Medicare Still Confusing to Many Turning 65

Ten thousand people each day are turning 65 in this country.   The majority of them have one thing in common; uncertainty and confusion about how Medicare works.

The good news is, there are some basics that can help you sort out your options and set up a timeline of what to do and when to do it.

Each week for the next few months, I will cover a different aspect of Medicare eligibility and enrollment in my blog.  This week we will talk about some fundamentals of enrollment.

First, if you are turning 65,  and currently have private individual insurance coverage (not through an employer or the employer of a spouse) you can sign up for Part A and/or Part B during the 7-month period that begins  3 months prior to your birthday, the month of your birthday, and 3 months after your birthday.  If Medicare is going to be your “primary” coverage, and you want that coverage to begin in your birthday month, you should enroll during the first three months of your IAP (initial enrollment period).   If your birthday is after the 1st of the month, and you enroll in the first three months of your IAP, your Medicare coverage will begin on the 1st day of your birthday month.  If your birthday is on the 1st day of the month your coverage will begin the first day of the prior  month.

If you are continuing to work after 65, and are covered by insurance through active employment of yourself or your spouse, the rules are a bit different and you should definitely review your options with Medicare or a Medicare knowledgeable advisor.  It gets a bit tricky if one person is working and the other is on Social Security and covered under an (actively employed) spouses group plan.  In this case, because the (non-employee) covered spouse is already receiving Social Security benefits, they will automatically be enrolled in Part A and Part B and they may need to decline Part B to preserve their IAP  for later.  The guideline is related to the number of employees in the company providing the group coverage.

A+ Longevity offers Medicare consulting and free Medicare classes for people who need help understanding their benefits.  Check out our current class schedule on the A+ Longevity Facebook page https://www.facebook.com/apluslongevity

 

Warning for Medicare beneficiaries – what you must know when you are hospitalized

Warning for Medicare beneficiaries – what you must know when you are hospitalized

I always try to warn new Medicare beneficiaries about the implication of being under observation versus being an inpatient when you are hospitalized.

observation-medicare

See the video that I received from the Center for Medicare Advocacy that tells one woman’s story.  As this video points out, this problem is becoming a problem at hospitals all over the country.  The sad thing is the hospital points to Medicare rules and Medicare says it isn’t their fault and the patient, meanwhile, is the one that suffers the consequence.  Last year I had one client whose family found out they had been under observation for 11 days!  When did they find out?  When they were trying to make arrangement for skilled rehab because she was being “released”.

What can you do?  The Center for Medicare Advocacy suggests you write your representatives in Washington and tell them you want this problem fixed.  Perhaps if enough people complain, eventually something might happen. But most importantly you can be pro-active when you go to the hospital. ASK not just once—continue to ask if you have been admitted as an inpatient or if you are under observation.

As they pointed out in this video, the ramifications for you as a Medicare Beneficiary are dire and very expensive.  If you need care from a skilled rehab and you have not been admitted as an inpatient and spent 3 midnights in the hospital. . . Medicare will not pay for you to go to a skilled nursing facility for rehab.  This is not something you or your family want to find out the day you are being released to one!  Trust  me , I get these panicked calls more than you can imagine.

Don’t make the mistake of thinking just because you have on one of their “air-conditioned” gowns; have tubes everywhere and are hooked up to machines; or are filling out menus for hospital meals- that you are an inpatient.

MEDICARE SUMMARY NOTICES GET NEW LOOK AS PART OF NEW MEDICARE INITIATIVE

People with Original Medicare get a “statement” in the mail every 3 months for their Medicare Part A and Part B-covered services. This is called a “Medicare Summary Notice” (MSN). (Medicare loves acronyms!)  The MSN shows all your services or supplies that providers and suppliers billed to Medicare during the 3-month period, what Medicare paid, and the maximum amount you may owe the provider.

The Centers for Medicare Services CMS recently announced a new design for the quarterly Medicare Summary Notices (MSN) you receive.  As part of the Medicare initiative “Your Medicare Information:  Clearer, Simpler, At Your Fingertips” The notices have a new look to make it easier for you to read and understand your Medicare information.  Depending on what state you live in, the redesigned notices should be hitting your mailboxes beginning this summer.  According to CMS, the notices have clearer language, larger type, and a format that is easier to follow.

Here’s what Medicare lists as some of the improvements you’ll see in your new MSN:

  • Larger text size and wider spacing to make reading easier
  • Plain, concise language you can understand quickly
  • A “snapshot” of
    • how much of your Part A or Part B deductible you’ve paid so far this year
    •  the providers you saw during the reporting period
    •  whether Medicare approved all your claims
  • Brief descriptions of your medical procedures
  • Easy-to-understand definitions for terms you might not know
  • A checklist to help you make sure you’re getting the most from your Medicare
  • Information on how to report fraud, preventive medical services, and important Medicare reminders
  • Easy instructions for how to file an appeal

These revised statements should be helpful to folks who have an “N” plan or a “G” plan Medicare Supplement in determining exactly how much of their deductible has been met.  Remember, if you have an “F” plan- it pays all co-payments and deductibles so you don’t have to worry about it!

Remember, if you are an A+ Longevity member, we are here to serve you!  If you have questions about your new MSN and want to sit down and review it together, just give us a call and we’ll set up a visit.

You can find more information at http://www.medicare.gov/forms-help-and-resources/mail-about-medicare/medicare-summary-notice-msn.html

Hope you find this information helpful.

