Medicare coverage for dermatology can be quite limited. If you or your loved one needs treatment NOW, take a look at your coverage before it’s too late and you’re stuck with a big bill!
Medicare Part B can cover some dermatology services. If your condition is medically necessary, Part B will cover doctor services relating to evaluating, diagnosing, or treating skin conditions. Medicare will not cover cosmetic treatments, and it will only cover skin cancer screenings if you are showing symptoms.
How Does Medicare Cover Dermatologist Visits?
Dermatologist and Patient | Medicare Plan Finder
For dermatology-related services, you will have to meet your Part B deductible first. For most people in 2019, the deductible will be $185.
Then, Medicare will usually pay 80% of the service cost. You will be responsible for the remaining 20%. For Medicare to cover that 80%, your dermatologist or physician must accept Medicare assignment. Your doctor should be able to tell you whether or not they accept assignment, but if you’re not sure, your insurance carrier or insurance agent can help you.
Some Medicare Supplement (otherwise known as Medigap) plans can cover the rest of your costs, like your deductible and the remaining 20%. If you’re interested in investing in a Medigap policy, one of our agents can help. Click here to get started on setting up your free Medicare Plan Finder appointment.
Uniquely, Medicare plans are now able to cover MyPath, a genetic test for malignant melanoma.
How Much Does It Cost to Go to a Dermatologist With Medicare?
Dermatology costs vary based on what insurance you have, where you live, and what services you need. If you have Medicare (demonstrated above), you will likely be responsible for 20% of services. Some dermatologists accept Medicaid as well.
Keep in mind that in the cases of Medicare and Medicaid, your care will most likely not be covered unless it is determined to be medically necessary. For example, acne care is not generally considered a medically necessary treatment plan, but skin cancer removal is.
Thankfully, dermatology visits are not typically wallet-breaking. Depending on what doctor you see, where you live, and what services you require, The Law Dictionary says you may only need to pay between $100 and $200, which is a low cost compared to other health services, like hospital stays.
Do You Need a Dermatologist?
We’re not doctors, but chances are that if you’re asking this question, you should go and see a dermatologist.
Some skin conditions that you may start to notice as you age are dry and itchy skin, benign growths, loose skin (especially around the eyes, cheeks, and jawline), transparent or thin skin, spotting, wrinkles, and easy bruising.
While those are all certainly typical signs of aging, there are steps you can take to keep your skin healthy and prevent further damage, like:
Don’t stay in direct sunlight for long periods of time.
Always use a sunscreen with SPF 30 or higher when spending time outdoors.
Stay away from tanning beds.
Check your skin or have a loved one check your skin for new growths or moles that appear to be changing in color or size.
See a dermatologist whenever you face a new concern!
Questions to Ask Your Dermatologist
Patient Asking Dermatologist Questions | Medicare Plan Finder
Knowing what questions to ask your doctor can be a challenge, especially if you are really unsure of what’s wrong. We searched the internet and compiled this list of questions you may want to ask your dermatologist:
What foods should I avoid for my skin health? What should I be eating more of?
How can I slow down signs of aging, like wrinkles and dark spots?
How can I check my own moles and how do I know when to call you?
What lotions and sunscreens do you recommend?
These are the skin products I use now (list sunscreens, lotions, exfoliators, makeup, etc.). Are they damaging?
How to Find a Dermatologist
To find a dermatologist near you, you can visit a site like “doctor.com” or perform a Google search. Usually, searching for “dermatologist near me” pulls up reasonable results. For example, these are the results when we searched from our office in Nashville.
Once you’ve looked at reviews and found some good dermatologists in your area, make sure they accept Medicare. If you have another plan that you’re using, like Medicare Advantage, make sure the dermatologist is in your plan network.
Dermatologists are specialists. If you have an HMO (Health Maintenance Organization) plan, you may need a referral from your primary physician before you can see a dermatologist. If you aren’t sure whether or not you need a referral or if you need help finding a dermatologist that is in your network, call your insurance agent!
A highly trained, licensed insurance agent can help you walk through the process of finding providers in your network and can help you make sure you have all the coverage you need. Don’t have an insurance agent? To set up an appointment with your new agent, give us a call at 844-431-1832.
Contact Us | Medicare Plan Finder
*This post was originally published on June 28, 2018, and updated on July 3, 2019.
Prescription Drug Price Trends
About one in four people say they have a tough time affording their prescription drugs. Prescription drug prices have been on the rise since 2017. According to Rueters, drug companies announced price increases for more than 250 medications in 2019.
According to the Centers for Medicare and Medicaid (CMS), prescription drugs already account for 20 percent of Medicare’s spending, and with the prescription drug price trend increasing, that number will only increase in the near future. That may mean that your vital medications will cost you more.
How to Get Prescription Drug Discounts
Rising prices shouldn’t mean that you have to stop taking your needed drugs. Wouldn’t it be great if you could get a discount for your necessary medications? You can with this free discount drug card!
Prescription Drug Discount Card | Medicare Plan Finder
This discount card is not an insurance plan. However, you can use your discount card to receive up to 75 percent off your prescriptions at more than 68,000 pharmacies. Simply download, print and show your card to the pharmacist when you check out to save money on your important medications.
Why Are Prescription Drug Costs Rising Rapidly?
Senior Man With Pill in Hand | Medicare Plan Finder
The prescription drug price trend may be going up due to a lack of competition for pharmaceutical companies, and mergers and acquisitions in the pharmaceutical industry.
Lack of Competition for Pharmaceutical Companies
Many major pharmaceutical companies own patents for their drugs. That means other manufacturers cannot legally create generic equivalents, and the patent holders can charge whatever they want for their products.
Usually, manufacturers will produce generic drugs once a brand name patent expires. Some drugs are expensive to develop even with an expired patent, so that often means the original manufacturer is the only company producing their drug.
Mergers and Acquisitions in the Pharmaceutical Industry
Drug manufacturers make deals to expand their product bases. Unfortunately, when pharmaceutical companies merge, they get a lot of bargaining power. The pharmaceutical companies can demand that pharmacy benefit managers (PBM) – people responsible for contracting with pharmacies and getting drug discounts – set prices higher. Those costs get passed on to the government and ultimately to you.
Sometimes, pharmacy benefit managers merge with health plans, like in the cases of Cigna and Express Scripts and CVS and Aetna. Those mergers may actually be able to HELP you, by lowering costs due to reduced overhead and improved communication.
