MedicareBob

MedicareBob

By Robert W. BacheBusinessInvesting
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MedicareBob episodes

  • FAQ Friday Does Medicare cover Cardiac Rehab Programs
    Medicare Part B covers comprehensive cardiac rehabilitation (CR) programs that include exercise, education, and counseling. Part B also covers intensive cardiac rehabilitation (ICR) programs that, like regular CR programs, include exercise, education, and counseling. ICR programs are typically more rigorous or more intense that CR programs. These programs may be provided in a hospital outpatient setting(including a critical access hospital (CAH)) or a doctor's office. You pay 20% of the Medicare-approved amount if you get the services in a doctor's office. In a hospital outpatient setting, you pay the hospital a copayment. The Part B deductible applies.
    People with Part B are covered. You must have had at least one of these conditions:
    • A heart attack in the last 12 months
    • Coronary artery bypass surgery
    • Current stable angina pectoris
    • A heart valve repair or replacement
    • A coronary angioplasty or coronary stent
    • A heart or heart-lung transplant
    • Stable chronic heart failu
    3 min
  • Wellness Wednesday: Can Medicare Help You Quit Smoking
    Each year more than 480,000 people in the United States die from illnesses related to tobacco use. This means each year smoking causes about 1 out of 5 deaths in the US. Smoking cigarettes kills more Americans than alcohol, car accidents, HIV, guns, and illegal drugs combined.
    Not only does smoking increase the risk for lung cancer, it’s also a risk factor for cancers of the:
    • Mouth
    • Larynx (voice box)
    • Pharynx (throat)
    • Esophagus (swallowing tube)
    • Kidney
    • Cervix
    • Liver
    • Bladder
    • Pancreas
    • Stomach
    • Colon/rectum
    • Myeloid leukemia
    Medicare can help you quit smoking. Medicare Part B covers up to 8 face-to-face visits with a healthcare professional for Smoking and Tobacco use Cessation counseling in a 12-month period. A qualified doctor or other Medicare practitioner must provide these visits. All people with Part B who use tobacco are covered and you pay nothing for the counseling sessions if your doctor or other health care provider accepts Medicare assignment.
    2 min
  • Medigap Monday: Does Medicare Supplement Plan G Cover Chiropractors
    Medicare does cover medically necessary chiropractic services. According to the CMS, Medicare Part B now covers 80% of the cost for “manipulation of the spine if medically necessary to correct a subluxation.” You can go as many times to the chiropractor as long as it’s medically necessary. There is no cap to those visits. Medicare doesn't cover other services or tests ordered by a chiropractor, including X-rays, massage therapy, and acupuncture
    Under Medicare Supplement Plan G, you would have to pay your Medicare Part B annual deductible ($183.00 for 2018). After that deductible has been met, the Plan G will pay the 20% coinsurance. Combined with Medicare there will be no charge for any medically necessary chiropractic work.
    2 min
  • FAQ Friday: Does Medicare Cover Chiropractors
    Medicare does cover medically necessary chiropractic services. According to the CMS, Medicare Part B now covers 80% of the cost for “manipulation of the spine if medically necessary to correct a subluxation.” You can go as many times to the chiropractor as long as it’s medically necessary. There is no cap to those visits. Medicare doesn't cover other services or tests ordered by a chiropractor, including X-rays, massage therapy, and acupuncture
    Under Original Medicare, without any additional insurance, you would have to pay your Part B deductible ($183.00 for 2018) and 20% coinsurance for all medically necessary chiropractic appointments.
    Medicare Supplement Plans will pay the 20% coinsurance. Combined with Medicare there will be no charge for any medically necessary chiropractic work.
    Medicare Advantage plans may cover chiropractic care. Since Medicare Advantage Plans are not standardized, each plan can offer a very different set of fees and benefits.
    2 min
  • Wellness Wednesday: Does Medicare Cover Dental?
    Medicare does not cover dental, vision or hearing therefore, none of the Supplement Plans cover them either. We have done a lot of market research looking for the best dental, vision and hearing plan and the best we have found is DVH through Manhattan Life Insurance company for around $35 per month for a $1,000 or $1,500 annual benefit. One key element of this plan that sets it apart from other dental combination plans is that you are free to use your annual benefit towards any of those three services, there is no cap per service. For example, if you needed some work done on your teeth one year, you could use your entire benefit towards your teeth. Most plans will give you an allotted amount out of their benefit that you can put towards dental, vision or hearing. We have listed some additional highlights of the plan below:
    • Choose your dentist - No Networks
    • Family Rates (includes a maximum of 3 children)
    • Individual 18 - 85
    • $1,000 - $1,500 policy year benefit option available
    7 min
  • Medigap Monday: What is Medicare Supplement Plan N?
    Medicare Supplement Plan N is also called Medigap Plan N. Medicare Supplement Plan N is a great option for people that want the benefits of having a Medicare Supplement Plan, however want to keep a lower monthly premium.
    Since the Medicare supplement Plan N has a lower premium than the Plan F and G, it does cover less. There are only 4 out of pocket costs that the Plan N requires you to pay compared to the Plan F.
    1. The Part B Deductible. (2018 this is $183.00 for the whole year.)
    2. $20.00 Doctor copay.
    3. $50.00 ER copay.
    4. Part B Excess charges. (NOTE, in Pennsylvania and Ohio, Providers cannot charge Part B Excess Charges. Therefore, especially in PA and OH, Plan N is a GREAT option.)
    If you are under 70 years old, the price difference between the Plan G and N is usually not enough to choose the Plan N over the Plan G. However, once you are over 70 years old, it might be a good idea to switch from a Plan G to a Plan N.
    2 min
  • FAQ Friday: What is a Medicare Advantage Plan?
    A Medicare Advantage Plan is not a Supplement Plan, it is a private alternative to Medicare. A Medicare Advantage Plan will not pay the bills that Medicare would normally pay, instead a Medicare Advantage Plan will charge you a different deductible, different copays and different co-insurance compared to Medicare.
    Medicare Advantage Plan Summary:
    • Low monthly premium. (Sometimes advertised as $0.00 per month)
    • You will usually have to pay a fee every time you use the plan. ($15.00 copay for PCP visit, $300.00 per day each day you are in the hospital, etc.)
    • You have to go to certain Doctors, Hospitals and Providers. (HMO or PPO Network)
    • You will have to get prior authorizations for some procedures.
    • You will have to get referrals to go see a specialist.
    9 min
  • Medigap Monday: Difference between Plan F and Plan G
    There is only one difference in coverage between the Medicare Supplement Plan F and the Plan G. That’s right, only ONE. The Plan F pays for Medicare’s Part B annual deductible of only $183.00 and the Plan G does not. However, the Plan G is the most cost-effective plan and I’ll explain why. There are three main reasons Plan G is a better choice than Plan F. 1) Simple Math: Plan F costs, on average, $600 more per year in premiums than the Plan G. Why pay Plan F $600 more when the only difference in benefits is that Plan G has a small $183.00 deductible? That is just giving more money to these big insurance carriers for no reason. 2) Rate Stability: No one that turns 65 after 01/01/2020 will be able to purchase the Plan F. This will cause the Plan F premiums to increase quickly. 3) The Part B Deductible is likely to continue increasing. This will also cause the Plan F premiums to increase at a higher rate than the Plan G.
    4 min
  • Wellness Wednesday: Top 10 Early Symptoms of Dementia
    An estimated 47 million people worldwide are living with some type of dementia, per the World Health Organization, and that number will likely increase to 75 million by 2030. The WHO expects the number to triple by 2050.
    Contrary to popular misconception, dementia isn’t a standardized syndrome. Different types of dementia affect the brain in very different ways, and as a result, some people ignore the early symptoms in themselves or their loved ones. Generally, dementia is progressive, so it gets worse over time, but early detection can greatly improve a patient’s quality of life. Listed below are some common warning symptoms of dementia or Alzheimer’s disease.
    7 min
  • Medigap Monday: What are Medicare Part B excess charges
    If you are enrolled in Medicare, you may be familiar with Medicare Part B Excess Charges. Some doctors accept what is called the “assigned” rate for their work. Others charge a higher rate, but they cannot charge more than 15 percent more than the assigned rate.
    For example, Medicare might decide that the fair “assigned” rate for a specific procedure should be $400. A doctor who accepts the Medicare assignment would bill at or below that rate.
    However, your doctor may decide that $400 is not a sufficient reimbursement. Doctors are allowed to charge up to an additional 15% over and above what Medicare has approved. Therefore, in this case, your doctor could charge you $460 and you would be responsible for paying the additional $60 “excess” charge out-of-pocket ($400 X 15% = $60 excess charge) in addition to any deductible and co-pay.
    5 min

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This is MedicareBob, a Podcast created to empower Seniors with Medicare knowledge.