Every year when the temperature drops, you begin to hear those dreaded words: flu season.
Not only does cold weather weaken our immune systems, it can strengthen viruses and make it easier for them to spread. No matter your age, vaccination may be the best safeguard against this bacterial onslaught. But adults over 50 are especially susceptible to the flu virus and many other dangerous infections like pneumonia and tetanus. An estimated 50,000 to 90,000 adults in the United States die from vaccine-preventable diseases every year and the mortality rates increase significantly as we age.
The Most Important Vaccines For Seniors
Luckily, in our current century, vaccinations are widely available for many of these potentially deadly pathogens and the Center for Disease Control recommends a schedule of specific vaccinations for older adults. And for seniors with certain types of Medicare, financial help may even be available to alleviate some of the costs of these immunizations. Here are the four most crucial vaccines for adults over 50.
Influenza (Flu) Shot
Influenza, commonly called the flu, is a viral respiratory infection that can be life-threatening for people of any age. But older adults must be especially cautious, as the normal aging of our immune systems can make it more difficult for our bodies to fight off the infection. It’s even more dangerous for those who live with a chronic condition like heart disease or diabetes, as complications can develop and even lead to hospitalization. In fact, according to the CDC, adults over 65 make up half of all influenza hospitalizations and between 70 to 90% of all flu-related deaths. Be sure to get your flu shot!
Pneumococcal Vaccine
Pneumococcal disease might not be a familiar household name but we have all heard of the conditions that it can lead to: pneumonia and meningitis among others. It is the most common cause of bloodstream infections and can infect the ear and sinuses as well. Like the flu, a weakened immune system and chronic conditions may increase these risks. While these infections can often be mild, pneumonia is actually the 5th most frequent cause of hospitalization in the United States and over half of those are from Americans over 65 years old.
Tetanus (Td) Shot
It’s often referred to simply as a tetanus shot, but the Tdap vaccine also helps our bodies fight off diphtheria and pertussis, or whooping cough. This particular vaccine can usually only be given once but if you never received it as a child, it’s not too late to get yourself immunized. But if those over 65 have already gotten the full Tdap shot, it is recommended that they seek the variety of vaccine called the Td shot every 10 years, which doesn’t include the pertussis component.
Shingles (Zoster) Vaccine
Herpes zoster (or shingles) is a painful skin condition brought on by the same virus that causes chickenpox. It’s common knowledge that individuals who have previously contracted chickenpox have a higher risk of developing shingles, but older people are also more vulnerable than their younger counterparts. Seniors are also more at risk for the complications that can arise from this infection, such as the painful nerve condition called postherpetic neuralgia (PHN). These kinds of complications occur in almost half of older adults who develop shingles.
When Should Seniors Get Vaccinated?
Though many vaccine-preventable diseases are associated with seasonal changes, most can be contracted at any time of year. To help make sure you are up-to-date with all your immunizations, the CDC keeps the newest recommended vaccine schedule for adults on its website.
Vaccine Schedule For Adults
Experts in this field often suggest vaccination schedules based on age. In some cases, these experts also recommend different varieties of a given vaccine depending on the age of the patient.
For example, flu vaccines are updated annually to make sure they are effective against the current strains of influenza. Additionally, the immunity provided by the flu shot is short-lived so it is best to get vaccinated every year. Flu vaccines are usually available from September through April depending on supplies. Several different forms of the vaccine exist including two designed specifically for people over 65, namely the “high dose vaccine” and the adjuvanted flu vaccine.
The shingles vaccine, on the other hand, is not required during a specific season but there are multiple variations available and it may still require a schedule to keep track of. The CDC suggests that healthy adults over 50 get the two-dose version of the vaccine, called the zoster recombinant vaccine (or RZV), as opposed to the single-dose zoster live variant. The two doses are generally spaced out over several months but are roughly 90% effective once they have both been administered.
Travel Vaccinations
Many seniors take up traveling after retirement has freed up more of their time. Wherever this trekking may take you, it is wise to stay up-to-date on your vaccinations. Certain vaccine-preventable illnesses like measles and seasonal flu are much more prevalent abroad than they are in the States. Check for your destination on the CDC’s website to see what vaccines may be needed where you’re going.
Now that you know when to get immunized, you might be wondering where you can get a quick, efficient, and affordable vaccination. This can get somewhat complicated depending on what vaccines you need and what state you live in but most vaccines can be administered at one of the healthcare facilities you visit regularly.
Doctor’s Office
Doctor explaining Medicare vaccine coverage.
Even though many other options are available, most will likely prefer to get their vaccinations at their regular doctor’s office. Your primary care doctor is a great resource not only for detailed information about what vaccines you or your family may need, but obviously for the administering of the vaccine itself. They can also advise on which variety of a given vaccine is best for you, as well as any side effects that may accompany it.
Pharmacies & Clinics
For many seniors, the most readily and easily available venue for vaccines is their local pharmacy. These establishments are usually closer to their homes than a doctor’s office or hospital and can provide many of the same vaccinations. It is probably best to call ahead to ensure the pharmacy or clinic is stocked with the vaccine you need as supplies can run low.
Medicare Vaccine Coverage
An often overlooked element of the threat posed by vaccine-preventable diseases is the financial cost. A 2007 study of the seasonal flu found that $87 billion was spent every year on direct and indirect medical costs. It also found that adults over 65 made up about 64% of that cost. Clearly, it is cheaper to get vaccinated than to potentially incur the medical expenses of treating the disease itself but if the cost of immunization still seems daunting, there are options available to help with or completely cover the vaccines.
Does Medicare Pay For Flu Shots?
Flu shots are completely covered by Medicare Part B, as they are categorized as a preventive service. As long as your healthcare provider accepts Medicare, your annual flu shot will be a cost-free benefit. For those who are enrolled in a Medicare Advantage plan, you may need to see an in-network doctor or pharmacy to be totally covered. This complete coverage applies to the pneumococcal vaccine as well!
Does Medicare Pay For Shingles Vaccine?
Medicare Part D plans, which are Medicare Advantage plans that cover prescription drugs, virtually all cover the shingles vaccine. As these are supplemental plans, an out-of-pocket cost is usually associated with these vaccinations. Whether this is in the form of a copayment or coinsurance, it is best to contact your insurance provider directly to discuss the potential out-of-pocket cost, as well as any specific rules they might have for the administering of the vaccine itself.
Turning 65 Checklist
Does Medicare Pay For Tetanus Shots?
Like the shingles vaccine, neither Td and Tdap versions of the tetanus shot are covered by Medicare Part B. These vaccines will need to be covered by an insurance plan that includes prescription drug coverage, such as Medicare Part D. These plans are purchased through private insurance companies and supplement the coverage provided by the original components of Medicare.
Depending on where you live, there could be countless Medicare Advantage plan options available and finding the one that best suits you can be exhausting and outright confusing. Take out some of the guesswork and get in touch with a licensed agent through Medicare Plan Finder today to find the best plan for your needs! Call us at 844-431-1832 or contact us online to get started!
Does Medicare Cover Mammograms and Other Women’s Health Services?
Medicare is not just for sick days! Did you know you could use your Medicare coverage for annual wellness exams, like check-ins with your gynecologist or OB/GYN? This post will tell you about all the ways women can use Medicare preventative benefits to stay healthy.
Does Medicare Cover Gynecology?
As long as you have an OB/GYN that accepts Medicare, your Medicare Part B gives you access to preventative women’s health care.
There are no exceptions – every woman enrolled in Medicare Part B has gynecology coverage. You should be taking advantage of these benefits! Remember that your Medicare is designed not just to help you in a time of illness or injury, but also to prevent those illnesses or injuries from occurring.