Medicare Prescription Drug Price Negotiation Act
One reason the prescription drug price trend is rapidly increasing is that CMS cannot legally negotiate drug prices. The Medicare Prescription Drug Price Negotiation Act is a bill that would require Medicare to negotiate prescription prices with pharmaceutical companies. It was first introduced in the House of Representatives in 2017, and re-introduced in 2019.
Other federal and state entities are making efforts to help reduce drug prices. The Food and Drug Administration is working toward approving more generic versions of brand name medicines. Many states have passed laws requiring drug companies to justify price increases.
Medicare Prescription Drug Plans
Prescription Drugs | Medicare Plan Finder
As prices rise, you may want to consider a new form of prescription drug coverage. Original Medicare does not help pay for prescriptions, but you can get prescription drug coverage through Medicare Part D, or through certain Medicare Advantage (Part C or MA) plans.
You can still use your discount drug card along with your insurance plan. When you go to the pharmacy to pick up your prescriptions, the pharmacist can determine your cost with each option.
Medicare Part D
Medicare Part D plans are also called prescription drug plans (PDPs). You can use PDPs to cover your medication costs. Many people who have PDPs also purchase Medicare Supplement (Medigap) plans to help pay for items such as coinsurance and copays.
Even though Medicare Supplements and Medicare Advantage plans sound similar, they are actually very different. Medigap plans “fill in” the gap between what you owe and what Original Medicare covers. MA plans help pay for medical expenses. If you have questions, one of our highly trained, licensed agents will be happy to help. Your agent can help you find the right plan for your budget and lifestyle.
PDPs typically use formularies that divide medications into tiers according to their copays. For example, one plan may feature four tiers with varying expenses. The first tier may only include generic drugs and cost $5 per prescription. Tier two may include preferred brand name medications and cost $15 per prescription.
Medicare Part D Checklist | Medicare Plan Finder
Medicare Advantage Prescription Drug Plans
Medicare Advantage plans are privately owned insurance policies that cover everything Original Medicare covers, but they can offer additional services including vision, hearing, and dental. Certain MA policies called Medicare Advantage Prescription Drug (MAPD) plans offer medication coverage.
Like PDPs, MAPDs use a formulary that lists every covered drug and separates them into tiers. The difference is that MAPD plans come with only one monthly premium for your covered services, and it includes prescription drugs.
Medicare Over-the-Counter Drug Coverage
Many people use over-the-counter (OTC) drugs along with their prescription medications. Like with prescription medications, Original Medicare does not cover OTC drugs. However, certain MA plans help pay for OTC medications. Some plans feature a pre-paid card that allows you to purchase covered items such as bandages and cold medicine.
How We Can Help You With Rising Prescription Drug Prices
Your agent can help you find a plan that not only includes all of your prescriptions, but covers the additional services you need. Call us at 844-431-1832or contact us here to learn more today.
Contact Us | Medicare Plan Finder
Get Middle Tennessee Dental Care with Medicare and Interfaith Dental
Nashville and Middle Tennessee residents don’t have to suffer from a lack of affordable dental coverage. In 1994, Dr. Tom Underwood founded Interfaith Dental with the help of the Nashville Dental Society and the Outreach Commission of West End United Methodist Church.
Interfaith Dental makes it possible for low-income families to access the dental care they need without having to pay full price.
Low Income Dental Clinics in Middle Tennessee
Middle Tennessee has quite a few public health clinics, and many specialize in dental care for low-income families and individuals. We work closely with Interfaith Dental, located both in the Fesslers Lane/Elm Hill Pike area of Nashville and near the St. Thomas Rutherford Hospital campus in Murfreesboro. Below are some of the low-income dental clinic options you have in Middle Tennessee.
Not located in Middle TN? That’s ok – there are plenty of low income dentists throughout the country. This government website is operated by the Bureau of Primary Health Care, a part of the Health Resources and Services Administration. You can use their tool to find a federally-funded community health center that offers dental services.
Additionally, you can search through the American Dental Association or the American Dental Hygienists’ Association to find supervised, low-cost care that is part of the training program for dental students. Your care will be supervised by licensed and experienced dentists. If you have Medicare, we can help you make sure you have the best Medicare plan to get you the dental services you need and help you find the best dentist that accepts Medicare.
Who is Interfaith Dental (IFD)?
Interfaith Dental is a low income dental clinic with a mission to “create a healthier community by providing transformational oral health care for those experiencing poverty.” They envision a Middle Tennessee community where every resident “has the opportunity to achieve and sustain a healthy smile,” regardless of income status.
When it began in 1994, IFD only had two chairs and one employee, operating out of the West End United Methodist Church basement. By 1998, they were able to move their operation to 1721 Patterson Street (just off West End, near the St. Thomas Midtown campus).
In 2012, they opened another clinic in Murfreesboro, expanding their reach into Rutherford County. In even bigger news, this past year (2019), the clinic was able to expand into a new office at 600 Hill Avenue (near the Fesslers Lane/Elm Hill Pike intersection).
They’ve come along way from their two-chair operation, now owning 26 state-of-the-art dental operatories.
How to Become an Interfaith Dental Patient
Since the Interfaith Dental Clinic offers such low-cost dental care, there is an application process before you become eligible for services. To be eligible, you must be legally considered low-income (living below the poverty line), uninsured, and suffering from a devastating dental disease.
To get more information or to schedule your first appointment, call 615-329-4790 for the Nashville office, or 615-225-4141 for the Murfreesboro office.
Your Interfaith Dental journey will begin with a phone questionnaire. You’ll be asked for some basic information which will determine if you are eligible for Interfaith Dental Clinic services and what services you need.
Next, the Patient Care Coordinator that you speak with will tell you when the next “Application Day” is. On that day, you’ll come into the office to complete your application. Both the Nashville and Murfreesboro locations have the same office hours in 2019, which are:
Monday through Wednesday, 8 AM to 4 PM
Thursdays, 1 PM to 7:30 PM
Fridays, 8 AM to 12 PM
Be sure to bring the following items with you on “Application Day”:
Current Year Tax Return
Two current pay stubs for anyone working in your household.
If you are paid in cash, provide written documentation from your employer on a business letterhead that contains the business name, address, phone number, and owner information as well as your hire date, hours worked per week, pay rate, and hourly income.
