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In this month's article, I will discuss Medicare's coverage of durable medical equipment, which is called DME for short. It is equipment that helps you complete daily activities. This category is also sometimes labeled more inclusively as DMEPOS for durable medical equipment, prosthetics, orthotics, and supplies. Medical equipment to help you daily Durable medical equipment (DME) are items that help you complete your daily activities including a variety of items, such as walkers, wheelchairs,...
Our Congress wrote legislation which was intended to reinforce the opportunity to enroll into Medicare when first eligible (if a delayed enrollment, such as when you are covered by your employer’s healthcare plan). This was done by adding a ten percent (10%) additional amount to the Part B monthly premium, for each 12-month period without fully enrolled Medicare coverage. Also, for individuals and couples filing jointly who may have greater annual modified adjusted gross incomes, an Income-Relat...
This month’s article provides an overview of Medicare coverage in 2025. The 2025 edition of the “Medicare & You” handbook provides much greater detail than is provided in this article; if you do not have a copy, please contact the Medicare Information Office and we are happy to provide one. This handbook is available as an eBook, as well as in large print, audio version, and in Braille. The “Medicare & You” handbook has also been translated into Arabic, Chinese, Korean, Russian, Spanish,...
Medicare coverage is good, but it is not all-inclusive. There are many things that Medicare does not cover. For example, Medicare does not cover most dental, vision and hearing care, including hearing aids. Nor does it cover most non-emergency transportation or care outside of our country. Even when Medicare covers your care, there may be costs left to you, like copays and coinsurances—these costs can add up. An example, for an outpatient visit to a physician who accepts the assigned billing r...
Preventive care helps avoid illness, detect medical conditions, and keep you healthy. A preventive medical service is conducted when you have no prior symptoms of disease. In contrast, diagnostic services address symptoms or conditions that you already have. In this month’s article I will describe how Medicare covers preventive care. Medicare covers preventive services Medicare’s Part B outpatient care covers many preventive services, such as screenings, vaccines, and counseling. To find out...
Medicare can be confusing for anyone. It is easy to misunderstand Medicare eligibility or the best time to enroll in the various parts of Medicare. The factors around Medicare eligibility and enrollment choices can be even more complicated for older people who were born outside the U.S. Immigrants may not have as much work history in the U.S., may have a variety of immigration statuses, or may have limited English proficiency—all making a potentially confusing process even more difficult. N...
From Oct. 15 through Dec. 7, I encourage you to review and, if needed, change your Prescription Drug Plan under Part D coverage. Changes you elect will become effective on Jan. 1. Certified Medicare counselors across Alaska can help you as part of the Medicare Information Office’s network of program Ambassadors, including through your local Aging and Disability Resource Center (ADRC). Give us a call, we would be glad to answer your questions, guide you through the process, and even complete t...
For those of us enrolled into Original Medicare (Parts A and B), most of us have also enrolled into one of Medicare’s Part D Prescription Drug Plans (PDPs). Each year, we may make changes to this prescription coverage during Medicare’s Open Enrollment period, which runs from Oct. 15 through Dec. 7, for changes which will then go into effect from Jan. 1 onward. Leading up to this Open Enrollment, you will start to receive notices with information relating to any changes in your plan for the com...
As Americans and as Alaskans, we share in the health care program costs of our Medicare, both through our federal income taxes and through the cost sharing paid by individuals enrolled into Medicare. But for some Alaskans with low income and low assets, these costs can be a significant part of the monthly budget – there are programs which can help save you money. In this month’s article, I will introduce the Medicare Savings Program (MSP), which can help with the bills for Original Medicare (as...
Medicare is the federal government program that provides health insurance to those age 65 and older or those under 65 with certain disabilities or chronic conditions. Medicare programs and policies are regulated by the Centers for Medicare and Medicaid Services (CMS). When you are new to Medicare, there can be a lot to learn about your enrollment and coverage choices. At least for now, there are no Medicare Advantage programs available to Alaskan residents (also known as Part C of Medicare), so...
This month’s article begins with a recommendation to prepare documentation of your personal desires as related to your medical situation and future health care needs. These can help convey your intentions should you not be able to voice them yourself. Next, a reminder that Medicare only provides coverage for services and equipment deemed medically necessary – you might find yourself in need of additional help with activities in your daily life. Finally, a mention regarding how hospice care pro...
This month’s article will focus on how Medicare may work with health benefits for federal employees, retirees and annuitants. Employees and retired employees of the federal government are eligible for Federal Employee Health Benefits (FEHB) coverage, subject to those positions that are excluded by law or regulation. Currently this includes employees of the U.S. Postal Service. The Office of Personnel Management administers the FEHB program. When someone becomes eligible for Medicare, most c...