If you are enrolled in Medicare, your annual mammogram screening is covered 100% so long as your provider accepts Medicare. Diagnostic mammograms are covered at 80%, which leaves you responsible for the remaining 20% ($60 on average). Diagnostic mammograms are used if you have suspicious or concerning results from your annual mammogram.
A Medicare Supplement plan can help cover the additional costs of diagnostic mammograms and other services. Depending on which type of Medicare Supplement plan you purchase, benefits can include:
Part A coinsurance and hospital costs
Part B coinsurance and copayments
Blood work copays (up to three pints)
Hospice coinsurance and copayments
Skilled nursing facility coinsurance
Part A deductible
Part B deductible
Part B excess charges
Foreign emergency travel
These financial benefits can help with any of your health-related costs, not just mammograms. If you would rather pay a small monthly premium to help protect yourself from unforeseen health expenses, a Medicare Supplement plan may be right for you.
Medicare Advantage plans are required to cover, at a minimum, the same as Original Medicare. This means that your annual mammogram is still cost-free to you and diagnostic mammograms are covered at 80%.
However, Medicare Advantage plans can offer several additional benefits beyond Original Medicare that can help you maintain a healthy and proactive lifestyle. These benefits include vision, hearing, and dental coverage, monthly OTC pharmacy allowance, non-emergency transportation, group fitness classes like SilverSneakers®, and so much more! These plans have continued to grow in popularity each year, and more than 20.4 million beneficiaries are taking advantage of these benefits.
Medicare Mammogram Eligibility
To be eligible for preventive mammogram screening coverage, you need to be a woman enrolled in Original Medicare (Part A and B) or a Medicare Advantage plan. Men are not eligible for annual Medicare-covered mammograms. While it is possible for men to get breast cancer, it is very rare. That’s why most men are not eligible for preventive mammograms. However, men who are at high-risk can have diagnostic mammograms covered at 80%, just like women.
How Often Does Medicare Pay for Mammograms?
We know Medicare covers Mammograms, but how many? Medicare will cover one preventive mammogram per year. If your results are concerning or show you have a high risk of developing cancer, Medicare will continue to pay 80% for each diagnostic mammogram needed. There is no limit on how many diagnostic mammograms Medicare will cover.
Does Medicare Cover Gynecological Exams?
Gynecological exams and services covered by Medicare include:
Gynecological exams
Breast exams
Pap smears
Gynecological cancer screenings
Testing for HPV, HIV, and other sexually transmitted diseases
Treatment for pelvic and vaginal infections
Treatment for abnormal vaginal bleeding
Contraception counseling
Menstrual pain and irregularities
Menopausal management
Does Medicare Cover Pelvic Exams, Pap Smears, and Breast Exams?
Your Medicare gives you access to pelvic exams, pap smears, and breast exams. These tests check for cervical, vaginal, and breast cancer. Coverage is available for pelvic exams and pap smears once every two years. If you’ve had abnormal results in the past three years, you’ll be covered for yearly tests instead.
You’ll also be covered for clinical breast exams. Breast cancer is the most common cancer for women. Risk increases with age, and you can be cured much more easily if it is caught early on. Take advantage of free preventative care!
Additionally, you can ask your doctor for STI (sexually transmitted infection) screenings and counseling. Counseling is recommended for those who are at a higher risk. Part B covers yearly tests for the most common STIs – chlamydia, gonorrhea, syphilis, and hepatitis B, as well as HIV. STI tests are completely free with a doctor who accepts Medicare assignment.
Gynecologists Covered by Medicare
Are you ready to see a gynecologist? The best way to confirm that your gynecologist accepts Medicare as insurance is to ask when you set your first appointment, but there are tools you can use to find out who accepts Medicare before you start calling around.
Remember that if you have a Medicare Advantage or Medicare Supplement plan, you may want to check to make sure that the doctor accepts your plan. If you only have Original Medicare (parts A and B), you can use the Medicare.gov physician finder tool to look for gynecologists in your area who accept Medicare.
To start, enter your location and the phrase “gynecologist” or “ob/gyn” in the search bar. The tool will not let you enter the type of doctor you’re looking for until you’ve entered your location.
Medicare.Gov Physician Finder Tool
After clicking the green “search” button, you’ll see a list of doctors in your area who accept Medicare for gynecology. The tool will tell you where they are located, how far they are from the location you entered, etc.
Medicare.Gov Physician Finder Tool
Get Women’s Health Coverage
Fortunately, Original Medicare covers most women’s health needs. However, Medicare Advantage and Medicare Supplements can supplement your Original Medicare coverage. If you are looking for additional health benefits through Medicare Advantage or financial benefits through Medicare Supplements, our licensed agents can help. They are contracted with all the major carriers so they can enroll you in a plan without bias. With Medicare Plan Finder, there’s never an obligation to enroll and appointments are always cost-free to you. Fill out this form or give us a call at 844-431-1832.
This blog was originally published on July 20, 2017 and last updated on October 3, 2019 by Anastasia Iliou.
A Guide to Osteoporosis Medicare Coverage
Osteoporosis literally means “porous bone”. It’s characterized by low bone mass and deteriorating bone tissue and it leads to fragile bones and an increased risk of hip, spine, and wrist fractures.
According to the International Osteoporosis Foundation (IOF), more than 61 million people will be affected by osteoporosis or low bone density by 2020. If you’re one of those millions of people and you have Medicare, you may wonder about osteoporosis Medicare coverage and what you can do to help your bone health.
Osteoporosis Medicare Treatment and Testing Coverage
Osteoporosis Screening Medicare | Medicare Plan Finder
Original Medicare covers certain preventive services and treatments for osteoporosis.
Does Medicare Cover Bone Density Tests?
As part of Medicare’spreventive care program, Medicare Part B may cover one bone density test every two years—more often if the tests are medically necessary—if you meet one or more of the following conditions:
You’re a woman whose doctor determines you’re at risk for osteoporosis, based on estrogen deficiency, your medical history, and other risk factors
Your X-rays show possible osteoporosis, osteopenia, or spine fractures
You take prednisone or steroid-type drugs or you plan to start
You have primary hyperparathyroidism
You’re monitored to see if your osteoporosis drug treatment is working
Does Medicare Cover Prolia Injections and Other Osteoporosis Drugs?
Original Medicare (Part A and Part B) may help pay for an injectible drug for osteoporosis (Prolia, Reclast, or other drugs) and visits by a home health nurse to inject the drug if you meet the following conditions:
You’re a woman.
You’re eligible for Part B and qualify for Medicare home health services.
You have a bone fracture that a doctor certifies is related to postmenopausal osteoporosis.
Your doctor certifies that you’re unable to learn to give yourself the drug by injection and your family members and/or caregivers are unable and unwilling to give you the drug by injection.
You may owe coinsurance and/or deductibles. You may be responsible for paying other services in full if Medicare doesn’t approve them.
Prolia Finder
If you don’t know where to get started looking for Prolia, click here. That will lead you to the Prolia finder tool. Enter your zip code in the box above the blue arrow. We used our home office in Nashville, Tennessee’s zip code, which is 37209.
Then select “Pharmacy Site” in the drop-down menu above the red arrow. Then click “Find Locations” beside the yellow arrow. That will lead you to a list of pharmacies where you can find Prolia. You may have to contact more than one to find the right facility for you.
The next step is going to your pharmacy and picking up your medication. You may owe Part D or Medicare Advantage drug fees. Once you obtain the medication, make an injection appointment with your healthcare provider.
You can also receive an injection at a Prolia treatment site, which you can find using the same Prolia finder tool.