College students, bring your class schedule
Work training program participants, bring proof of enrollment.
65+, provide social security/pension/retirement proof of income.
Proof of address (utility bill, bank statement, etc.)
TN driver license
Referral from medical professional, social worker, or employer (if you have one)
Due to high demand, there may be a waiting period for your services. There are a limited amount of applications that are handed out on a first-come, first-serve basis every month.
While walk-ins are generally not accepted, please call Interfaith Dental if you have a dental emergency. Some emergency services are offered on a first-come, first-serve basis.
What to Expect from Your First Interfaith Dental Appointment
At your first Interfaith Dental Clinic appointment, you’ll begin by meeting the team members. Then, someone will sit with you to review your medical and dental history and discuss all of your dental concerns.
Interfaith Dental care is comprehensive – they want to know how your dental health has affected your career, your family, and even your self-confidence. Is your goal to have a beautiful smile again, or to eliminate pain? Your care providers will hear all of your concerns and follow up with the best possible care.
The next step of your first appointment is a series of full diagnostic X-rays and oral exams that will help the doctors determine a treatment plan. Phase one will usually include fillings, cleanings, and extractions, and phase two will include crowns, root canals, and even partial dentures, if necessary.
If that sounds like a lot, it’s because it is. Your first appointment with Interfaith Dental can take up to two hours, in some cases – so be sure to allow that much time out of your day.
Original Medicare only covers dental services when they are part of a hospital stay.
For example, if you go to the St. Thomas emergency room with a fractured jaw and need emergency dental care in the hospital, those services may be covered by Medicare Part A. However, common dental services and treatments such as annual exams, cleanings, root canals, dentures, implants, etc. are not covered by Original Medicare.
To get Medicare dental coverage, you’ll need to either enroll in a private, individual dental plan or a Medicare Advantage (Part C) plan. Medicare Advantage plans, even though they are Medicare health plans, are operated by private insurance companies, which allow them to add benefits that the Original Medicare program does not cover. This can include not only dental benefits but also benefits like fitness programs, vision, meal delivery, etc.
Medicare Plan Finder and Interfaith Dental, Bringing Change Together
Medicare Plan Finder works with Interfaith Dental by helping their patients fill the gaps in their dental coverage. Interfaith Dental is not always able to provide free or very low-cost care. For example, there may be times where a $10,000 dental procedure costs $5,000 at Interfaith Dental. You’d still be paying $5,000 less than if you went to a regular dentist, but that $5,000 may be more than you can handle. At Medicare Plan Finder, we try to match you up with a low-cost insurance plan that can cover those extra out-of-pocket costs.
Start by scheduling your appointment at the Interfaith Dental Clinic located nearest to you. Call 615-329-4790 for the Nashville office, or 615-225-4141 for the Murfreesboro office.
Then, if your doctor determines that you need a series of procedures that you can’t afford (even with Interfaith Dental’s help), give us a call at 844-431-1832. We can help you determine whether or not you are eligible for Medicare (did you know you don’t have to be 65?). If you’re eligible, we’ll help you find low-cost coverage so that you can go back to Interfaith Dental to get the services you need.
6 Tips to Find the Right Dentist That Takes Medicare
Oftentimes, people wait until it’s too late to visit the dentist. Many common oral health problems don’t even have noticeable symptoms right away, but your dentist can catch them.
Regular dental exams and cleanings should be a part of your healthcare routine. If you’re eligible for Medicare, you may want a dentist that takes Medicare insurance to help cover dental costs.
However, even if your dentist takes Medicare, you could be missing out on a huge opportunity for better care. Use these six tips to find a better dentist.
1. Find the Right Dental Insurance, First
Before you select a dentist, make sure that you have dental insurance coverage with a network that allows you to pick your own dentist.
Original Medicare will only provide dental coverage for medically necessary services. That means dentists cannot accept Medicare Part A or Part B for routine dental care. However, some private insurance plans called Medicare Advantage plans can help pay for services that Original Medicare does not, like hearing, vision, and of course, dental.
It may seem difficult to find out what insurance plans dentists take in your area. You may not even know where to start. Our licensed agents are highly trained and can help you locate dentists that take Medicare Advantage plans.
Some people may need coverage for more dental services than Medicare Advantage plans provide. You can purchase separate private dental insurance plans that may provide the additional coverage you need. Talk to your agent about private dental insurance plans.
2. Learn What Other People Say About Local Dentists
Other people are a great resource for learning about dentists in your area. Ask friends and family what they think about their dentists, or ask your doctor for a referral. You can also find information from professional associations such as the American Dental Association (ADA) or the Academy of General Dentistry (AGD).
Even though you can find plenty of reviews on Google, be wary of fake accounts. If a review looks like a machine wrote it or it’s too over-the-top, proceed with caution.
3. Check out the Dentist’s Website
Woman Looking at Dental Websites | Medicare Plan Finder
The ADA has a directory website that allows you to search for dentists in your area by specialty. For example, let’s say you have good oral health, and you want to find a general dentist. The ADA directory will show you all of the local dentists who are ADA members and their contact info.
The dental practice’s website will display much of the information you need such as the insurance plans they accept, operating hours, address and contact information.
Take the office’s location into account, and ask yourself if you can get there easily. Assess whether their business hours fit into your schedule.
How to Use the ADA’s Local Dentist Finder Tool
Click here to use the ADA’s local dentist finder tool. Enter your zip code in the box beside the red arrow. We used our home office zip code, which is 37209. Then, in the box above the yellow arrow, select how close you want your dentist to be. The next step is to select your dentist’s specialty, which you can do in the box under the orange arrow. Then click “SEARCH” beside the blue arrow.
Then you’ll come to your list of local ADA dentists.
4. Make Lists of Offered Services
You have an idea of what services you might need. For example, if you have dental implants, you may need to find a periodontist or an oral surgeon who specializes in gum disease. However, if you’ve only had a couple of cavities and you only need routine cleanings and examinations, a general dentist may be a better fit.
As you browse dental websites, list what services they offer and compare the services with your needs. You may find that only a couple of dentists in your area specialize in your condition, or you may find that you have many options.
5. Visit the Facility
Once you’ve narrowed down a few choices, visit their offices. Look around and ask yourself if the facility is neat and organized. See if dental staff wear protective equipment such as gloves and if they seem to enjoy their jobs. Listen to how the staff talks to patients.
