We’re all aware we should make an effort to regularly see our physicians. But we also know that life tends to get in the way.
Especially for seniors, transportation and cost can often prevent routine doctor visits. However, just because you can’t get to your doctor’s office, doesn’t mean you have to stay in the dark about your health. There are quite a number of tests that you can perform without ever leaving home!
Tests You Can Do At Home Today
The range of at-home tests and testing methods varies widely. Some require expensive medical equipment only available through a supplier and with a prescription, while others require only a pen and paper. Here are some tests that you can do today with little to no supplies
SAGE Test for Dementia
The Self-Administered Gerocognitive Exam, or SAGE, was devised by researchers from the Wexner Medical Center at Ohio State University. SAGE can help detect early warning signs of cognitive impairment and memory loss in less than 15 minutes.
The test has several components and several forms, all of which can be viewed and downloaded at the Wexner Medical Center’s website. These include sections on orientation, language, memory and visuospatial awareness.
The most well-known element of the SAGE is known as the clock drawing test. All you need to do is get out a pen and paper and draw a picture of a clock, with the hands reading 3:40. Then compare your drawing to a real clock to see how you scored.
If your circle is closed, give yourself a point. If all twelve numbers are accounted for and in the right place, you get two more points. If your hands are in the correct position as well, you passed with flying colors. A score of any less than three points, however, might be an indication that you should see your physician for further screening. This test is sometimes performed without the rest of the exam, though it is usually recommended to perform the entire SAGE test for dementia detection.
Window Test for Vision Loss
Our eyes take a lot of abuse these days from the onslaught of screens and artificial lighting. It’s even more severe as we get older and the natural, age-related loss of vision begins to take effect. If you experience some trouble reading, give yourself this informal at-home eye exam to judge whether or not you should seek an eye care professional.
First, sit across the room from a large window or door so that you can see all the lines of the frame around it. Cover one eye and focus on the window or door frame with your open one for 30 seconds. Then repeat with the opposite eye. The horizontal and vertical lines of the frame should be clearly visible with no missing or hazy areas. If the edges of the frame seem distorted or warped, this may indicate macular degeneration, a disease that is currently the leading cause of irreversible vision loss in people over 60.
Cushion Test for Peripheral Arterial Disease
The cushion test can be performed without even getting out of bed! It can help detect blocked arteries in your legs and feet, a condition known as PAD, or peripheral arterial disease. Those with high blood pressure or diabetes, both common among seniors, are especially at-risk for this disease.
To perform this test, lie on a bed and elevate your legs with pillows or cushions until they are resting at a comfortable 45-degree angle. Keep them there for one minute, then sit up and swing your legs over the side of the bed so that they hang at an angle of 90 degrees. If either or both of your legs turn pale when elevated and take several minutes to return to their normal shade after sitting up, you may need to consult your physician with the results from this peripheral artery disease test.
Phalen’s Maneuver for Carpal Tunnel
We are an increasingly computer-savvy society and people of all ages are typing more than they used to. Extended periods of typing are strongly associated with carpal tunnel syndrome, a painful condition caused by a pinched median nerve in the wrist, but many other activities like driving can bring on these symptoms as well. Furthermore, people over 55 years old are at a much higher risk and those over 65 are more likely to have cases that are severe.
Phalen’s maneuver is a test devised to diagnose carpal tunnel at home and has been shown to be surprisingly effective. To see for yourself, press the tops of your hands together with your fingers pointing toward the floor and your elbows extended. If you can, hold this position for a full minute. If you feel an unpleasant sensation, such as prickling, tingling, or burning, you may likely have carpal tunnel and should consider preventive measures.
Check out this video from Physiotutors on YouTube that explains how to perform the Phalen test:
Testing With Medical Equipment
Some at-home health tests will require special instruments to fully gauge the results. While many of these items can be freely obtained from online and brick-and-mortar retailers, some require ordering through a medical supplier with a doctor’s prescription. Below, we will detail some of the testing you can do at home with the help of specially-designed medical equipment.
Blood Sugar Test
For the 12 million seniors living with diabetes* (about 25% of those over the age of 65), monitoring blood sugar levels is an near-constant concern. Luckily, this is something that can be checked at home or on-the-go using a blood glucose monitor, or glucometer. These can be found online or in pharmacies in the form of kits, which include testing strips, needles (called lancets), and the glucometer itself.