To find a treatment location, go through the same steps to find a pharmacy site, except select “Treatment Site” from the drop-down menu above the red arrow. After you click “Find Locations” you’ll reach a list of Prolia treatment sites and contact information. Again, you may have to call more than one to find the best fit.
Medicare Coverage for Other Osteoporosis Drugs
In most cases, Original Medicare doesn’t include prescription drug coverage. If your doctor prescribes ibandronate (Boniva), alendronate (Fosamax), and/or risedronate (Actonel, Atelvia) and you want Medicare coverage, you’ll need to enroll in either a Medicare Part D plan or a Medicare Advantage plan with a prescription drug benefit.
How to Increase Bone Density at Home
Along with taking your prescribed medications, there are many things you can do to help increase your bone density at home. According to the National Osteoporosis Foundation (NOF), you can protect your bones by exercising, eating right, avoiding tobacco, and limiting alcohol.
Exercises for Osteoporosis
The two most important types of osteoporosis are weight-bearing and muscle-strengthening exercises. Both types of exercises can help build and maintain bone density. As always, you should check with your healthcare provider before starting any exercise program.
Weight-Bearing Exercises
Weight-bearing exercises include activities that make you move against gravity while staying upright. Weight-bearing exercises can be high-impact or low-impact.
High-impact weight-bearing exercises help build bones and keep them strong. However, you may need to avoid high-impact exercises if you have a broken bone.
Some examples of high-impact weight-bearing exercises:
Dancing
High-impact aerobics
Hiking
Jogging/running
Jumping Rope
Stair climbing
Tennis
Low-impact weight-bearing exercises are also effective at keeping bones strong. They’re also a safe alternative if you can’t do high-impact exercises.
Some examples of low-impact weight-bearing exercises:
Using elliptical machines
Doing low-impact aerobics
Using stair climbers
Brisk walking on a treadmill or outside
Muscle-Strengthening Exercises
Muscle-strengthening exercises use a weight or some other resistance to push or pull against gravity. They are also known as resistance exercises and include:
Lifting free weights
Using weight machines
Using elastic exercise bands (resistance bands)
Lifting your own body weight (pull-ups, pushups, etc.)
Functional movements that you use in daily life, such as standing from a sitting position
Yoga and pilates can also help improve strength, balance, and flexibility. However, certain positions may not be safe for people with osteoporosis or low bone density. If you have questions about the safety of an exercise, consult your doctor or physical therapist.
Medicare Fitness Coverage
Medicare Fitness Coverage | Medicare Plan Finder
Original Medicare does not cover gym memberships or fitness classes. However, certain Medicare Advantage plans offer coverage for fitness classes along with other supplemental benefits such as dental, hearing, and vision coverage.
A licensed agent with Medicare Plan Finder may be able to help you find a plan that suits your needs. Plans vary by zip code, but some Medicare Advantage with fitness benefits have $0 premiums. To set up a no-cost, no-obligation appointment, call 844-431-1832 or contact us here.
Diet for Osteoporosis
Diet for Osteoporosis | Medicare Plan Finder
According to NOF, a “balanced diet that’s rich in calcium and Vitamin D” is important for your bone health.
NOF says the following foods are good for your bones because they may contain nutrients such as magnesium, potassium, Vitamin C, and Vitamin K along with Vitamin D and calcium:
Dairy Products
Low-fat milk, yogurt, and cheese
Non-fat milk, yogurt, and cheese
Fish
Canned sardines and salmon (with bones)
Fatty varieties such as salmon, mackerel, tuna and sardines
Fruits and Vegetables
Artichokes
Bananas
Beet greens
Broccoli
Brussels sprouts
Chinese cabbage
Collard greens
Dandelion greens
Kale
Mustard greens
Okra
Oranges
Papaya
Pineapple
Plantains
Plantains
Potatoes including sweet potatoes
Red peppers, green peppers,
Spinach
Tomato products
Turnip greens
Fortified Foods
Some food manufacturers add Vitamin D and calcium to products such as cereal, juice, and bread. Always check the product’s label to see exactly what’s in the container.
Find Osteoporosis Medicare Coverage Today!
Talk to one of our agents if you want to learn more about Medicare’s coverage for osteoporosis. Our licensed agents are highly trained and they may be able to help you find a plan that fits your budget and lifestyle.
If you’ve been diagnosed with low bone density or osteoporosis, you may need treatment as quickly as possible. One of our agents can show you what’s available in your location. Call 844-431-1832 or contact us here to arrange a meeting now.
Contact Us | Medicare Plan Finder
BREAKING NEWS: Tennessee SilverSneakers® Program Splits from YMCA
SilverSneakers® announced on Tuesday, September 17, that the Tennessee State Alliance of YMCAs decided to leave the SilverSneakers® network effective January 1, 2020, citing financial disagreement.
The alliance apologized, stating, “Seniors are a vital part of our membership, and we apologize for any inconvenience this decision may cause. Tennessee Ys are committed to continuing to serve seniors in our community.”
SilverSneakers® is a Medicare fitness program that allows eligible Medicare beneficiaries access to gyms, fitness centers, and classes. Many of these often take place within YMCAs, offering not only physical fitness benefits but also a social atmosphere.
Eligibility for the program is simple – anyone who is age 65 or older and has a private Medicare plan that includes the SilverSneakers® benefit can join.
Watch this brief video to learn more about Medicare fitness programs:
The news that SilverSneakers® may not cooperate with Tennessee YMCAs anymore may be detrimental to seniors who made use of that benefit. If you’re one of those people, what should you do next?
What to do if You’re Losing Your YMCA SilverSneakers® Benefit
If you have SilverSneakers® but are no longer going to be able to visit a YMCA with your membership, all hope is not lost! There are a few steps you can take:
Pay for your own senior YMCA membership ($59/month in Middle TN. Prices range based on location)
Find a plan that has Silver & Fit® instead (another Medicare fitness program that is very similar to SilverSneakers® but still works with YMCAs as of September 2019)
Silver & Fit vs. SilverSneakers
Other Gyms You can Visit with SilverSneakers ®
Tivity Healthcare, the company that operates the SilverSneakers® program, wants to make it clear that there are still over 350 facilities in the state of Tennessee that SilverSneakers® members can use. Planet Fitness, Gold’s Gym, Anytime Fitness, and Workout Anytime as well as a variety of community centers are still part of the SilverSneakers® network in Tennessee and may be a great option for you.
Planet Fitness
Planet Fitness locations across the state of Tennessee offer benefits like massages, tanning, and even discounts on travel and Reebok products. Most locations have long hours, and some are open 24-7. Many of them also have free WiFi!
Gold’s Gym
Gold’s gym locations offer group exercise classes, personal training, and more. Group exercise classes include Yoga, Zumba, Mixed Martial Arts, Group Cycle, and High-Intensity Interval Training.
Anytime Fitness
Different Anytime Fitness locations offer different equipment such as treadmills, ellipticals, cycles, stair climbers, rowing machines, weights, kettlebells, etc. They also offer different classes like Zumba, cardio, yoga, and additional services like tanning, private showers, wellness programs, and personal training.
Workout Anytime
Workout Anytime locations have high-quality equipment from Matrix Fitness, which has received rewards for innovation. They also have high-quality polypropylene, antimicrobial flooring that is beautiful, comfortable, and clean.
If you decide that you would rather stick to a YMCA membership and do not want to try out some of the other SilverSneakers® locations options, a licensed agent can help you find a plan that includes Silver & Fit® instead.
Silver & Fit® is similar to SilverSneakers® and includes a digital resource library, home fitness kits, community activities, and several different fitness classes at various fitness centers in Tennessee.