You want to get an idea of what your experience might be like if you make this person your regular dentist. If you like what you see, consider making an appointment.
6. Compare Costs
Dentist and Patient Discussing Treatment Plan | Medicare Plan Finder
Even if you find a dentist who accepts your insurance plan, you may still owe some bills. Make an appointment for a consultation and have the dentist make an itemized list of the services you need and their costs.
If the dentist recommends a long list of costly treatments such as oral surgery, veneers, or crown replacements, you may want to get a second opinion.
We Can Help You Find Dental Coverage
Finding the right dentist can seem overwhelming. Your Medicare Plan Finder agent may be able to help you find the right Medicare Advantage or private dental insurance plan. Call 844-431-1832 or contact us here today.
11 Crucial Tips for Taking Care of Elderly Parents at Home
Taking care of an elderly parent at home may be the most important thing you ever do, but it can be easy to get bogged down with the day-to-day struggles you may encounter.
You can help minimize your physical and financial stress that can come with caring for aging parents with some planning and resources. Follow these 11 tips to set yourself up for caregiving success.
1. Monitor Medications
One vital part of caregiving is making sure your parent receives his or her medications on time. Many pharmacies have apps that allow you to set up automatic refills for qualifying prescriptions, and you can even have prescriptions mailed directly to you.
It’s important to find a health insurance plan that will help pay for all of your parent’s medical needs. Medicare is a fantastic resource for paying medical expenses, but Original Medicare may not cover all of the services your loved one needs, such as prescription drugs.
You may have to look into private insurance policies called Medicare Supplements or Medicare Advantage plans to cover additional services and ensure that your parent’s insurance meets his or her needs.
If you need help paying for your parent’s medications, Medicare Part D or certain Medicare Advantage plans offer prescription drug coverage. There may be many plan options out there for you, and asking a qualified professional for help finding the right one may make the difference in your loved one receiving the right care.
2. Find Assistive Devices to Help Make Life Easier
As your parent ages, he or she may have difficulty performing actions such as bathing, standing up, or walking, and you may consider using assistive devices or Durable Medical Equipment (DME) to help make life easier. Assistive devices for the elderly range in supportive functions from fall prevention and mobility (canes, walkers, wheelchairs) to helping button shirts or clean.
Medicare Part B will help cover DME if your doctor prescribes the devices. You may owe deductibles or coinsurance. Some items such as wheelchair ramps and handrails may not be considered DME, but some Medicare Advantage plans cover those home modifications.
3. Hire Outside Help if Necessary
At some point, your parent may require more help than you can provide. You may have to enlist the help of skilled nurses or other healthcare professionals to perform the required level of care. If you don’t know where to start looking, your parent’s doctor may recommend a home healthcare service, or Medicare has a registry where you can find agencies in your area.
If it’s extremely difficult for your parent to leave the house, Medicare will cover intermittent skilled nursing services, meaning that the skilled professional doesn’t visit your parent every day or for extended periods of time.
Some parents will need long-term care, and Medicare will not cover those services. You can, however, purchase long-term care insurance to help pay for expenses such as a full-time nurse.
4. Make Sure Your Loved one Stays Active
Healthy Seniors Lifting Dumbbells | Medicare Plan Finder
An active lifestyle that includes regular exercise may help prevent chronic diseases. Resistance training combined with cardiovascular exercise can help manage symptoms of osteoporosis, diabetes and chronic hypertension. Go on walks with your parent, go to the pool or look for fitness classes geared toward seniors such as Silver & Fit® or SilverSneakers® in your area. Certain Medicare Advantage plans cover fitness classes.
5. Find Proper Nutrition for Your Loved One
Ensuring that your parent eats properly can be time-consuming. You may be responsible for grocery shopping, meal preparation, and making sure your loved one eats at the right times throughout the day. Not only that, but your parent’s doctor or dietitian may recommend that your parent eats a certain number of calories or that your parent’s diet focuses on lean protein sources, fruits, and vegetables.
You can cut down on the time it takes for meal preparation by preparing meals for a few days in advance and putting them in single-serving containers. Look for recipes with simple cooking methods such as using a slow cooker or one-pan meals.
Some Medicare Advantage plans even cover meal delivery, which would dramatically cut down on the time you spend worrying about your parent’s nutrition.
6. Create a Schedule
Creating a schedule and sticking to it is extremely important when taking care of elderly parents at home. You’ve got a lot to do for yourself and your loved one, and if you don’t establish a routine for house cleaning, running errands, or bathing, then those things may not get done.
Take some time every week and make a list of everything you and your parent need to accomplish. Create a calendar that includes all of the events for the week because seeing doctor’s appointments, meal delivery times, etc. will help you coordinate everything your parent needs and also let you schedule some time for yourself.
7. Take Time to Care for Yourself, Too
Smiling Woman in Meditative Pose | Medicare Plan Finder
It can be easy to forget about self-care when you’re so involved with your loved one, but taking some time for yourself is extremely important.
Find some time to relax. Take bubble baths, meditate, or do anything else that makes you happy. The important thing is that you feel refreshed and recharged when you go back to your parent.
Be active. Exercise is not only beneficial for your physical health, but also your mental health. The vast majority of people who exercise regularly report lower stress levels than sedentary individuals. Consider doing yoga, jogging, cycling or joining the gym where your parent takes fitness classes.
8. Find a Support System
Self-care may look like finding a support group or therapist so you can talk about how you feel. Your job as a caregiver may be overwhelming if you feel like you’re alone. If you can openly talk about what’s going on and get information on how to cope, you can provide better care because you’ll have better emotional health.
Sometimes you may just need a break, but you’re unable to leave your loved one alone.
Ask other family members to step in when you need some time off or it could be time to consider finding respite care services, which allow you to rest. Respite care may mean that your parent stays in a hospital temporarily or goes to adult day care.
Medicare will only cover respite care if it’s part of hospice, but the NFCSP or National Association of Area Agencies on Aging (N4A) can help you find respite services in your area that may be in your budget.
9. Know Your Rights
You have rights as a caregiver. The Family Medical Leave Act (FMLA) allows employees who meet certain requirements to take up to 12 weeks per year off to care for qualifying immediate family members.
If your employer has 50 or more employees, you must be allowed to return to your original position or its equivalent when you return to work.
