Quality Home Health Care

Reasons to Check Your Medicare Policies Annually

Medicare and Supplementary Plans Change Every Year

Medicare is the popular health insurance plan for people who are 65 years or older. Younger people with disabilities and can also benefit from this plan. Medicare Recipient & NurseFor instance, people with End-Stage Renal Disease (ESRD) are eligible for Medicare. This health insurance plan covers specific services and these these services are categorized under Medicare Part A, Medicare Part B, Medicare Part C and Medicare Part D. below are the features of each of these parts.

Medicare Part A (Hospital Insurance)

This covers some aspects of hospice care, stays in the hospitals, some health care and nursing facility care.

Medicare Part B (Medical Insurance)

This option covers medical supplies, certain preventive services and some doctors’ services.

Medicare Part C (Medicare Advantage Plans)

This plan is usually offered by a private company that contracts with Medicare. Under this plan, you enjoy both Part A and Part B benefits. Most Medicare Advantage Plans provide prescription drug coverage and a number of other benefits.

Medicare Part D (Prescription Drug Coverage)

This adds prescription drug coverage to other plans such as the Original Medicare and Medicare Medical Savings Accounts Plan. The Medicare Part D is provided by insurance companies and other private firms approved by Medicare.

Keep Track of Annual Changes in Your Plan

If you have any of the Medicare Plans above, you should keep track of changes in the plan you have chosen. This is because Medicare and the carriers who offer some of these plans make changes to these plans every year. Below are some more reasons you should review your Medicare policy every year.

Changes in Your Health

Your health may change over the course of a year. If this happens, you need a policy that is just right for you. For instance, you may find that you need new drugs that you did not need in the previous year. In this case, you should review your Medicare coverage to ensure that the new drugs are covered. It is also possible that some drugs you were taking in the past are no longer useful to you in the present. You have no reason to pay for drugs you do not need so you should review your Medicare coverage to reflect the current reality.

Annual Changes in Drugs

Some Medicare private drug plans change the list of drugs they cover every year. Your drugs are vital and you do not want any unexpected changes to have a negative effect on your health. In case some of the drugs you are taking are no longer covered by your Medicare plan, you need to make other arrangements immediately or switch to a more convenient plan.

Annual Changes in Cost

You have a budget for your Medicare plan and you want to stick to this budget. A sudden change in the cost of the premium for your Medicare plan may not be in your financial interest. To avoid any unpleasant surprises, you should review your Medicare plan annually. This way, you can easily move to a plan that is more budget-friendly if the need arises.

Getting a Better Deal

Even if you are completely satisfied with your current Medicare coverage, you can still shop for a better deal. It is possible to get the same coverage at a lower premium if you do a bit of window-shopping. It does not hurt to look at other Medicare options in your area. Compare them with your present deal and you may discover a cheaper and more convenient option.

Final Word

You can change or modify your Medicare policy annually if you have good reasons to do so. You can also take out another policy to supplement the one you already have. Review your Medicare policy each year and you will discover the one that is just right for you.

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Why You Can Trust Boca Home Care Services with Your Elderly Parent

The amount of pressure that comes with having an elderly parent, who is not independent  should not be trivialized. Even though you may love your parents very much and want to be able to care for them as they old age, it is often not possible. Due to the hectic pace of life and the rising cost of living and daily expenses, people need to work. This presents a challenge when it comes to your elderly loved ones. Companies such as Boca Home Care Services, which has been serving seniors in Plam Beach and Broward counties since 1998, provide comprehensive solutions for seniors who need
home care, either due to age, recovery from surgery or injury and seniors who are suffering from a progressive disease, such as Alzheimer’s or dementia.

Elderly Woman and AideAll of BHCS’s home care aides are fully screened, and certified to work with the elderly. Boca home care services puts each senior and aide through careful selection criteria, that will decide whether the home care aide is a good match or fit or the elderly patient. Not only are these individuals qualified to offer care in the homes of seniors, but also in hospitals and rehabilitation centers.