Silver & Fit® locations across major cities in Tennessee are listed below:
To find a plan that includes Silver & Fit®, call 844-431-1832 or send us a message. We’ll connect you with a licensed agent in your area who may be able to help you make the switch.
How Mail Order Prescriptions Can Save You Time and Money
Did you know that you can order your prescriptions online and save money? That’s right – no more rushing to get to the pharmacy on time or having to ask someone to pick up your prescriptions for you. You may even be able to schedule your prescriptions to deliver exactly when you need them with automatic refills!
Pros and Cons of Mail Order Pharmacy
Using a Mail-Order Pharmacy | Medicare Plan Finder
Ordering prescriptions from a mail order pharmacy comes with pros and cons.
Pros
Time Saving: You can save hours by not having to make monthly, weekly, or daily trips to the pharmacy. All you’ll have to do is click a button and wait to receive your medications – no standing in line, no rushing to get to the pharmacy.
Cost Saving: You can save money on gas and help minimize wear and tear on your car. Using a mail order pharmacy eliminates the need to travel.
Automatic Refills: Most mail-order offer an automatic refill option. This is great for people who forget to have their prescriptions refilled or pick them up. Some pharmacies will even call your doctor to renew your prescriptions!
Cons
Waiting for Prescriptions: Even though you can order your prescriptions with the click of a button, you still have to wait for your prescriptions. That can be a drawback if you need your prescription immediately.
Prescriptions Can Be Lost: It’s rare, but sometimes prescriptions can be lost in the mail. However, most mail-order pharmacies will re-ship your medication at no additional cost. If you’re concerned about package theft, it may be in your best interest to pick up prescriptions in person.
Automatic Refills: Having your prescriptions refilled automatically can be both a pro and a con. If you’re someone who usually sets and forgets, you could end up with a lot more pills than you need!
The Delivery Fee
Contrary to popular belief, most mail order prescriptions can be delivered without a shipping fee! If delivery fees are what was holding you back from using an online pharmacy, you can check that off your list. Pharmacies don’t have to charge a shipping fee because mailing your prescriptions can actually save them money.
They don’t have to pay for the time and labor it takes to stock prescriptions in-store and they can ship to you directly from a warehouse. There may be shipping fees associated with medical equipment and supplies, but most prescriptions can ship free.
When Should I Stick to my Local Retail Pharmacy?
There are only a few downsides to mail order prescriptions. Mainly, you will lose out on the face-to-face interaction with your pharmacist. However, you can always call your pharmacist to ask questions or speak to your doctor instead.
Your local retail pharmacy, like a CVS or Walgreens, can delivery your prescriptions to your door as well. If you are comfortable using your local retail pharmacy instead of searching for a new mail order pharmacy, stick to it instead of trying to fix what is not broken.
When Should I Expect to Receive my Prescription?
Some prescriptions may take up to 14 days to arrive at your door, so you may still need to visit your pharmacy in person to get your cold medicine and other immediate needs.
Long-term prescriptions, though, can be automatically mailed when you need them. If you work with your pharmacy to set up auto-refills, you should receive your prescription in the mail well before you need it so that you never run out of your medication.
Top Mail Order Pharmacies
It’s always a good idea to start by checking if your health plan has its own mail order pharmacy. Many carriers do, and they can save you a lot of money that way! For example, Cigna just merged with digital pharmacy Express Scripts. You can also check with your favorite drugstore chain. CVS, Walgreens, and Publix are just three examples of chains that offer prescription delivery services. You can also consider the following:
Blink Health – What’s unique about Blink Health is that you can have your prescriptions delivered to your home, or you can pick them up from a local participating pharmacy. Either way, you can see the prices before you buy and choose the cheapest and easiest option for you.
EnvisionPharmacies – Envision is divided into three parts. Envision Mail is a typical mail order prescription service, EnvisionSpecialty provides patient, caregiver, and provider support, and Envision Compounding is quite different. The compounding sector creates alternative forms of medications and sends them to patients who cannot swallow pills or have unique allergies.
HealthWarehouse.com – Selling both brand name and generic prescriptions for both you and your pets! Over the counter drugs, diabetic supplies, and home medical equipment is also available. Just create an account and ask your doctor to send your prescriptions to HealthWarehouse.
PillPack – Not only does PillPack allow you to order your medications online, but they can also sort your pills by dose for you. For example, if you both Drug A and Drug B at 8 AM every day, and you take Drug C at both 8 AM and 8 PM every day, you’ll receive two packs for each day: one that contains Drug A, Drug B, and Drug C and is labeled “8 AM,” and one that contains Drug C and is labeled “8 PM.” They are dated so that you won’t lose track. PillPack is now owned by Amazon.
How to Find a Safe Online Pharmacy
Any pharmacy your Medicare plan recommends will likely be legitimate. However, there are many fake online pharmacies that will try to scam you. They appear to be legitimate pharmacies but they actually send fake drugs.
To help raise awareness about these fake online pharmacies, the Food and Drug Administration (FDA) launched BeSafeRx. According to the FDA, a legitimate pharmacy will:
Require a valid prescription from your provider
Be licensed by your state board of pharmacy, or equivalent state agency. (To verify a pharmacy’s licensing status, check your state board of pharmacy.)
Have a U.S. state-licensed pharmacist on staff and on call to answer your questions
Be located in the United States, and provide a physical street address, not just a post office box
How to Report Illegal Medicine Sales
If you become aware of unlawful medicine sales, you can report the rogue pharmacy with the FDA. Fill out the form here with as much detail as possible.
How is my Insurance Plan’s Mail Order Pharmacy Different From Other Online Pharmacies?
Excellent question! Not every insurance plan has its own Medicare mail order pharmacy, so it is important to check your coverage and be sure that you have access to mailed prescriptions.
Additionally, some insurance plan mail order pharmacies are limited in what they can offer, while private online pharmacies operate independently and can function just like a brick and mortar drug store.
Compare Prescription Costs
Even if you don’t want to use the internet for ordering prescriptions and having them delivered, you can at least use it to view drug prices. GoodRx is a leader in drug price tracking. All you have to do is type in the name of the prescription drug you need, and GoodRx can tell you what pharmacy has the best price! You can also use GoodRx to print free coupons and save as much as 80% on some drugs!
GoodRx Prescription Finder Tool
To use GoodRx’s prescription finder tool, click here. Then type your prescription in the search bar. We’re using atorvastatin (Lipitor) for demonstration purposes, but you can use any medication you want prices for. Then click “Find the Lowest Price” beside the red arrow.
Prescription Finder Step 1 | Medicare Plan Finder
Then you’ll come to the price list with several pharmacy options.
Prescription Finder Step 2 | Medicare Plan Finder
Prescription Savings Coupons
When GoodRx, mail-order prescriptions, and your Medicare coverage aren’t enough, there are prescription drug discount cards! Since these cards are not part of Medicare, you can sign up for a card at any time. Having a prescription drug savings card is sort of like having a coupon book.
There may be times when you don’t need your Rx card because your Medicare coverage gets you even bigger savings, but there are other times when your card can save you a lot of money!
Free Prescription Discount Card
Get Medicare Mail Order Pharmacy Coverage Today
Do you have a Medicare Advantage or a Part D prescription drug plan? Do you know if you qualify for LIS, a prescription drug savings program for Medicare beneficiaries? We can help answer your questions and make sure you are getting the best benefits at the best price, and make sure you are eligible for mail order prescriptions.Set up an appointment at no cost to you by calling us at 844-431-1832 or contact us here.
Contact Us | Medicare Plan Finder
*This post was originally published on February 8, 2018 and last updated on September 23, 2019.