If your employer fires you or demotes you, or refuses to grant leave, you may have a case against your employer for FMLA violations and workplace discrimination.
Talk to an employment lawyer or to your to the Department of Labor if you think your rights have been violated.
10. Obtain Power of Attorney to Make Important Decisions
Caregiver Helping Parent With Power of Attorney Paperwork | Medicare Plan Finder
In order for Medicare to allow you make decisions for your parent, you must first have the right kind of power of attorney (POA). There are many different types of POA, but a Durable Power of Attorney is the only kind Medicare will accept, and it’s the most beneficial for taking care of elderly parents at home. A Durable Power of Attorney will allow you to make medical decisions for your parent before he or she becomes incapacitated.
11. Find Government Assistance for Caregivers of Elderly Parents
Taking care of elderly parents at home can be a full-time job. You may be able to find government assistance for caregivers of elderly parents and receive payment for your hard work. Medicare will not pay for you to provide caregiver services, however, Medicaid will in some states.
It may feel like you’re all alone, but there are some federal resources that can help ease your stress. The National Family Caregiver Support Program (NFCSP) provides a wealth of resources to caregivers information on where to find support groups, educational materials for specific conditions and contact information for advocacy organizations. You’ll be a better caregiver if you use the government resources available to you.
We Can Help You and Your Loved One Find Coverage for Home Care Services
The right insurance plan can help cover the cost of at-home care services. If you have power of attorney, a highly-trained licensed agent with Medicare Plan Finder may be able to help you find a plan that fits your budget and lifestyle needs. Call 844-431-1832 or contact us here to learn more.
Father’s Day 2019: Healthy Gifts for the dad who Wants Nothing
Are you one of the millions of people looking for gifts for the dad who wants “nothing?” Maybe this is the year that you can finally give him something other than a new tie. As dad ages, consider gifting him the education, care, and technology he needs to stay healthy.
Sometimes the best gift is not a physical object. Consider gifting your dad with:
Bringing him healthy meals or taking him out to healthy lunches
Fitness Gifts for Dad
One of the easiest ways to get dad a gift that encourages him to practice healthy habits is by looking at the fitness industry. These gifts not only say, “I love you,” but also allow you to be proactive for his health:
A gym membership (if he qualifies for Medicare, you can get him a gym membership by helping him sign up for certain Medicare Advantage plans).
List of Male-Specific Diseases
The best gift you can give your aging father is education and readiness for what life may throw at him next. Even if dad is healthy now, help him learn about diseases that he may be susceptible to. Is he nearing or over age 65? Help him also learn about different insurance options that he may not have heard about yet!
These are some male-specific diseases and diseases that are more likely to affect aging men than women. Remind your dad to look for the signs.
According to the Centers of Disease Control and Prevention (CDC), cancer is the 2nd leading cause of death for people over the age of 65. It’s extremely important for seniors and Medicare eligibles to remain proactive when it comes to their health. If cancer is caught early enough through screenings, it may be treatable. The most common cancers found in men are:
Prostate cancer
This type of cancer generally grows slowly and is initially found in the prostate gland where it may not cause extreme harm. However, prostate cancer can grow quickly and create bigger issues. If your dad is over 50 years old, African American, or if prostate cancer runs in your family, he has a higher risk of developing prostate cancer.
Colorectal cancer
Did you know colorectal cancer is the second leading cause of cancer-related deaths in the US? Colorectal cancer develops from abnormal growths called precancerous polyps. These growths can be removed before they turn cancerous, so it is vital to stay alert and proactive.
Medicare Coverage for Men
If your dad is eligible for Medicare, Medicare covers a digital rectal exam and a prostate-specific antigen (PSA) test once a year. In addition to these tests, Medicare covers numerous colorectal screenings like the fecal occult blood test, flexible sigmoidoscopy, and colonoscopies. Screenings are extremely important. The CDC says that close to 1,000 colorectal cancer deaths could be prevented each year if even 70.5% of people attended regular screenings.
Are you interested in exploring Medicare insurance available for you? Our agents can explain your coverage options and help you find a plan that best fits your needs and budget. If you are interested in arranging a no-cost, no-obligation appointment with an agent, complete this form or give us a call today at 844-431-1832.
*Originally published on August 16, 2018, and updated on June 13, 2019.
Does Medicare Cover Genetic Testing for Melanoma (MyPath)?
Malignant melanoma is a type of skin cancer that starts in the skin’s pigment-producing cells. About two percent of people will develop melanoma in their lifetime, and 5-10 percent of those cases are hereditary.
Parents with specific gene mutations have about a 50 percent chance of passing those genes to their children. Genetic testing for melanoma can reveal the gene mutations associated with skin cancer and allow you to seek treatment right away.
Medicare Coverage for Genetic Skin Cancer Testing
Doctor Discussing Cancer Testing Results | Medicare Plan Finder
Anyone who is eligible for Medicare has some financial assistance available for their healthcare. Medicare can help pay for expenses such as doctor appointments for diagnosing and treating melanoma. Medicare will cover genetic testing for melanoma if you have certain risk factors.
Melanoma is just one type of skin cancer. The most common types of skin cancer are called carcinomas and they are usually the result of exposure to UV rays. Melanoma can be attributed to certain gene mutations.
Medicare will only cover genetic testing for cancer if it’s medically necessary. Currently, Medicare offers coverage for the Myriad Genetics myPath and the Castle Biosciences DecisionDx tests.
Myriad Genetics myPath
The myPath Melanoma test from Myriad Genetics measures 23 genes and differentiates melanoma from normal cells. The genes in the test include:
PRAME one gene involved in the process where a cell changes from one type to a different type
S100A7, S100A8, S100A9,S100A12 and PI3, a group of genes involved in the cell communication process that regulates cell activities
CCL5, CD38, CXCL10, CXCL9, IRF1, LCP2, PTPRC and SELL, involved in the immune system response to tumors
Measurements of nine housekeeping genes (genes that maintain basic cell function) to use as a baseline in determining normal gene expression
Castle Biosciences DecisionDx
Castle Biosciences offers the DecisionDx-Melanoma test to help doctors determine if a patient has Stage I or Stage II melanoma. The test screens for the following genes:
Does Medicare Cover Genetic Testing for Melanoma | Medicare Plan Finder
Along with genetic risk factors, several other factors may mean you’re more likely to develop melanoma, including:
Fair skin: People with fair skin have a much higher risk of developing melanoma than people with darker skin. Those with red or blonde hair, blue or green eyes, or skin that freckles easily and is susceptible to sunburn are at an increased risk of developing melanoma.