To test blood sugar at home, you will need to insert a test strip into the electronic monitor and prick the side of your finger with the provided lancet. Gently apply pressure to that finger until you see a drop of blood form, then touch it to the edge of the test strip. In just a few seconds, you will have an accurate metering of your current blood sugar levels, no matter where you are.
Blood Pressure Test
Along with heart rate, breathing rate, and body temperature, blood pressure is one of the four most significant vital signs that our bodies produce. High blood pressure can be caused by countless factors like high cholesterol, stress, and even fear, and affects almost 70% of adults between the ages of 65 to 74. Monitoring blood pressure accurately is vitally important, as symptoms may not manifest until these levels are dangerously high. Doctors maintain accuracy by using large, costly machines but there are ways to test blood pressure at home with minimal equipment.
The quickest and most accurate results will come from automated, electronic blood pressure monitors that come with an upper arm cuff. Many different brands of at-home blood pressure cuff exist and can be found at pharmacies or similar retailers. The directions for use may change from model to model but there are certain rules that apply no matter what brand you use, including placing the cuff directly on the skin, placing the feet flat on the floor, elevating the arm to chest height, and avoiding smoking or drinking for 30 minutes before testing.
At-Home Lab Tests
Another popular method of in-home health testing comes in the form of test kits that can be ordered right to your door. These vary widely, not only in terms of what is being tested, but also in the method of sample collection. Some services will send a team of professionals to administer and retrieve your test, while others will only send instructions and require you to send your samples back in the mail for results. These can be purchased to test for a wide range of conditions, including food sensitivity, hormone testing, DNA testing, and other at-home blood tests.
Medicare DME Coverage
Durable medical equipment, or DME, is a designation that Medicare uses to classify coverable medical equipment that can be used in the home. This benefit might be used to cover the cost of equipment to aid in the at-home testing we have already covered. The covered equipment can range from crutches and canes to CPAP devices and hospital beds, though it all must come from a Medicare-approved medical supplier.
Medicare-Approved Glucose Meters
Blood sugar monitors and test strips are usually covered under Medicare Part B as durable medical equipment for home use with a doctor’s prescription. You may be able to rent or buy a glucometer but Medicare will only provide coverage if both your physician and the supplier are both enrolled and participating in Medicare. Be sure to clarify this with your doctor and equipment supplier, as some may be enrolled but not “participating” and may not accept the cost of assignment.
Medicare Part B may cover the cost of a blood pressure monitor or ambulatory blood pressure monitoring (ABPM) device but only under very specific circumstances. Part B will cover a blood pressure monitor and stethoscope for those who receive blood dialysis treatment in their home and will pay for the rental of an ABPM device for patients who have exhibited “white coat hypertension,” a phenomenon where nervousness in clinical settings causes artificially high blood pressure readings.
For those with Medicare Part C, or Medicare Advantage, all the benefits of Parts A & B will be covered but may also include additional benefits and expanded coverage. Contact your insurance company to find out if your Part C plan covers blood pressure monitors or glucometers.
If you don’t have a Medicare Advantage plan, give us a call at 844-431-1832 or contact us online to speak with a licensed agent and find a plan that can address your healthcare needs!
A Guide to Medicare Coverage for Dementia
A Guide to Medicare Coverage for Dementia
Dementia is a decline in mental capacity that becomes severe enough to hinder a person’s ability to function. According to the Alzheimer’s Association, one-third of Americans die with some form of dementia.
Medicare Parts A and B (Original Medicare) will cover everything that’s medically necessary for dementia patients, but many other services won’t be covered.
Original Medicare dementia care may be limited, but certain Medicare Advantage plans offer coverage for more services that can include unexpected offerings like meal delivery.
Medicare Coverage for Dementia Patients Clarified
An Original Medicare plan will cover services that your doctor deems medically necessary. Medicare Part A covers inpatient hospital care, and Medicare Part B covers outpatient care and medical expenses such as doctors’ appointment costs.
Original Medicare will pay for the first 100 days of care in a skilled nursing facility (there may be some associated fees), and some Medicare Advantage (Part C) plans may include long-term care coverage as well as skilled nursing care.