How to Find the Right Geriatric Doctor
Finding an internal medicine doctor you really connect with can be difficult, and finding the right geriatric doctor, or geriatrician, can be even more difficult. You must have confidence in your provider’s ability to treat your conditions or to refer you to other providers with extensive experience working with older adults.. Your health is the most important thing you have, and you need a doctor you’re comfortable with.
What to Look for in Geriatric Doctors
All geriatric doctors specialize in the diagnosis, treatment, and prevention of disease and other medical or chronic conditions common to seniors. You want healthcare providers who know how to treat your population and provide quality care plans. However, a doctor’s area of focus is just one thing you should look for. You also want to find a doctor that you can feel comfortable with.
It’s important that you feel comfortable asking questions about personal health concerns and that you can trust that your doctor is listening. You should feel like your health is as important to your doctor as it is to you.
The right geriatrician will take pride in providing the best quality of care possible. You should feel like your doctor thinks of you as a whole person, not just a list of conditions and symptoms.
Your geriatrician should be capable of finding solutions to your health problems. For example, let’s say you get sick one day, so you go to the doctor. Your doctor diagnoses your health condition and prescribes a medication he or she thinks is best. You should have follow-up appointments to assess how the medication works, and your doctor should be committed to finding a prescription that works if the first one doesn’t.
A good place to start is to find out what other patients say about doctors in your area. Talk to friends, family, and caregiver if you have one to see if they like their geriatricians. Ask for recommendations from healthcare professionals you know and trust.
Look at doctor reviews on websites such as Healthgrades.com and read Google reviews. When you look for reviews on Google, also search for the doctor’s name and see if he or she is in the news. If his or her name pops up with a long history of legal trouble, you should move on.
How a Medicare Advantage Plan can Help
Look for a doctor who takes your insurance. If you have Medicare, you have a great resource to receive quality healthcare. However, Original Medicare doesn’t always approve every charge, and Medicare Parts A and B can be limited in what they cover.
That’s where Medicare Advantage (MA) plans come in. MA plans come from private insurance carriers and they can cover a lot of services Original Medicare does not. Medicare Advantage plans can cover a range of services including meal delivery, hearing, vision, and even fitness classes. Some plans even include prescription drug coverage!
There may be many MA plans to choose from in your area, and a great way to find out what’s available is to talk to a qualified professional who can help you find the right plan. You won’t lose your Original Medicare coverage if you enroll in a MA plan, and the “extras” your doctor recommends, like physical activity or home health devices, may be covered.
What if I’ve Already Found a Geriatric Medicine Doctor I Like?
Maybe you’ve found a doctor you like, and he or she decides to stop taking your insurance plan. If you have a Medicare Advantage plan, you may have to wait until the Annual Enrollment Period (AEP) to make changes to your plan unless you qualify for a Special Enrollment Period (SEP). If you want to stick with your doctor and are willing to wait until the AEP, which is every year from October 15 to December 7, find out what MA insurance plans your doctor accepts.
Usually, your doctor will give you a list of carriers he or she accepts, and Medicare Plan Finder benefits advisors have access to many different plans and carriers. Your benefits advisor will work with you to find a plan that will allow you to keep your geriatric doctor.
What is the Difference Between a Geriatric Doctor and a Regular Doctor?
Geriatricians provide primary care for seniors who have complicated medical issues. Age is not the only factor that causes people to need geriatricians. For example, an 80-year-old who is active and only takes a couple of medications doesn’t need to see a geriatrician, but a 65-year-old who has diabetes and heart disease does.
Your geriatric care will involve a team of medical professionals that will provide a comprehensive healthcare plan. You’ll work with your primary geriatric doctor, and often times a social worker, physical therapist, and/or a nutritionist depending on your needs.
If a doctor does not specify that they are a geriatric doctor, that does not necessarily mean that they do not work with older patients. However, doctors who do call themselves geriatric doctors typically have studied geriatrics and are more specialized in that area.
Geriatric Doctor
When You Should Find a New Doctor
If you feel like your doctor refuses to answer your questions, it may be time to find a new one. Your doctor has a responsibility to listen to you and answer your questions. If you say you’re concerned about a recommended procedure, your doctor should ask why. Your doctor should be able to ease your concerns and make sure you’re comfortable.
You should also find a new geriatrician if the office staff is unprofessional. If they don’t do their due diligence and provide you with all of the information you need, your health could be at serious risk. Your doctor and the office staff should have great communication skills. Look for a new doctor if your geriatrician doesn’t communicate with the rest of your care team, Your doctor should respond to you within a reasonable timeframe.
How to Find a New Doctor
The first step you should take when looking for a new doctor is to look for recommendations. Ask your friends and family members if they have a doctor that they like. Then, you can call that doctor’s office to verify that they accept your insurance.
If you don’t have any good recommendations, you may want to use an online search tool to find a doctor that accepts your plan.
Your plan might have a search tool of its own. That would be a great place to start because you know for sure that the information will be as up-to-date as possible. You can be sure that the doctors listed there will accept your plan (though it is always a good idea to call the doctor and ask before you set your first appointment).
Medicare.Gov and ZocDoc are two other great tools you can use.
Medicare.Gov’s Physician Finder Tool
Medicare.Gov is a great place to start because it will tell you which doctors accept Original Medicare (Parts A and B). If you have a private plan like Medicare Advantage, be aware that just because a doctor accepts Medicare does not necessarily mean they will accept your private Medicare Advantage plan.
All you have to do is visit medicare.gov/physiciancompare and enter your location and the type of doctor you are looking for.
You may be asked to select exactly which type of doctor you are looking for. Then, you’ll see a list of doctors who accept Medicare near you. You can filter by board certification, group affiliation, male/female doctors, distance, and whether or not they accept Medicare-approved payment (meaning you won’t be billed for more than the Medicare deductible and coinsurance).
ZocDoc is another great online tool for finding doctors near you, and it includes reviews! There is also an appointment scheduling feature so that you can book an appointment without having to call the office.
You can filter your search by the procedure you need as well as by appointment time, languages, gender, hospital affiliations, etc.. To show you how that works, we used our home city of Nashville and “primary care” as an example. Notice how we selected “Medicare” as our form of insurance.
Having the right geriatric team and insurance plan is paramount to having the best overall health possible. The team at Medicare Plan Finder can help you navigate the Medicare plans out there and find the best fit. Call us at 800-691-0473 or contact us here today.
Contact Us | Medicare Plan Finder
This blog was originally written on May 17, 2019, by Troy Frink and updated on September 19, 2019, by Anastasia Iliou.
4 Things No One Wants to Tell You About Getting Older
While many seniors will tell younger people to enjoy their youth, your senior years can be a great time to look forward to. In many cases, you’ll have more time to spend with family and friends, more time for hobbies, and more time to relax.
Getting older also presents some challenges, like declining health and mobility limitations (It’s these challenges that cause many seniors to recommend against aging…).
Aging is a natural process, however, and not something to be worried about or scared of. Instead, it’s something to prepare for.
Consider the challenges that aging presents so that you can age gracefully and get the most out of your final years.
Here are four things to prepare for as you get older:
Metabolism and weight changes
Cognitive decline
Vision and hearing loss
Increasing vulnerability
Metabolism and Weight Changes
As you get older, your metabolism slows down. A slower metabolism makes it easier to gain weight. It’s more important than ever to commit to some kind of daily exercise and physical activity. Consistent exercise can help boost your metabolism and keep a good range of mobility.
Keeping your metabolism in mind, pay attention when your body tells you it’s full. You may not need to eat as many calories as you did when you were younger. Listening to your body will help you eat the right amount.