It is important that the aide has patience and compassion as the amount of care that the senior may need could vary. In some cases, the elderly loved one may just need a few minutes interacting with the aide, while in other cases, the home care aide may need to spend several hours with your loved one in less formal surroundings and circumstances. In this case. it is almost inevitable that a professional relationship will also flourish into a more personal one and it is not uncommon for seniors to grow attached to their aides and vice versa.

If your loved one needs medical attention, it is essential that a caregiver is a licensed professional nurse. Only a licensed medical professional can attend to medical needs. Boca home care, our sister company, works with Medicare certified individuals to attend to medical needs. Call 561-989-0441 for Medicare-related inquiries.

Though the individuals who provide personal non-medical home care need to be qualified, they also need to have a conducive personality and characteristics, since they will be working very intimately with your loved one. Some of the tasks that they will be in charge of are bathing, dressing, light housekeeping, preparing meals and even feeding. There are some home care aides that also get involved in helping with shopping and
transportation. A personal home care aide is therefore, responsible for doing anything that proves to help your loved one live a better and more productive life, with a minimum amount of inconvenience and disruption to their normal routine.

Senior home care is about companionship as well. This is why it’s not uncommon for people to switch between 3 to 4 home care aides before settling with the right one. This is because, the home care aide must have a personality that compliments your elderly loved one. Some ways to ensure that you are choosing the most suitable home care aide for your loved one is by simply observing the dynamics between the two. Once you are alone with your loved one, you can ask clarifying questions, such as “Did you like them?”. The response of your loved one is vital to the decision-making process.

Boca Home Care Services take care of all the above so you don’t have to. A major part of their services is doing consistently monitoring of the relationships between the seniors and their home care aides, by sending supervisors through to monitor the climate in the home of the elderly.

To learn more, schedule an in home assessment of your elderly loved one’s needs and the type of aide most suitable for him or her. Call Boca Home Care Services at: (561) 989- 0611.

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Understanding The Four Parts of Medicare

In the United States, Medicare is a federally-funded social health insurance program for people over the age of 65 who have worked and paid into the system, persons under age 65 who have disabilities and people suffering from the final stage of chronic kidney disease and Amyotrophic lateral sclerosis. Elderly careTo be eligible for this insurance, you must be a US citizen or a permanent US resident lawfully residing in the US. Medicare is financed by a portion of the payroll taxes paid by employees and their employers as well as from monthly premiums deducted from social security checks. In essence, Medicare consists of four main parts: A, B, C and D. Here is a detailed look at each of those parts:

Medicare Part A: Hospital Coverage

Medicare Part A (hospital insurance) helps you pay for:

• Inpatient hospital care: This includes semi-private rooms, meals, and tests for up to 90 days in an inpatient facility, 60 lifetime reserve days in a general hospital, and a maximum of 190 days in a Medicare-certified psychiatric hospital.

• Skilled nursing facility (SNF) care: Medicare covers convalescence in a skilled nursing facility provided the following three conditions are met:

1. The patient must have completed a three-day inpatient hospital stay, including 3 midnights prior to seeking SNF care.

2. The nursing home must be for something diagnosed during the stay, the care availed in the facility must be skilled. Long-term care, non-skilled care, daily living and custodial activities are not covered. The expenses covered by part A include: meals, semi-private room, skilled nursing care, medications, medical supplies and equipment, and transportation for those needing skilled nursing services seven days a week, or physical, occupational or speech therapy services five days a week.

3. The maximum allowable stay period for a nursing facility is 100 days. During this period, Medicare pays for the first 20 days in full. However, for the remaining 80 days, the patient has to foot a portion of the bill (copayment).

• Hospice care: This is for the terminally ill patients or those patients with about six months to live. This package covers doctor services, nursing care, medical equipment, and medical supplies including pain relief and symptom control medications.

Home health services such as skilled nursing care and medical social services. Additionally, it also includes home use medical devices and related medical supplies.