Personal history of melanoma or other skin cancers: If you’ve already had melanoma or another type of skin cancer, you could be at risk for it again.
Having a compromised immune system: Your immune system fights off cancer and other diseases. If your immune system is weak as a result of certain diseases or medical treatments, you’re more likely to develop melanoma.
Age: Melanoma is more likely to occur in older adults than younger adults.
Sex: Men older than 50 have a higher rate of melanoma than women.
Xeroderma pigmentosum: People with xeroderma pigmentosum (XP) have a high risk of developing melanoma. XP is a rare condition that interferes with the skin’s ability to repair DNA damage.
Melanoma Statistics and Facts
Melanoma is becoming more common, and it can often be treated if it’s caught early.
Melanoma rates have been steadily rising for the last 30 years.
The American Cancer Society estimates that there will be approximately 96.5 new melanoma diagnoses and about 7,200 melanoma deaths in 2019.
Melanoma’s five-year survival rate is about 97 percent when the cancer is detected early. If the disease spreads to the lymph nodes, the survival rate declines to 68 percent, and to 15 percent if the cancer reaches other organs.
Treatment for Melanoma
Treatment for melanoma is different depending on the stage of cancer (I-IV), where it is on your body, and your overall health.
Stage 0: These melanomas have not penetrated the top layer of skin yet. A wide excision surgery will remove the melanoma and a small amount of normal skin around it.
Stage I: Wide excision surgery will also remove these melanomas, and also portions of normal skin around them. The amount of normal skin removed depends on how thick the melanoma is, and where it is on the body.
Stage II: Surgery to remove the melanoma and some of the normal skin around it is also the treatment for stage II melanoma. Many doctors will also recommend a lymph node biopsy, because cancer may have spread to the lymph nodes near the melanoma.
Stage III: In stage III melanoma, the cancer has already reached the lymph nodes when it’s first diagnosed. The treatment usually involves removing the melanoma with surgery, and dissecting the lymph nodes around the tumor. After the surgery, doctors will recommend prescription drugs for immunotherapy or targeted therapy for cancers with BRAF gene changes.
Stage IV: These melanomas are often difficult to cure because they have already spread to lymph nodes far from the melanoma. Skin tumors or enlarged lymph nodes can oftentimes be surgically removed or treated with radiation therapy. If the cancer has spread to internal organs, it can be removed depending on how many incidents of cancer there are, where the incidents are, and how likely the cancer is to cause symptoms. Other treatments include immunotherapy drugs and chemotherapy.
Contact Us Today
Medicare can cover specific genetic testing for melanoma and skin cancer treatment if you meet certain criteria. If you need coverage beyond what Original Medicare pays for, private health insurance plans called Medicare Advantage plans or Medicare Supplements may better suit your needs.
A representative with Medicare Plan Finder can help you find the right Medicare plan to fit your budget and lifestyle. Call us at 844-431-1832 or contact us here to learn more today.
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Prescription Help for Medicare Beneficiaries
For many people, prescription drugs are the most expensive part of health care. Some medications are so expensive that many people stop taking their prescriptions, and their health problems get worse. Thankfully, there are options for prescription help for Medicare beneficiaries.
Apply for LIS
You might be qualified for Extra Help, or Low Income Subsidy (LIS). Extra Help is a Medicare savings program based on income level. If your yearly income and total assets are at or below 150 percent of the federal poverty level, you may qualify for LIS. Some beneficiaries have saved nearly $4,000 per year by enrolling in LIS. If you’re not sure if you’re qualified, speak to your agent! We can help you look over the qualifications and go through the application process.
If you qualify for LIS, you might also qualify for Medicaid. If you’re eligible for both Medicare and Medicaid, you qualify for Dual Special Needs Plans (DSNP), which are a type of Medicare Advantage plan. DSNPs typically provide coverage for doctor appointments, hospital services and prescription medications.
If you have a DSNP, you will also qualify for a Special Enrollment Period (SEP), which allows you to enroll in new plans or make changes to your existing coverage at any time throughout the year, rather than having to wait for certain times.
Special Needs Plans | Medicare Plan Finder
Change Your Medicare Plan
If you don’t qualify for a SEP, you will have to wait for the Annual Enrollment Period (AEP) to make changes to your coverage or enroll in a new plan. Original Medicare does not provide prescription drug coverage. However, Medicare Part D or certain private insurance policies called Medicare Advantage plans cover medications and provide prescription help for seniors on Medicare.
Private insurance carriers offer Medicare Advantage (MA) plans to pick up where Original Medicare falls short. Along with prescription drugs, some MA plans can provide coverage for vision, dental, transportation and even fitness classes. Talk to your licensed agent to find a plan that fits your budget and lifestyle.
Medicare Advantage | Medicare Plan Finder
Consider a Plan With Gap Insurance
The donut hole is a limit on what your prescription drug plan will cover, and it applies to all Medicare clients who don’t have Extra Help. The donut hole will be going away in 2020, but for now, here’s a cost breakdown for 2019:
You will pay for 100 percent of your drug costs until you hit your deductible, which is $435 in 2020. Once you meet your deductible, you will only pay a small percentage of your drug costs until you’ve spent $4,020. At that point, you enter the you will pay up to 25 percent for brand-name drugs and up to 25 percent of generic drugs until you reach $6,350. At that point, you will only be responsible for five percent of your drug costs for the rest of the year.
Some Medicare plans offer additional coverage to protect you from the donut hole. That’s something you can ask your agent about when you meet to discuss your coverage options!
Rx Discount Card | Medicare Plan Finder
Request Generic Drugs
Most drugs that your doctor prescribes will have a generic counterpart that works just as well. In fact, the FDA requires that generic drugs have the same level of quality and performance as their brand name counterparts. Brand name drugs are more expensive because the companies that manufacture them had to pay for research and development. They pass those costs onto the consumer.
Ask your doctor if he or she prescribed a name-brand or a generic drug. If your doctor is willing to switch from a brand name to a generic, you might be able to save hundreds of dollars every year!