Eat a good diet with plenty of fruits and vegetables. This will help ensure that your body gets all the nutrients it needs to function properly. Try this 28-day Healthy Living Challenge to do more for your health.
Your cognitive abilities need to be kept in good shape during your early senior years. You can do mental exercises that help keep your mind sharp and engaged.
It’s also important to take this time to prepare for a day when you may lose some of your normal cognitive abilities. Get your finances in order.
What account information would a caretaker need? Put it all in one place. It’s worth having a hard copy. Let the people you trust know where it is.
It’s also worth sitting down with a trusted attorney to put together a will and make decisions on how your finances will be handled if you become unable to manage them yourself.
As you’re getting your finances in order, put in place safeguards that make it harder for you to be a victim of scams or fraud.
Is there a trusted person you have to call before making big financial decisions? What if you can’t reach that person? Are there withdrawal limits or other things you can add to your accounts so that even if you attempt to hand over your hard-earned money, you can’t?
Putting some safeguards in place early can help you stay financially stable throughout your senior years.
Vision and Hearing Loss
As you age, your body starts to wear down because it’s been living a full life. You may experience some vision and hearing loss. It’s important to have your eyesight and hearing checked regularly.
If you notice you’re squinting a lot, can’t see much in the distance, or are zooming in to see things better on your screen, schedule an appointment with your doctor. Your doctor can test your eyesight, prescribe glasses, or even recommend surgeries to improve your vision.
If you have hearing loss, you may need to get hearing aids. A doctor can check your hearing to see what your needs are and work to prolong your hearing.
As you age, you become increasingly vulnerable in many aspects. Seniors can be more vulnerable financially to frauds and scams. Physically, seniors get sick more easily and may take longer to recover. It’s important to maintain good hygiene and wash your hands before meals.
To keep yourself from getting sick, don’t spend time with people who are contagious, especially during the winter. If a friend or family member is sick, send a card instead of visiting.
If you are aware of potential health issues in your family history or from your own medical history, see a doctor regularly. Regular checkups make it easier for doctors to advise preventive measures that can prevent bigger problems down the road. The earlier doctors catch a problem, the easier it is to resolve.
Preparing for Your Senior Years
There’s no reason you shouldn’t live your senior years to the fullest. Keep taking care of your body with good nutrition and exercise.
Take time to prepare for a day when you’re no longer able to be as independent as you once were — put your finances in order, finalize your will, and have crucial conversations with loved ones.
Pay attention to how your body is changing. Have regular doctor’s visits and be open with your doctor. The sooner an irregularity or problem is noticed, the faster and simpler it can be to fix.
Taking care of yourself and preparing for the future will help you have peace of mind and enjoy your golden years.
5 Ways to Boost Brain Health for Seniors
It’s perfectly natural to lose some mental “processing speed” as we age. This process is called cognitive aging and usually starts as soon as we reach adulthood. While certain brain functions like vocabulary might even improve as we get older, others will gradually decline. A common list of cognitive changes in elderly people typically includes slower problem solving, diminished spatial awareness, and a decline in perceptual speed and memory.
Most of these aging brain symptoms are entirely normal but the rate of this decline may increase, leading to MCI (mild cognitive impairment) or even dementia. However, scientific research has uncovered several methods proven to help maintain elderly brain health and most of them are simple things you can do in your day-to-day life!
Staying Active At Any Age
The connection between exercise and brain health for seniors has long been established. But new studies are suggesting that staying active may be the best way to prevent memory loss in old age! While it might be most effective before severe memory loss begins, it also appears to benefit those with advanced conditions like Alzheimer’s or vascular dementia.
Seniors who exercise regularly can experience reduced inflammation, improved blood flow, and even increased growth of new blood vessels in the brain. An active lifestyle can also improve the quality of sleep, which we will see later is another crucial factor in maintaining brain health. In fact, sustaining a moderate regimen of low impact exercises from six months to a year has even been associated with increased volume in the prefrontal and medial temporal cortices, the parts of the brain responsible for memory and critical thinking!
Medicare Fitness Programs
Unfortunately, the research also indicates that exercise must be a regular commitment in order to see some of these amazing benefits. But dedicating at least three hours a week can be difficult for seniors who don’t have access to a gym. This is where Medicare plans that include fitness programs can help. Plans can include Medicare fitness programs Programs like SilverSneakers® and Silver&Fit® that are designed specifically for seniors and can provide access to fitness and exercise centers. Some may supply their less mobile members with home fitness kits.
Many of us probably remember our mothers extolling the virtues of “brain food.” Turns out she was right! A diet consisting of mostly fruits, vegetables, nuts, beans, and fish has been closely linked to brain health and a lower risk of dementia. This “Mediterranean diet” is also often touted for its positive effects on heart health and cardiovascular risk factors, which can indirectly influence the health of the brain.
In addition to a more healthy diet, many seniors take supplements to get a higher dose of these crucial ingredients than can be found in the foods themselves. Some of the most popular include fish oils like omega-3 fatty acids, antioxidants such as resveratrol, as well as creatine and even caffeine.
Companies have begun producing memory supplements targeted at seniors. Some of these include:
Brainol (includes 19 ingredients for improved cognition, like B-Vitamins, Huperzine A, L-Theanine, and DMAE.
Neurofuse (includes B-Vitamins, L-Theanine, DMAE Bitartrate, and Huperzine A.)
Irwin Naturals Brain Awake (includes Vitamin B6 and L-Theanine)
BriteSmart (includes Huperzine A)
While memory supplements are not typically covered by Medicare, some Medicare Advantage plans might have an OTC (over the counter) allowance benefit which would allow you to purchase supplements. Click here to read more about OTC benefits in Medicare.
One of the easiest methods for seniors to maintain mental acuity is daily brain training. This interactive practice can take on many forms, from crossword puzzles to arts and crafts. And now more than ever, there are services and applications specifically designed to give you your daily dose of critical thinking.
Activities for Alzheimer’s Patients at Home
There are countless ways for seniors to get their brains engaged on a daily basis. Many are things you might already enjoy, including puzzles or card games. In the technological age, of course, many of these activities can be done on a computer or smartphone.
In addition to these traditional games, there are many apps that are designed specifically as activities for seniors with dementia and Alzheimer’s. Apps like Lumosity are great for challenging your brain on a daily basis and some, such as Mindmate, even include exercise and nutrition tips. A cursory Google search may also help you find other free brain games for seniors.
Some doctors suggest that one of the best ways to retain memory and cognitive functioning is to remain engaged with a social group. Many seniors use social media to stay in touch with family and friends and there are even apps like Timeless that are designed to help people with dementia or Alzheimer’s stay social.
Clear Your Mind (And The Rest Will Follow)
The importance of everyday factors like stress and sleep on brain health for seniors shouldn’t be overlooked, especially for the elderly. A good night’s sleep will clear the brain of toxins that accumulate throughout the day like beta-amyloid, a protein which is also commonly found in Alzheimer’s patients. Stress can also play a huge role in how the brain functions by introducing high levels of cortisol and even possibly reducing the size of the prefrontal cortex, the part of your brain that governs memory and learning.
Meditation and Aging
Meditation has been shown to increase the thickness of the hippocampus and decrease the volume of the amygdala, which is responsible for stress and anxiety. Research into mindfulness meditation has even indicated an effect on the process of aging itself. A 2017 UCLA study showed that the brains of people who meditate regularly actually declined at a slower rate than those who did not.