Prescription Drug Plan coverage is a valued element within Medicare. Known more commonly as Part D of Medicare, these policies are offered by privately managed insurance companies, and regulated both by the State of Alaska’s Division of Insurance along with the national Centers for Medicare and Medicaid Services (CMS). The cost of your Medicare Part D-covered drugs may change throughout the year. If you notice that your drug prices have changed, it may be because you are in a different phase of...
If you or a loved one are receiving in-patient medical care, there comes a time when that care will end. Hopefully, this is because the patient is ready for discharge, but sometimes, the patient is notified that care will be discontinued, possibly due to a notice from Medicare. You have a right to appeal this decision. What if my medical care ends too soon? If you are receiving care in a hospital or non-hospital setting and you learn that your care is going to end, you have the right to a fast,...
Medicare coverage and costs change each year, so it’s important to understand and review your benefits. Here’s an overview of what’s new in 2024. Medicare Part A and Part B costs in 2024 Medicare Part A covers inpatient hospital services, skilled nursing facility services, home health care, and hospice. Most people don’t owe a premium for Part A, but if neither you nor your spouse have 10 years of Social Security work credits, you may owe a monthly premium. If you’re admitted to the hospital...
While I am writing this month’s article, we are in the last few days of the annual Open Enrollment Period, when you may sign up to change your enrollment in a Medicare Part D Prescription Drug Plan. This period occurs annually from Oct. 15 through Dec. 7; changing your plan at other times of the year may require you to be eligible for a Special Enrollment Period. But what if you don’t meet this requirement, and your prescription drug cost share (the amount you pay when you pick up the prescripti...
Choosing a medical provider can be both challenging and overwhelming for many patients. Here in the Great Land, Alaskans often travel significant distances to obtain healthcare. Medicare can help, when searching for and finding a provider. You can also save money by choosing providers who accept Medicare assignment. This last term, “assignment,” is an important one to remember, especially if you are newly enrolled in Medicare. First, a brief introduction to finding health care providers, fro...
During Medicare’s Open Enrollment Period, you will likely experience more marketing from private Medicare insurance providers, such as Part D prescription drug plans. Companies try to reach consumers in various ways, like television commercials, radio ads, events, mailings, phone calls and texts. The government has rules, though, to protect you from forceful or misleading marketing. Knowing the rules and red flags can help you make the best choices for yourself during Open Enrollment. M...
From Oct. 15 through Dec. 7, I encourage you to review and, if needed, change your Prescription Drug Plan under Part D coverage. Changes you elect will become effective on Jan. 1. Certified Medicare counselors across Alaska can help you as part of the Medicare Information Office’s network of program Ambassadors, including through your local Aging and Disability Resource Center (ADRC). Give us a call, we would be glad to answer your questions, guide you through the process, and even complete the...
As you may know, Original Medicare (Parts A and B) covers approximately 80 percent of the cost of most services. But what about the remaining 20 percent, or even the other out-of-pocket costs like deductibles or inpatient copayments? You may want to obtain a Medicare Supplement Insurance (also known as Medigap) policy as a companion to your Medicare coverage. But how to know which one? My first recommendation is to obtain a copy of the Consumer Guide to Medicare Supplement Insurance (Medigap),...
Ambulances are a critical resource in transporting patients to and from medical facilities, like hospitals. Ambulances are medically equipped and staffed by professionals like paramedics and Emergency Medical Technicians (EMTs). Emergency transportation Medicare Part B covers emergency ambulance services. Medicare considers an emergency to be any situation when your health is in serious danger, and you cannot be transported safely in another way. There are certain requirements you must meet for...
Medicare includes Part D, the prescription drug benefit, offered through private health insurance companies. Each prescription drug plan meets federal requirements as managed by the Centers for Medicare & Medicaid Services (CMS). Insurance companies enter into agreements with both drug manufacturers and drug distribution networks. Some of the costs associated with Part D drug coverage are: Premium: The monthly amount that you pay to your Part D plan for coverage. Premiums vary by plan, and the...
Mental health care can diagnose and treat mental illnesses or mental health conditions. A mental illness or mental health condition may affect your thinking, feeling or mood. Examples of mental health conditions include depression, anxiety and schizophrenia. Some also consider addiction, like opioid use disorder and alcoholism, to be mental health conditions. Mental health conditions are typically not the result of any single event or circumstance. Rather, they are complicated conditions involvi...
Obtaining the best health care involves good communication between you and your doctor. Today I will help explain how you can build an effective relationship with your doctor and make the most of your visits. Communicate well with your health care provider Communication is very important when building relationships with your health care providers and getting the best possible care. To help you communicate with your providers, take the following steps: Be prepared. Arrive at your doctor’s o...
Receiving home health care can be available for some Medicare recipients. To be eligible for Medicare coverage of home health services, you must be homebound. In other words, it must be difficult for you to leave your home and doing so requires a lot of effort. Medicare considers you homebound if you need help to leave your home. The help you need can be from another person or from medical equipment such as crutches, a walker or a wheelchair. You are also considered homebound if your doctor...
