• Medicare

    Knowing what doctors can charge you in Medicare

    When you need to see a doctor, and have traditional Medicare, always ask the doctor’s office if they accept Medicare patients and if they accept assignment. The answer will determine how much you pay: Assignment: A doctor who accepts assignment is agreeing to charge no more than the approved Medicare amount for any particular service. You’re assigning Medicare to pay the doctor for your care. In this situation, Medicare will pay 80% of the approved amount, you’re responsible for the remaining 20%, unless you also have supplemental insurance. No Assignment: A doctor who accepts Medicare patients but not assignment can charge you up to 15% over the amount that Medicare…

  • Medicare

    Long-Term Care Pharmacies

    Nursing homes use special Long-Term Care (LTC) pharmacies that dispense prescriptions in special packaging, the drugs come in single sealed doses rather than the usual containers. This system is for hygiene and safety reasons in a setting where nurses administer many different drugs to many patients. All Part D plans must include LTC pharmacies in their network. If the pharmacies your nursing home uses aren’t in your plan’s network, Medicare expects the plan to contact with those pharmacies so that you don’t need to change to another plan. However, when you enter a nursing home, you need to check if its LTC pharmacy is in your Part D plan’s network.…

  • Medicare

    Advance Beneficiary Notice

    If you’re going to receive a service that Medicare likely will not cover, you likely will receive an Advance Beneficiary Notice (ABN). Any provider – a physician, hospital, lab, skilled nursing facility, home health agency, medical equipment supplier, ambulance company, etc. – can give you an ABN if it thinks Medicare will not pay. A provider isn’t required to issue an ABN for any service or item that Medicare definitely does not cover (such as hearing aids or routine foot care) but may do so voluntarily as a professional courtesy. Options on an ABN: A ABN asks you to sign it after checking one of three options: You want the…

  • Health Care Reform

    Home Health Care Services

    Home Health Care Services are services providing some of the same types of care that you might receive in a skilled nursing facility but in your own home. These include: Skilled Nursing Care: provided on a part-time basis (no more than eight hours a day over a period of 21 days or less) and include services such as injections, feeding through a tube, and changing catheters and wound dressings. Physical, Speech, and Occupational Therapy: from professional therapists to help you walk again, overcome problems in talking, or regaining the ability to perform everyday tasks, such as feeding and dressing yourself, whichever your medical condition requires. Help from Home Health Aides:…

  • Health Care Reform

    American Health Care Act

    I’ve waited to post on this issue because there’s so much noise regarding this proposed bill it’s been a little deafening. Even if this political hot potato reaches the US Senate, which currently looks iffy at best, that body of esteemed politicians are not ones to rubber stamp anything. So changes will be made, and back to the House it goes. In the mean-time, below are a few links to what’s currently on the table. American Health Care Act Summary of AHCA from the Kaiser Family Foundation Congressional Budget Office Report

  • Medicare

    Choosing a Medicare Supplemental Policy

    Your choice of a Medicare Supplemental Policy depends on two things: which one provides closest to your needs and how much you’re willing to pay for it. The latter point depends on several factors: What type of policy you buy: Policy A has the fewest benefits, whereas policy F has the most. As with most things in life, you get what you pay for. When you buy the policy: Buying during a time frame when you get important consumer protections can make a huge difference in your premiums. Where you live: Medicare Supplement premiums vary according to geographical area. Premiums tend to be lower in metropolitan area as opposed to…