Natural Sleep Remedies For The Elderly
We know that sleep is essential for overall brain health for seniors, but many older adults experience trouble sleeping. Some practices for getting better sleep include turning off screens and lights, regular exercise, reducing sugar intake, and keeping a consistent sleep schedule with naps no longer than 20 minutes. If something more serious is causing you to lose sleep, you might need to consult a physician to test for sleep apnea or to evaluate any medications you might be taking.
Medicare Annual Wellness Visit
If the decline in cognitive functions persists or accelerates, you may need to seek professional help as a preventive measure. As part of your Medicare benefits, you may be entitled to a paid Annual Wellness Visit with your primary care provider to develop a personalized prevention plan that takes into account your lifestyle and risk factors.
In addition to checking physical factors like height, weight, and blood pressure, they can perform a cognitive assessment and screen for various forms of dementia or cognitive impairment. Additionally, a Special Needs Plan might be used to supplement your Medicare benefits. These plans are Medicare Advantage products specifically focused on providing care and coverage for patients with dementia.
Prescription Drug Plans for Alzheimer’s
If your condition or that of a loved one develops into Alzheimer’s or another form of dementia, Medicare Part D may cover the cost of prescription drugs to treat the symptoms. These medications include brands like Aricept and Exelon. Though they are not cures for the disease itself, they are effective at temporarily improving common symptoms of dementia, such as confusion or aggression.
Memory Care Through Medicare
Some severe cases of dementia and Alzheimer’s can make it nearly impossible to handle all the daily duties that come with living alone. In these cases, Medicare may help pay for nursing home care for a period of up to 100 days but will not cover such a solution in the long-term. However, some Medicare Part C plans may help cover the high costs of a nursing home or memory care facility.
For help enrolling in a Medicare plan that covers memory care and other brain health services, call us at 844-431-1832 or click here.
Guide to Medicare Mental Health Coverage
Mental illnesses, even though you can’t always see them, are just as real and treatable as physical diseases. Depression and anxiety can affect you physically in the same way that an illness can. In fact, depression IS an illness.
It can cause extreme fatigue and lethargy to the point where getting out of bed seems impossible. It can also lead to oversleeping or insomnia, as well as overeating or starving. It’s important to take care of your mental health just as you would your physical health.
Does Medicare Cover Mental Health?
Therapy Appointment | Medicare Plan Finder
Seniors and Medicare eligibles may have an increased risk of developing depression for both physical and mental reasons. Weakened immune systems and other ailments make the brain more susceptible to mental illnesses, which are most often the result of a chemical imbalance in the brain.
The anti-socialization that retirement can bring can easily affect one’s mood and lead to depression. Managing your mental health can relieve stress, improve memory, help you sleep better, and boost your overall mood.
With those circumstances in mind, you may wonder, “Does Medicare cover mental health?” Yes, but only under certain conditions.
Medicare Mental Health Benefits for Inpatient Care
Medicare Part A covers mental health services that you receive in an inpatient hospital setting. The out-of-pocket costs are the same regardless if you receive treatment in a general or psychiatric hospital.
You can only receive coverage in a psychiatric hospital for 190 days per your lifetime. If you are already hospitalized when you enroll in Medicare, you can be reimbursed for up to 150 hospital days.
Part A hospital coverage is broken into 60-day periods. First, you must pay your deductible, which is $1,408 in 2020, but after this is met, your first 60 days are completely covered.
If you are still in the hospital after 60 days, you will need to pay $352/day for days 61-90, and $704/day for days 91-150. Your Part A coverage will end after this time. However, once you have been out of the hospital for 60 days, your “day count” resets to 0 and this cycle can start over.
2020 Medicare Part A Copayments
Medicare Outpatient Mental Health Coverage
Medicare Part B covers all doctor visits related to mental health. That means any psychiatrists, psychologists, social workers, nurses, therapists, and addiction center visits are covered by your Medicare.
Counseling or therapy sessions are slightly more limited because they are only covered under Medicare if you see a doctor who accepts Medicare assignment. More specifically, this includes:
Individual and group therapy
Substance use disorder treatment
Occupational therapy
Active therapy (art, dance, music therapy)
Family counseling
Lab tests
Annual depression screening
Prescription drugs you cannot administer yourself
Original Medicare will cover these services at 80% of the Medicare-approved amount. This means you will likely pay 20% coinsurance after you meet your Part B deductible. However, keep in mind that your provider must take Medicare assignment, otherwise, Medicare will not pay for the services.
How to Find a Medicare Therapist
Psychology Today has a tool that can help you find a local therapist who takes Medicare. To get started, click here. Then enter your zip code. We used 37209, which is the zip code for our corporate offices in Nashville, Tennessee.
How to Find a Medicare Therapist Step 1 | Medicare Plan Finder
That will lead you to a page that lists the therapists in your area. From there, you can further filter your search results by therapist specialties and the qualities that matter most to you, such as gender, age, and faith.
How to Find a Medicare Therapist Step 2a | Medicare Plan Finder How to Find a Medicare Therapist Step 2b | Medicare Plan Finder
Medicare Mental Health Costs
Medicare mental health costs will vary based on your unique situation and personal needs. Treatment can range as low as $1,000 or as high as $9,000. Thankfully, Part D, Medicare Supplements, and Medicare Advantage plans can help lower your out-of-pocket costs.
Mental Health and Part D
Original Medicare does not cover prescription drugs. A Part D prescription drug plan is a great alternative to help cover the costs of any antidepressants or other health-related drugs.
Part D plans have an annual deductible of $435 for 2020. This means that every year, you will need to spend $435 before your coverage starts. Since Part D plans are sold by private insurance companies, each plan may be a little different. Some plans may waive, reduce, or charge the deductible up front.
Once you’ve reached your Part D deductible, you will enter the initial coverage phase. You’ll stay in this phase until you spend $3,820 in 2019. During this time, you will need to pay a copay for every prescription based on the plan’s drug formulary (list of drugs that are covered).
Drug formularies are organized by tiers according to co-payments. For example, a generic, tier-one antidepressant may only cost you $32, whereas a tier three, brand-name antidepressant can cost you $133.
Any drug labeled as “preferred” will be cheaper. Plus, you may be eligible for extra prescription drug cost savings through Medicare Extra Help. To learn more, or to schedule an appointment to discuss the best Part D plans in your area, fill out this form, or give us a call at 844-431-1832.
Part D Checklist | Medicare Plan Finder
Mental Health and Medicare Supplements
Medicare Supplement plans can add financial benefits and help you save in the long run on mental health coverage and other health-related costs. These plans help pay for things like copayments, coinsurance, and deductibles.
There are ten different plan types (A, B, C, D, F, G, K, L, M, N) and each plan offers different coverage and pricing. Your best bet is to speak with a licensed agent. If you’re interested in arranging a no-cost, no-obligation appointment, fill out this form or give us a call at 844-431-1832.
Medicare Supplements Plan Finder | Medicare Plan Finder
Mental Health and Medicare Advantage
Medicare Advantage plans must cover, at a minimum, the same as Original Medicare. However, they generally often several more benefits such as prescription drug coverage, hearing, dental, or vision coverage, OTC pharmacy allowance, non-emergency transportation, and group fitness classes like SilverSneakers®.
A licensed agent can help you find the best plan at the best rate that is specific to your needs and budget. Fill out this form or give us a call at 844-431-1832 to get in contact with a licensed agent.
Find Medicare Advantage Plans | Medicare Plan Finder
Improving Your Mental Health With Medicare
Did you know that stress and depression can weaken your immune system? Your mental health affects you physically as well as emotionally. Thankfully, Medicare provides benefits that can serve as “mood boosters” to help keep you both physically and emotionally healthy. Learn how emotions affect the body and how you can stay healthy.