Let Us Help
Prescription help for seniors on Medicare can come from changing your Medicare Plan, Extra Help or from buying cheaper prescriptions. A highly trained licensed agent with Medicare Plan Finder can help you find a plan that’s right for you. To set up an appointment, call us at 844-431-1832 or contact us here today.
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This post was originally published on October 26, 2017, by Anastasia Iliouand was updated on May 23, 2019, by Troy Frink.
Does Medicare Cover Sleep Apnea?
Sleep apnea is a condition in which a person repeatedly stops breathing while they sleep for about 10 seconds. Its effect on sleep quality is astronomical.
Sleep apnea is one of the leading causes of insomnia in adults over age 40. If you’re eligible for Medicare and have trouble sleeping, you may want to know, “Does Medicare cover sleep apnea?”
Medicare coverage for sleep apnea starts with Part B, and it includes some of the costs related to sleep apnea, such as doctor’s visits to diagnose and treat the condition.
Does Medicare Cover CPAP Machines?
Does Medicare Cover Sleep Apnea? | Medicare Plan Finder
Medicare Part B will cover a CPAP machine to help treat your sleep apnea if your doctor determines that it is medically necessary. A CPAP machine stops the airways from collapsing by sending pressurized air into the throat, allowing the user to sleep.
Medicare coverage for CPAP machines comes with a three-month trial period. You may be responsible for paying 20 percent of your CPAP rental with Medicare costs, and 20 percent of the masks and tubing costs.
If your doctor determines that the CPAP machine helps your sleeping disorder, Medicare will continue to cover your CPAP machine. Medicare will continue to pay for your CPAP rental for 13 months.
You own the machine after the rental period. If you already owned a CPAP machine before you enrolled in Medicare, you might be able to receive coverage for renting a replacement machine or accessories.
How to Get a CPAP Machine
The Centers for Medicare and Medicaid (CMS) consider CPAP machines to be durable medical equipment (DME). Medicare.gov has a resource for finding DME in your area.
If you have a prescription for a CPAP machine, click here. Enter your zip code to find your nearest Medicare-approved DME provider. For demonstration purposes, we chose 37209, which is the zip code for our corporate offices in Nashville, TN.
How to Get a CPAP Machine Step 1 | Medicare Plan Finder
You will then reach a page that lists providers for many types of DME. Since we’re only going to cover CPAP machines, click the box marked “CPAP, RADs, & Related Supplies & Accessories” as shown below in red. Then click “Search” as shown below in blue.
How to Get a CPAP Machine Step 2 | Medicare Plan Finder
Once you do that, you will come to a page that tells you how many CPAP machine providers are in your area that looks like this. Click on the box that tells you how many local results there are.
How to Get a CPAP Machine Step 3 | Medicare Plan Finder
The next page will display contact information for the DME providers. Call them to discuss their services and costs. You may need to call more than one to find a good fit.
How to Get a CPAP Machine Step 4 | Medicare Plan Finder
Does Medicare Cover Sleep Apnea Equipment?
Some people may not be able to use a CPAP machine. Medicare will cover an oral appliance in that case, if your doctor prescibes one. An oral appliance holds the jaw open and allows the user to breathe by keeping the airway clear.
Does Medicare Cover Sleep Apnea Testing?
Medicare Part B will cover sleep apnea testing if your doctor orders a test for you. Medicare will typically pay for 80 percent of the associated costs after you’ve met the Part B deductible.
Sleep tests are usually performed at a sleep center or at a hospital, and the tests record your nighttime sleep patterns. The tests provide your doctor with a detailed snapshot of how you sleep, and he or she can use the results to render a diagnosis.
Medicare will cover in-home test types I-IV if you display sleep apnea symptoms. The in-home tests can only screen for sleep apnea and not for other sleep disorders.
What Else Does Medicare Cover for Sleep Apnea?
Medicare Part B is public health insurance. Its coverage is limited to what the federal government approves.
Sleep apnea affects every area of a person’s life, and patients should be treated with their overall health in mind.
Private insurance carriers offer policies called Medicare Part C (Medicare Advantage) plans that can provide coverage beyond Original Medicare. Some plans offer transportation to doctor’s appointments, meal delivery, fitness classes, and prescription drugs.
Doctors typically do not prescribe medications as a primary sleep apnea treatment, but sometimes doctors recommend drugs to help manage sleep apnea symptoms. Medicare Part D or certain Medicare Advantage plans will cover prescription drugs such as Ambien to help you sleep or Provigil to help you stay awake.
Rx Discount Card | Medicare Plan Finder
Sleep Apnea Causes
The most common form of sleep apnea is obstructive sleep apnea. It occurs when the throat muscles relax and block the airway. Throat muscles support the tongue, the side walls of the throat, and the tonsils.
With sleep apnea, the muscles relax and your airway collapses, you can’t get enough air into your lungs, and your oxygen levels decline. To compensate for this decline, your brain will wake you up so that you can breathe freely.
The time awake is often so brief that you don’t remember it, but the frequent sleep interruptions make it impossible for you to enter into a deep sleep. Your body needs that deep sleep to produce hormones and repair muscle and bone tissue.
Central sleep apnea is less common, and it occurs when your brain doesn’t signal your breathing muscles to activate. This means your brain won’t make an effort to breathe for a brief period, and you’ll wake up with shortness of breath and likely have a tough time falling asleep again.
Risk Factors for Obstructive Sleep Apnea
Doctor Talking to Patient About Sleep Apnea Risk Factors | Medicare Plan Finder
Obstructive sleep apnea risk factors include:
Obesity: Excess weight dramatically increases the risk of sleep apnea. Fat deposits surrounding your upper throat can block your breathing.
Neck circumference: Thicker necks can mean narrower airways for some people.
Sex: Adult males are twice as likely to develop sleep apnea than women.
Age: Older adults have a much higher rate of sleep apnea than younger adults.
Family history: If you have immediate family members with sleep apnea, that can mean a greater risk of you developing the sleep disorder.
Smoking: People who smoke are at a significantly higher risk of sleep apnea because tobacco use can increase throat inflammation and fluid retention.
Nasal congestion: If breathing through your nose is difficult because of allergies or an anatomical problem, you’re at a higher risk of developing obstructive sleep apnea.
Risk Factors for Central Sleep Apnea
Central sleep apnea risk factors include:
Age: Like with obstructive sleep apnea, older adults have a higher risk of developing central sleep apnea.