Medicare Part B: Medical Insurance/Physician Coverage

Part B helps to pay for care from doctors and other health providers that are medically necessary to diagnose, treat or manage your health condition. It covers, but is not limited to, many of the following services:
• Doctors services, including an annual wellness exam.

• Ambulance services if your health condition requires transportation to and from your home to the health facility.

• Rehabilitative services such as outpatient physical therapy and occupational therapy.

• Many preventive care services such as flu and pneumonia shots.

• Laboratory services such as blood tests, urinalysis and other related services.

• X-ray, MRI, CT scan, EKG and some other related diagnostic tests.

• Select diagnostic tests such as colorectal and prostate cancer tests and mammograms.

• Durable medical equipment for use at home such as oxygen, wheelchairs and walkers. Your doctor must certify that you need these and they must be supplied by a Medicare approved vendor.

• Emergency room services .

• Skilled nursing care and health aide services for the homebound on a part-time or intermittent basis.

• Mental health care as an outpatient.

• Certain prescription drugs as well as some physician-administered drugs.

Medicare Part C: Medicare Advantage

Medicare Part C refers to Medicare-approved private health insurance plans for individuals eligible for or enrolled in Original Medicare (Part A and Part B). It is worth noting that, when you join the Medicare Advantage Plan, you would still need to continue paying your Part B premium. Medicare Advantage Plans provide all of your Medicare Part A and Medicare part B coverage. These plans offer additional benefits, such as optical, dental, and hearing care and many include prescription drug coverage. Medicare Advantage plans often charge a premium in addition to the Medicare Part B premium. They also generally charge a fixed amount called a copayment whenever you receive a service. You can join any Medicare Advantage plan if you meet the following conditions:

• You have Medicare Parts A and B
• You live in the plan’s service area
• You do not have End-Stage Renal Disease (ESRD).

Medicare Part D: Prescription Drug Coverage

Medicare Part D is essentially private insurance that pays for prescription drugs. This coverage is available to Medicare beneficiaries in one of two ways:

• A Medicare prescription drug plan: This is a stand-alone plan that can be added to your Original Medicare coverage.
• A Medicare Advantage Prescription Drug Plan: This plan offers the same benefits as Original Medicare and includes prescription drug benefits.

Medicare Part D plans generally prescription drugs for a medically acceptable condition. It is worth noting that drugs covered by Part D cannot be covered under Part A or Part B. Additionally, to enjoy Part D coverage, you would need to pay a monthly premium.

Conclusion

Medicare consists of four main parts: A, B, C and D. This article has discussed each of these parts in detail.

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Does Medicare Cover Alzheimer’s? What Are The Criteria’s?

Does Medicare Cover Alzheimer's? What are the criterias?

Medicare and Alzheimer’s Coverage

Medicare is a health insurance plan funded by the federal government and covers people who are usually over the age of 65. Beneficiaries must also be receiving Social Security retirement benefits. In some cases, people under the age of 65 may receive financial help from Medicare, such as those who have received disability benefits for 24 months or longer. Medicare, the original program, is divided into parts A and B. Part D was added later. Part A is known as “hospital insurance” and Part B is known as “supplemental insurance.

Medicare Part A provides coverage for inpatient hospital care as well as part of the medical items needed for a patient suffering from Alzheimer’s or dementia, and some of the doctors’ fees. It will cover up to 90 days in a hospital because a temporary “spell of illness”. If a longer stay is needed to recover, there is a “Lifetime Reserve” of an additional 60 days. These days can only be used one time. These temporary stays are considered acute care and also include skilled nursing home care, hospice care, and home health care.

Medicare Part B covers such services as:

  • Home health care services
  • Durable medical equipment
  • Diagnostic x-rays
  • Outpatient hospital services
  • Physicians’ services
  • Blood
  • Mental health services
  • Laboratory tests
  • Physical, speech and occupational therapy

Parts A and B have different insurance co-payments, deductibles and benefits, so be sure to contact the Centers for Medicare and Medicaid Services for details.