Depression is all-too-common among seniors and Medicare eligibles, and it can often come from the stress of aging or physical health conditions. The feeling of stress is triggered by the release of the hormone cortisol, which slows down motivation and metabolism.
This means that stress can cause you to not only lose the motivation to eat healthily and exercise, but also lose the metabolism to break down fatty foods, ultimately leading to unhealthy weight gain. Aside from weight gain, the influx of cortisol can inflame the immune system, weakening it and making it easier for you to catch infections and get sick.
On the same side of the token, a positive mood will allow you to heal more quickly. If you take a positive attitude with your illness or injury, your immune system will stay stronger and you’ll have less cortisol holding you down.
Medicare Mood Boosters
Fitness Class | Medicare Plan Finder
What makes you happy? All the little small things that you enjoy can help you heal emotionally and physically, as the two are connected. Consider starting with your senses – do you have a scent that makes you happy? Light a candle or spray a fragrance. Do you have a sound that makes you happy? Play some music.
A lot of people find that physical activity is a great mood booster. Medicare’s SilverSneakers® program promotes healthy social and physical behaviors for people like you. The program revolves around group exercise programs hosted within gyms and YMCAs including activities like strength, flexibility, walking, and yoga classes.
The group setting gives you an opportunity to socialize with other seniors in your area, and the activities will help strengthen your physical health.
If SilverSneakers® is a benefit included in your Medicare plan, you should receive a list of participating facilities. Then, all you’ll need to do is bring your SilverSneakers® card with its 16-digit member number to the facility.
Get Medicare Mental Health Benefits
To enroll in a Medicare Advantage plan or to find answers to any questions you have about your mental health coverage, click here or call 844-431-1832.
Contact Us | Medicare Plan Finder
This blog was originally published on May 18, 2017, by Anastasia Iliou, and was updated on August 9, 2019, by Troy Frink.
Does Medicare Cover Rehab for Stroke Recovery?
Strokes are fatal in 17% of cases and are the fifth leading cause of death in the United States. For the remaining 73%, stroke recovery is needed to reduce brain injury, but it can cost an average of $17,000 in the first year! It’s important to understand the role of Medicare and how a Medicare Supplement plan can help you save on costs.
Medicare Coverage for Stroke Victims
Stroke Recovery Appointment | Medicare Plan Finder
An inpatient rehabilitation facility requires you to participate in three hours of therapy every day. If you are unable to participate in three hours of care per day, you can move into a skilled nursing facility with a rehab program.
Choosing the right stroke rehabilitation facility is crucial for recovery. Once you are released from the hospital, your options include an inpatient rehabilitation facility, a skilled nursing facility, or a long-term care hospital. Depending on the severity of your stoke, you may be able to return home and utilize home healthcare or outpatient therapy.
Here are some questions to keep in mind when choosing a facility:
Are they accredited through the Commission on the Accreditation of Rehabilitation Facilities?
What medical services are available?
How intense is the recovery program?
How much does Medicare pay for stroke rehab?
Inpatient Rehabilitation:
Medicare will pay for an inpatient rehabilitation facility the same way it covers hospital stays. This means you are fully covered for 60 days. After 60 days, you will pay $341/day until you reach 90 days, and then $682/day until you reach 150 days. If your care extends past 150 days, you will have to pay the full amount, but your cycle resets after you spend 60 days at home.
Your hospital coverage includes a semi-private room, hospital meals, nursing services, intensive care, drugs and medical supplies used during your stay, lab tests and x-rays, operation and recovery services, some blood transfusions, rehabilitation, and symptom management.
It does NOT include non-medically necessary amenities like completely private hospital rooms, private nurses, and personal care items that hospitals may provide (shower supplies, TV, etc.). To learn more about Medicare Part A coverage, click here.
Home Health Care:
If you are discharged to your home, Medicare will cover up to 60 days for home health services. Medicare Part B will cover your outpatient therapy (physical, speech-language pathology, occupational) at 80%; you will be responsible for 20%.
How many days will Medicare pay for a rehab facility?
Medicare has a 100-day rule for skilled nursing coverage, meaning that Part A will cover 100 days in a skilled nursing facility. The first 20 days are covered completely, but the remaining days (21-100) require coinsurance of $170.50/day.
When you are hospitalized for a stroke, you have 30 days to enter the skilled nursing facility. Like hospital stays, benefit periods last for 60 days. If you leave the facility and are back home for at least 60 days, the next time you enter a facility your “day count” will reset to 0.
Stroke Rehabilitation
The goal of stroke rehabilitation is to recover your body’s functions as much as possible. The process includes exercises to improve actions like talking, walking, and using the restroom.
In some cases, full recovery may be difficult. In this case, your therapist will teach you compensatory strategies. For example, if you lose the ability to use your arm, your therapist will teach you other ways to use the restroom, get into bed, and cook your own meals.
How long does it take for a person to recover from a stroke?
The average stroke patient will see the most improvement in the first three months. However, recovery time will vary on a case-by-case basis depending on the stroke severity. If your brain stem was damaged during the stroke, your recovery time could be a year or longer.
What percentage of stroke patients make a full recovery?
The National Stroke Association estimates that roughly 10% of stroke patients make a complete recovery. This may sound like a small percentage, but don’t let that discourage you! 25% recover almost completely excluding minor impairments (like minimal vision or memory loss). Another 40% will recover but require special short-term care.
Can paralysis from a stroke be reversed?
When you have a stroke, the lack of oxygen and blood cells to your brain can cause damage to millions of brain cells, which can lead to paralysis. This damage is irreversible if the cells are killed, but damaged cells can resume function over time.
Plus, scientists at the Pacific Neuroscience Institute are researching ways to reverse the effects of a stroke by transplanting stem cells and using them as a source for brain cell regeneration. This research will continue, but for now, stroke rehabilitation is the best method to regain independence and recover several of your body’s functions.
How soon after a stroke can you start rehab?
Stroke recovery starts as soon as you are stable. This is typically 24 to 48 hours after a stroke. The first stage of recovery typically takes place in the hospital, but this is dependent on your unique circumstances. After you are discharged from the hospital, your doctors, nurses, and family can help you choose a suitable living arrangement based on your needs.
Benefits of Medicare Supplements
The costs for stroke recovery can add up quickly, and these costs should not disrupt your rehabilitation plan. A Medicare Supplement plan can help cover your copayments, coinsurance, and deductibles. There are 10 plan options (Plan A, B, C, D, F, G, K, L, M, and N). The costs will vary per plan and on which state and county you live in.
Plan F is the most popular Medicare Supplement plan. If you do not have Plan F but you would like to, you can lock yourself in by enrolling NOW. You must enroll before January 1, 2020, to receive Plan F coverage. If you miss this deadline, there’s good news!
Plan G is almost identical to Plan F! The only difference is that Plan G does not cover the Part B deductible (which is less than $200 for most people). In reality, by switching to Plan G you will not be losing much at all. However, keep in mind that you can still keep your Plan F after January 1, 2020, if you enroll in 2019.
If you are interested in exploring Medicare Supplements or have any questions regarding your current coverage, contact us! We have licensed agents across 38 states who are dedicated to making sure you are enrolled in the plan that best fits your needs and budget.
If you are looking for coverage beyond Original Medicare, our agents can help you select a Medicare Advantage (MA) plan instead. Many MA plans offer hearing, dental, and vision coverage, and some even offer group fitness classes like SilverSneakers®. Call us at 844-431-1832 or fill out this form to get in contact with an agent.
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This post was originally published on March 7, 2019, by Kelsey Davis and was updated on August 7, 2019, by Troy Frink.
