cover Transportation for Orthotics Appointments?
If you don’t need an ambulance, some Medicare Advantage plans cover non-emergency medical transportation to doctor’s appointments, to the hospital, and to the pharmacy. Contact your agent to learn more about Medicare Advantage supplemental benefits.
Does Medicare Cover Podiatry?
While Medicare will only cover orthotics if they’re part of a leg brace or for diabetes, Medicare will cover treatment for the following conditions:
Morton’s Neuroma is irritation of nerves in the toe. One common sign of Morton’s Neuroma is numbness, and podiatric treatment for Morton’s neuroma includes using a metatarsal pad, cortisone injections and surgery in some extreme cases.
Plantar Fasciitis is when the plantar fascia tears. The breakdown causes severe pain with standing and walking. Patients usually experience the most pain first thing in the morning because the calf and foot muscles tighten up overnight.
Plantar Fasciitis treatment includes physical therapy for proper stretching exercises, wearing a splint at night and cortisone injections. If pain becomes severe, a podiatrist might recommend surgery.
The pain and stiffness associated with bunions usually worsen gradually. Podiatrists normally start small with treatment and prescribe bunion pads, toe spacers or shoe inserts. If those items fail, the podiatrist may recommend surgery.
Stress fractures occur after repeated blows to an area cause tiny fractures. Common causes of stress fractures include walking, running, frequent jumping and playing sports.
Most stress fractures will heal on their own after the patient walks with crutches or uses a walking boot. In some severe cases, the fracture won’t heal because it’s in a complex foot bone, and surgery will be the only course of action to correct it.
Peripheral Neuropathy is caused by nerve damage. The damaged nerves are unable to send the proper messages from the central nervous system to the rest of the body.
Peripheral Neuropathy causes the patient to experience pain, burning sensations, numbness, tingling, and weakness. Common Peripheral Neuropathy causes include:
Peripheral Neuropathy has no cure, and treatment only relieves the patient’s symptoms. The most common treatment for neuropathic pain is prescription drugs, but also topical creams, gels, and patches. In some cases, a cortisone sympathetic nerve block can provide temporary pain relief.
Medicare will only cover your treatment if your podiatrist says it’s medically necessary. Medicare Part B may cover 80% of the Medicare-approved costs. You will be responsible for the Medicare Part B deductible in order for Medicare to cover podiatry.
Podiatric Care Not Covered by Medicare
Medicare does not cover routine podiatry services, because CMS doesn’t consider them to be medically necessary. Some of those treatments and services include:
Foot cleaning and soaking
Removing corns and calluses
Treatment for flat feet
Get Medicare Coverage for Orthotics and Podiatry Today
Medicare will only pay for limited podiatric services, and having the right coverage can make all the difference in your quality of care. The licensed agents at Medicare Plan Finder are highly trained and ready to help you find a plan to suit your budget and lifestyle. Call us at 833-431-1832 or contact us here today.
This post was originally published on May 28, 2019, and updated on December 11, 2019.
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