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By Carol Marak
Chief Public Relations Officer, Aging Alone Spokesperson & Advocate
Published: Oct 12, 2018.
The Medicare open enrollment period runs from October 15 through December 7 each year. During this period, people on Medicare have the opportunity to change coverage.
Medicare Part C plans, known as Medicare Advantage plans, are private health insurance plans, mainly HMOs and PPOs, for people enrolled in Medicare. If you enroll in a Medicare Advantage plan, you still have Medicare, but you get all of your Medicare-covered benefits through a private plan. Most Medicare Advantage plans also cover prescription drugs and may cover other services, like vision, dental, and hearing. If you have Part A and Part B and are covered under the traditional Medicare program, then you do not need to sign up for a Medicare Advantage plan during Open Enrollment unless you want to get your Medicare benefits through a private plan.
Medicare Advantage plans restrict the health care providers that enrollees see (provider networks) whereas beneficiaries in traditional Medicare may see any doctor that accepts Medicare, without needing prior authorization or a referral from their primary care doctor.
11.9 million American seniors opt in to buy a Medicare Supplement (Medigap) insurance plan. But choosing a plan is confusing. I read a study that said some of us overpay by thousands of dollars and the data shows that over 3,500 insurance companies overcharge. To give you just a few examples cited by the study:
Know that all Medicare Supplement insurance plans are standardized by the government and all companies provide the exact coverage. Why would you want to pay more than you need for the same coverage? So, shop around.
You can learn about coverage options (without a computer) by calling 1-800-MEDICARE (1-800-633-4227), or by speaking with someone at your local State Health Insurance Assistance Program (SHIP).
SHIPs offer local, personalized counseling and assistance to people with Medicare and their families.
You can call 877-839-2675 to get the phone number for the SHIP in your state. You can also use the Medicare Plan Finder, a searchable tool on the Medicare.gov website. You can compare Medicare Advantage plans, Medicare Part D plans, and Medigap supplemental policies. Or call 1-800-MEDICARE (1-800-633-4227).
Carol Marak, aging advocate, Seniorcare.com. She's earned a Certificate in the Fundamentals of Gerontology from UC Davis, School of Gerontology.
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Aging Matters
More than 52 million Americans are age 65 or older, according to the U.S. Census. In 2014 alone, the Center for Disease Control data, reported 29 million falls causing seven million injuries and costing an estimated $31 billion in annual Medicare costs. Falls in the older population leads to serious injury, a loss of independence and even death.
With more than 10,000 older Americans turning 65 each day, the number of fall-related injuries and deaths is expected to surge, resulting in cost increases unless preventive measures are taken.
After Medicare refused to pay for the cost of treating a fall with injury that might occur during a hospital stay, the administration began searching for ways to prevent falls. Medicare deemed such falls preventable, and state they "should not occur after admission to the hospital." However, falls continued.
With the improvement of the cost of video monitoring, trained employees can now watch a patient in a hospital room. A few on the market today are made by AvaSys, Cisco, and Nexus. It's reported that the tele-sitters have reduced falls by 8 percent.
Technology at home has taken a big step forward with apps. These have been developed by a physical therapist, Agewell's Equilibrium and Kinesis QTUG. The apps uses a smartphone or wearable device to detect a possible fall, and then determines the best treatment to reduce the risk. A family member or caregiver can make the assessment using either a smartphone for periodic testing, or a wearable sensor for continuous monitoring of physical function. The device can also be used by physical or occupational therapists, care workers, doctors and nurses.
The Equilibrium prototype operates on an Android platform and has been tested in assisted living, outpatient physical therapy, home health and community settings. A pilot program can be accessed on their website. "Falls are the leading cause of injury-related death in older adults and can lead to social isolation, depression, lack of independence, hip fracture and sadly, even death," according to the Equilibrium website. "Many who fear falling limit their activity and engagement in enjoyable activities leading to loss of strength. Ironically, these are the two main reasons people have falls."
Read more about technology reducing falls at http://blog.csa.us/2017/12/best-fall-prevention-technology-for-2018.html.
Join my weekly Age with Purpose newsletter via email to Carol@Seniorcare.com.
Carol Marak, aging advocate, Seniorcare.com. She's earned a Certificate in the Fundamentals of Gerontology from UC Davis, School of Gerontology.