KEEPING OUR EYE ON IMPACT OF OBAMA BUDGET

As President Obama rolls out his budget this week we will be keeping our eye on articles outlining proposed changes to Medicare.  Recently I read an article talking about merging Part A and Part B of Medicare.  This would create an opportunity to move more cost-sharing to Medicare beneficiaries by increased deductibles, co-payments, and virtually reducing the progressive changes to preventative care made in 2012.    Most people are already straining to cover Part B premiums and some type of supplemental plan and a drug plan (premiums may not be excessive – but often co-payments for drugs can be ).  Changes that increase costs for current beneficiaries are undoubtedly going to cause problems for many who are already juggling.

Although many “boomers” are continuing to work after 65, many  seniors who are living on a fixed income – already hurt by extended low interest rates- are understandably nervous about Medicare program changes – especially if it includes increased out of pocket costs.

Stay tuned for additional posts as news is released on Medicare changes.

Considering Assisted Living???

Many of us have made the transition from living at home to life in an assisted living.   Many of us are looking at helping a relative or friend begin to look at assisted living.

Here are 10 tips to consider:

  1. NEVER make an appointment to tour an assisted living…….if you show up, and there is “no one to tour your” or “we only give tours on Wednesday”…run!  ALL Assisted living facilities should have a person who can give you even a basic tour….from the maintenance guy to a caregiver.
  2. DO show up around a meal period……..I recommend around 10:30 in the morning, so you see what activities are happening and how many residents are engaged in activities.    Depending on the time you spend, you should be able observe lunch.  This is an excellent time to see the residents, how they interact, how the food looks.  Meals are a BIG part of life in an assisted living.
  3. DON’T show up in “off hours”…….in the evening, before 8am, etc.    Residents are usually tired, and the staff is busy assisting in bed time routines, or getting people ready for the day.
  4.  DO stay for a meal.  Ask to be seated with residents, NOT the marketing director!   Seniors will rarely tell you how they feel, but they will certainly tell you what they THINK!
  5.  Observe the staff during your tour……are they engaged with the residents?  Are they smiling?  Do they speak to YOU as you tour?
  6. Smell, smell, smell…………..certainly there can be times where there is an issue (especially in an Alzheimer’s building or nursing facility).  The ONLY thing you should smell is “clean”….if there is a heavy cover-up of fragrance, I would wonder why.  If you smell warm cookies, the residents should be baking them!
  7. Ask to bring your loved one back for a tour.  Include an appropriate activity and a meal.
  8. NEVER let anyone pressure you with statements like “We only have one room left”, “We never have studios become available”, “We have an enormous waiting list.”  While all of these things may be true, moving to an assisted living is a big decision.  Never rush.
  9. Trust your instincts!  If it “feels” good, and there is a good vibe to the building, then that’s probably true!   Same in the reverse……if walking up to the building, the grounds are unkempt or there are cigarette butts on the ground (or even worse, staff outside smoking!)……that should tell you something.   First impressions carry weight!
  10. If you think you or a relative may need an assisted living in the future, look NOW.   Don’t wait until there is an emergency or a crisis.   When you are relaxed and comfortable, you can freely look and observe and decide what community is best for you!  There are many lovely Assisted Livings out there…take the time to find what’s best for you!

Women and Long-Term Care — The Growing Threat

According to a study released recently by Age Wave and Genworth Financial , we are not as fearful of dying as we are of becoming a burden to our families.  Almost two-thirds of people will require some type of long-term care, but most Americans still do not look seriously at one of the biggest risks facing us as we age; the potential need for long-term care services and the affects on our families and our finances from not being insured or at least prepared to deal with it.   Women are especially vulnerable.

According to the National Alliance for Caregiving and AARP:

  • Two-thirds of caregivers are women and women make up 47 percent of the workforce in the United States.
  • Female caregivers may spend as much as 50% more time providing care than male caregivers.
  • Many working caregivers have to reduce their work schedule to part time or leave the workforce altogether to meet the needs of a family member or loved one who needs ongoing care due to a debilitating illness or injury.

As you read these facts from the Women-Owned Business Update compiled by the Center for Women’s Business Research, you begin to get a picture of the scope of this looming problem and the far-reaching implications of failing (as a generation and a society) to plan and prepare for long-term care needs:

The Overall Picture: 2008-2009

  • 10.1 million firms are owned by women (50% or more), employing more than 13 million people, and generating $1.9 trillion in sales as of 2008.
  • Three quarters of all women-owned businesses are majority owned by women (51% or more), for a total of 7.2 million firms, employing 7.3 million people, and generating $1.1 trillion in sales.
  • Women-owned firms (50% or more) account for 40% of all privately held firms

Businesses Owned by Women of Color
•    1.9 million firms are majority-owned (51% or more) by women of color in theU.S.
•    These firms employ 1.2 million people and generate $165 billion in revenues annually.

Million Dollar Businesses

  • One in five firms with revenue of $1 million or more is woman-owned.
  • 3% of all women-owned firms have revenues of $1 million or more compared with 6% of men-owned firms.

According to Jesse Slome,  executive director of American Association of Long Term Care Insurance, the vast majority of women who are age 50 or older, considerably underestimate the risk and have no plan in place to cover long-term care.  Financial protection aside, having long-term care insurance for yourself, your spouse, your parents, and in-laws, also increases and protects care options that will be available in the event of a debilitating illness or injury.   The time required to address the needs of a parent or loved one who can’t manage without assistance, can completely derail your life.

It’s time to move this task to the top of your “To Do” list.  For a free copy of “A Woman’s Guide to Long-Term Care Insurance Planning”, email lynn@apluslongevity.com.