Medicare Part D is an additional part of the Medicare health insurance plan, provided only by private insurance companies, that covers specific drugs. When a person who is already enrolled in or is eligible for Medicare, and he or she is suffering from either dementia or Alzheimer’s, they qualify to enroll in Part D. There are some limitations on this program such as a limit on the quantity of a drug you can receive, or the restriction of paying for a more expensive drug only after a less expensive “step-up” drug has been tried first and has been determined by a doctor not to work.

In 16 of the states in America, including Florida, Medicare offers a policy covering training and teaching to families and caregivers of Alzheimer’s patients suffering from behavioral symptoms and Alzheimer’s disease it. These trainings are offered because Medicare understands the need for skilled nursing care to demonstrate to caregivers the proper ways to manage behavioral symptoms displayed by the Alzheimer or dementia sufferer.

According to the Alzheimer’s Association, in the year 2013, Special Needs Plans became available specifically for people who suffer from dementia, including those with Alzheimer’s disease. These Special Needs Plans are offered by Medicare Advantage and specialize in the coverage of care for its beneficiaries with dementia.

These SNP’s are only available in two specific areas including twenty-two counties in Minnesota and twenty-one counties in Florida. The Florida HMO plan is offered by Universal Health Care, while the Minnesota HMQ plan is offered by Medica Complete Solution – Dementia.

If you live in a Florida county covered by a Medicare SNP, be sure to check out Boca Home Health Care Services. BHCS is a care driven company dedicated to superb customer service.

*http://www.alz.org/care/alzheimers-dementia-medicare.asp#managed

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Choosing Between Medicaid and Medicare

Medicare or Medicare?

Medicare or Medicare?

As we age, which program is better – Medicaid or Medicare? In order to answer that question, we need to define each program. What does Medicaid do? What does Medicare mean?

Medicaid is a government sponsored assistance program that helps low income families and some individuals pay for their health care. The Medicaid program is state run, but funded half by the state and half by the federal government. The federal government may contribute less in a state that has a wealthier population. As a state run program, Medicaid’s eligibility guidelines vary state to state, as does the type of coverage. To be eligible for this program, you must have $1,000 or less in liquid assets. The amount of help you receive from Medicaid is based on a sliding scale. The more income an individual or a family has, the less Medicaid they will receive. Some states require beneficiaries to pay a co-payment or deductible to their health care provider for medical services provided, although in some states the co-pays can be as little as $30.00 per month.

Medicaid covers chronic conditions as well as long term care, and Medicaid covers a wider range of health care services than Medicare does. Medicaid pays for x-rays, pediatric care, hospitalization, clinic treatment, laboratory services, family planning, surgical and medical dental care, and in-home nursing facilities for those over 21 years of age. 60% of nursing home residents’ health care expenses are covered by Medicaid.

Medicare is a federally run and sponsored program.  Unlike Medicaid where coverage can vary from state to state, all coverage under Medicare is uniform nationally. Eligibility for Medicare only requires that you be over 65 years of age and have paid taxes into the Social Security fund at some point in your life.  Income does not factor into your eligibility for Medicare.  People who are suffering from end stage renal disease or disabled individuals who are receiving or are eligible to receive Social Security benefits are also eligible for Medicare.

There are different divisions of the Medicare program: Parts A, B, and D. Part D covers prescription drugs, Part B covers medical insurance and Part A covers hospital care such as nursing facility stays, hospice care, respite care, and inpatient hospital stays.  All of these are included under the acute care umbrella. It is important to note, however, that Medicare is not a long term care program, so it does not cover chronic conditions.  Regardless of the type of Medicare that you receive, co-pays or deductibles for certain medical services may be required under Medicare and Medicare reserves the right to refuse to pay for medical treatments that it deems unnecessary.

So given all of that information, how do your health care needs compare to the services provided by Medicare and Medicaid?   Making the decision between the two coverage options is not easy.  You should always consult with health care professionals regarding your choice, and request as much information as possible from the government regarding each program to determine which is the most suitable for you.

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