Private insurance companies offer Medicare Advantage plans, so they have the freedom to cover benefits Original Medicare doesn’t. Medicare Part D or certain Medicare Part C plans cover prescription drugs such as cholinesterase inhibitors that can temporarily improve symptoms of dementia.
Medicare Supplements (Medigap) plans can help cover the expenses that Original Medicare does not. Unlike Medicare Advantage plans, Medigap plans do not cover medical expenses, but they cover financial items such as Part A and B coinsurance and copayments. Even though Medigap and Medicare Advantage are two different types of plans, you cannot enroll in both at the same time.
Does Medicare Pay for Dementia Testing?
Medicare Part B covers cognitive testing for dementia during annual wellness visits. A doctor may decide to perform the test for patients who are experiencing memory loss.
The test consists of about 30 questions like, “What year is this?” to assess the patient’s memory and awareness. The test can be used as a baseline evaluation for future wellness visits and can be a valuable tool for catching dementia early.
Medicare Testing for Alzheimer’s
Dementia is a symptom that can result from many different diseases. Alzheimer’s disease is just one cause of dementia. The risk of developing Alzheimer’s increases with age and with a family history of Alzheimer’s.
There is a correlation between genes called apolipoprotein E (APOE) and Alzheimer’s, but those genes do not necessarily cause the disease. Medicare will not cover genetic testing for APOE genes.
Dementia as a SEP-Qualifying Condition
Medicare eligibles with dementia also qualify for specific Medicare Advantage plans called Chronic Special Needs Plans (CSNPs). These health insurance plans involve coordination and communication between the patient’s entire medical team to help ensure the patient gets the best possible care.
The best way to sort through the thousands of plans available and find the right CSNP for you is enlisting the help of a qualified professional by contacting us here.
If you’re diagnosed with dementia and already enrolled in Medicare Parts A and B, you will qualify for the Special Enrollment Period (SEP). The SEP allows you to enroll in new Medicare coverage or make changes to your existing CSNP whenever you need to instead of having to wait for certain times of the year.
Eligibility for Medicare Coverage for Dementia
If you meet the eligibility requirements for Medicare Parts A & B, you will also be eligible for the dementia coverage provided by Medicare. You can obtain Medicare coverage for dementia services if you are:
Age 65 or older
Any age and have a disability, or end-stage renal disease (ESRD)
Dementia patients are also eligible for other specific Medicare plans once they are officially diagnosed with the condition, like special needs plans (SNPs) and chronic care management services (CCMR.)
Medicare can also cover home health care that dementia patients often need. In order to receive this coverage, it must be certified as necessary by a doctor. The patient must also be classified as homebound, meaning they have trouble leaving the house without help.
Does Medicare Cover Memory Care?
Memory care is a specific type of long-term care for Alzheimer’s patients or people with dementia. Original Medicare will cover occupational therapy but does not cover assisted living facilities. However, certain Medicare Part C plans may include coverage for Medicare dementia care services such as adult day care or help to get dressed or to bathe.
Medicare dementia coverage is split between its component parts. Part A helps cover the cost of inpatient hospital stays, including the meals, nursing care, and medication that you need while you’re there. Meanwhile, Part B will cover the doctor’s services that you might receive during your stay in the hospital, such as testing or medical equipment.
Even more services can be covered by Part C, also called Medicare Advantage. In addition to everything covered by Parts A & B, these plans can also offer options for long-term and home care for dementia patients.
How Much Does Medicare pay for dementia care?
Each different part of Medicare will pay for its benefits in different ways. For example, Part A will cover the entire cost of your hospital or skilled nursing facility stay for the first 60 days. After this period, you will need to pay 20% coinsurance until day 90, when Part A will stop paying entirely.
Part B, on the other hand, will usually pay for 80% of all services that it covers. Medicare Supplement plans are often purchased to cover the remaining costs, and can also provide additional benefits to the patient.
Does Medicare cover long term care for dementia?
The long-term care insurance offered by Medicare depends on the nature of the service being provided to the patient. In many cases, the long-term care needed by dementia patients is classified as custodial care and won’t be covered by Medicare.
However, if your doctor prescribes a long-term care service as “medically necessary,” Medicare may help cover the costs. These exceptions can include services like hospice care, and part-time nursing care or occupational therapy provided in the home.
Does Medicare Pay for Home Health Care for Dementia Patients?