Sex: Males more commonly develop central sleep apnea than females, just like with obstructive sleep apnea.
Heart conditions and stroke: Having congestive heart failure means you’re more likely to develop central sleep apnea.
Why Sleep Apnea is Dangerous
Sleep apnea is a serious condition that can be associated with a host of other conditions. Chronic sleep problems can lead to extreme daytime fatigue, which means you’re more likely to fall asleep while driving.
Sleep apnea makes heart attacks and strokes more likely because it can cause an irregular heartbeat. You can develop insulin resistance with sleep apnea, which means type 2 diabetes is a strong possibility. Your liver can develop scar tissue that signifies nonalcoholic fatty liver disease.
You may have sleep apnea if you have symptoms such as loud snoring, if you wake up with dry mouth every morning, or if your partner tells you that you stop breathing while you sleep. If you experience those symptoms, you should talk to your doctor.
We Can Help You Find Medicare Sleep Apnea Coverage
Original Medicare will help cover the cost of your CPAP machine, but you may need a Medicare Advantage plan to cover other parts of your sleep apnea treatment. There are many Medicare Advantage plans to choose from, and a licensed agent can help you choose the right one for you. Call us at 844-431-1832or contact us here today.
Contact Us | Medicare Plan Finder
Does Medicare Cover Urgent Care?
More than 89 million patients visit an urgent care facility each year. In fact, the number of facilities nationwide has increased from 6,400 to 8,100 since 2014 with roughly 600 more expected to open in 2019. Urgent care is a cost-effective way to get the care you need. If you’re wondering if Medicare covers urgent care, look no further, Medicare Plan Finder makes understanding your coverage easy.
Urgent Care Services Covered by Medicare
Urgent care is typically covered by Medicare Part B. It’s important to note that urgent care centers are not required to accept Medicare. While it’s rare for a facility to deny Medicare, it’s ultimately up to the centers and doctors. Part B covers lab tests, x-rays, emergency transportation, durable medical equipment, mental health, and partial outpatient hospitalization. Urgent care centers provide several services that fall under Part B including illness treatment, minor injury care, x-rays, lab tests, annual exams, and immunizations.
Does Medicare Part B pay for Urgent Care?
Yes, Medicare Part B would cover your urgent care costs if certain conditions apply:
You are already enrolled in Medicare Part B
Your Part B deductible ($185 in 2019) is met
You visit an urgent care facility that participates in Medicare
What is the Medicare Copay for Urgent Care?
Typically, after your deductible is met, Medicare Part B will cover 80% of your costs. You will be responsible for a 20% copay. This may be different if you are enrolled in some sort of savings program or plan that covers Part B copayments (like certain Medicare Supplement plans).
Without insurance, urgent care visits can cost over $100. Imagine having to pay only $20 instead of $100!
What Does Medicare pay for Emergency Room Visits?
Medicare will typically pay up 80% of most services, including emergency room visits. That means that you will likely owe 20% of your emergency room bill. This again can differ if you have a certain Medicare Supplement plan or are part of a savings program that covers your copayments and coinsurance.
It’s important to know where the closest urgent care facility that accepts Medicare is. Don’t abuse your local emergency room. Go to an urgent care facility if you are feeling sick and can’t get a doctor’s appointment.
Click on your city below to see urgent care facilities in your area that accept Medicare (we’re adding more cities weekly). If your city is not yet listed, visit medicare.gov to search for facilities near you that accept Medicare.
How Much Does Medicare Pay for Urgent Care Visits?
Urgent care visits cost less than the emergency room, but can still cost $100 on average before insurance. Since urgent care centers cover a wide array of illnesses and injuries, it’s hard to estimate how much your visit will be. However, Medicare will cover 80% of your costs in urgent care. You will be responsible for the remaining 20% and up to $20 copay unless you are enrolled in a Medicare Supplement plan.
Medicare Supplements and Urgent Care
Medicare Supplement (Medigap) plans are financial benefits that can work alongside Original Medicare. They help to cover costs that Original Medicare does not including deductibles, copays, and coinsurance. There are ten plans available (A, B, C, D, F, G, K, L, M, and N), and each letter represents different coverage at a different price point. Medigap plans can help pay for the remaining 20% of your urgent care costs. For example, if you visit an urgent care facility, and had not met your deductible yet, and were billed with a $20 copayment and 20% coinsurance, Medicare Supplements could help with those costs. Depending on which plan you enroll with, you could pay as low as nothing out of pocket.
Medicare Advantage and Urgent Care
Medicare Advantage plans (MA) are required to provide, at a minimum, the same coverage as Original Medicare. This means that urgent care is still covered. However, MA plans offer several benefits that Original Medicare does not including dental, vision, or hearing coverage, and even group fitness classes like SilverSneakers®. It’s important to keep in mind that Medicare Advantage plans have networks so you will need to make sure the urgent care facilities you visit are covered. At Medicare Plan Finder, our licensed agents can help you enroll in a plan that offers the additional benefits you want with the network you need. Why wait? FIll out this form or give us a call at 844-431-1832. Appointments are no cost to you and there’s never an obligation to enroll.
Urgent Care vs. Emergency Room
Urgent care centers and emergency rooms both address your issues quickly and provide same-day relief. They are both covered under Medicare, but trips to the emergency room can leave you with higher out-of-pocket costs and can take longer to get the medical attention you need. It’s important to understand the difference between these facilities so you better understand where to go in the future.
Urgent care centers are intended for injuries or illnesses that are not life-threatening and cannot wait to be treated by your primary care physician. This includes injuries or illnesses like:
Allergic reactions
Muscle sprains
Rashes, cuts, or scrapes
Swelling or irritation
Mild fever
Cold or allergies
Nausea, vomiting or diarrhea
Sore throat
Flu
Emergency rooms are for serious or life-threatening injuries and illnesses that need immediate attention. This includes injuries or illnesses like:
Heart attack
Stroke
Chest pain
Coughing up blood
High fever
Loss of consciousness
Severe wound
Major fracture
Serious burn
Enroll Today
If you’re interested in enrolling in a Medicare Advantage or Medicare Supplement plan, fill out this form or give us a call at 844-431-1832. Our agents are happy to answer any questions regarding plans in your area, eligibility requirements, coverage, costs, and so much more.