It is usually difficult to obtain coverage from Medicare for elderly care at home. However, it can completely cover some home health services that are deemed medically necessary by your doctor, including:
Physical and occupational therapies
Part-time skilled nursing care
Medicare social services
Most nursing home care is also classified as custodial care by Medicare, meaning it will not be covered. Medicare will cover custodial home health care for dementia patients only if it’s a part of hospice care.
Medicare Advantage plans, however, can offer many different home health benefits for those who suffer with dementia. Examples include personal care assistance, homemaker services, and meal delivery.
Does Medicare Cover Assisted Living for Dementia?
Original Medicare will not cover any services that are deemed custodial or personal care, including any that aid in typical activities of daily living, such as:
Using the restroom
This rule also applies to assisted living and memory care facilities which provide these services. But depending on your state and the facility of choice, Medicaid may be able to help cover the cost of long-term custodial care provided in assisted living facilities.
Medicare Dementia Hospice Criteria
In order for Medicare to cover hospice care, your doctor must first document that you have less than six months to live. You or your durable power of attorney must sign documents indicating that you agree to accept care for comfort and that you waive other Medicare benefits.
What dementia services does Medicare not cover?
In almost all cases, Medicare will not cover any non-medical care services, such as:
Assisted-living or long-term care
Custodial services provided in a facility or in the home
There are exceptions to these rules, but the service in question must be recommended as medically necessary by your doctor. Medicare Advantage plans may offer coverage for these and other personal care services not covered by Medicare.
How to Cover the Gaps with Medicare and Dementia
Paying for dementia care can be daunting, even for Medicare beneficiaries. Both Parts A & B have deductibles you have to meet, and Part B only pays for 80% of its covered services. At the end of the day, a patient and their family may be left wondering how to pay for Alzheimer’s care.
The answer may come in the form of Medicare Part C, also called Advantage plans, which can pay for many of the custodial care costs not covered by Original Medicare. Another option may be a Medicare SNP, or special needs plan, which are geared toward patients with certain chronic conditions such as dementia.
Early Signs and Symptoms of Dementia
Dementia can have a variety of symptoms depending on the cause, as well as if the patient is in the early stages or late stages of the disease. However, some common signs symptoms include:
Loss of memory
Difficulty finding the right words during conversation
Getting lost while driving to and from familiar places
Difficulty with logical reasoning or solving problems
Difficulty with completing complex tasks
Difficulty with planning and organizing day-to-day activities
Difficulty with muscular coordination and motor functions
Being confused or disoriented
Changes in personality
Inappropriate or irrational behavior
How to Find Memory Care
Medicare.gov has a tool to find nursing homes that accept Medicare for medical services. To get started, click here. Not all of these facilities have dedicated memory care teams, so you’ll need to contact them to verify their services.
Once you’re on the nursing home finder tool page, enter your zip code as shown below in red. We used 37209, which is our corporate headquarters’ zip code in Nashville, Tennessee. Then click “Search,” shown in yellow.
Then you’ll reach a list of nursing homes in your area. The nursing home finder tool lets you sort facilities by star rating, which is based on a scale of one to five.
Basically, the higher the rating, the better the care the facility provides. For demonstration purposes, we only chose to see homes that have a five-star rating (shown below in red) and that take Medicare insurance (in green.)
You may have to contact more than one facility to find the right one for you. Ask about costs and how they help patients with dementia. If one seems like it may be a good fit, ask to tour the home to really get a feel for it.
Resources for Families
Family members of dementia patients have access to a wide variety of resources to help them cope. The first step for helping your loved ones is to educate yourself about the disease and to learn how you can be the most supportive.
You should also look into support groups for your family so they can find like-minded people who are having similar experiences. Dementia should not be dealt with alone.
If you are a caregiver for a parent with dementia, you should consider important things such as who will have the power of attorney and make financial decisions for the patient at the end of his or her life. If you haven’t enrolled in a life or a final expense insurance policy, you should consider doing so now.
We Can Help You Find Medicare Coverage for Dementia
Dementia is difficult for everyone involved. If you or a loved one has dementia, we can help you navigate Medicare dementia care and find a Chronic Special Needs Plan that’s right for you. Set up a no-obligation appointment with a licensed agent by calling 844-431-1832 or contacting us here today.