What is Medicare and who is it for?
Medicare is a federal healthcare program provided for those seniors who are 65 years and older. In some cases, medicare is provided for young people with disabilities, and for those with end-stage renal disease.
Medicare began in the United States in 1965, as a part of the Social Security Administration, which is now administrated by the Centers of Medicare and Medicaid Services.
What are the types of plans with medicare?
Medicare has four different types of plans/coverages that are provided for seniors. Medicare Part A is there for your inpatient care in a hospital setting, or for your limited time in a nursing facility. The nursing facility is often following a hospital stay. Part A also covers some forms of home health care and hospice care.
Medicare Plan B is the medical insurance that you can use to pay for services from doctors and other healthcare providers. This includes outpatient care, home health care, preventative services, as well as for medical equipment. All of your outpatient and rehab services are covered under this plan.
Medicare Advantage Plan, previously known as Part C. This type of coverage includes all the benefits included in Part A and B, along with added benefits of prescription drugs, vision, hearing, and dental.
Medicare Plan D is a prescription drug coverage plan. This plan helps to cover the cost of prescription drugs.
What is Medigap and how can it help me?
Medicare Supplemental Insurance, also known as Medigap, helps to fill gaps in the Original Medicare. The remaining health care costs left from Medicare are covered under Medigap, which is sold through private companies. Medigap policies can help cover copayments, coinsurances, and deductibles.
Some key things to know about Medigap policies:
- Medigap policies require an individual to have Mediare Part A and Part B.
- For Medicap policy, you are required to pay a monthly premium in adition to the monthly premium that is paid to Medicare.
- Under Medigap policy only one person is covered. This means that your spouse would have to buy their own separate policy.
- Medigap policies after 2006 aren’t allowed to include drug coverage, so for that, you would have to pick Medicare Part D for prescription plan.
- Medigap policy cannot be sold to those with Medicare Advantage Plan, unless you are switching back to the Original Medicare.
When do I sign up?
The initial enrollment period generally begins when you turn 65. This period lasts for 7 months, starting 3 months before you turn 65, and it ends 3 months after you turn 65.
If you miss the 7-month initial enrollment period, you would have to wait to sign up. Along with that, there would be a monthly late enrollment penalty for as long as you have Part B coverage.
Each year, the general enrollment period begins from January 1st and ends on March 31st. If you have health insurance through a job and still working – you can sign up for Part A and Part B as long as you have a group health plan coverage or if you or your spouse is working for the employer that provides your health coverage.
How Can I File a Complaint?
You can file a complaint if due to any concerns regarding the quality of care or for services you get from a provider under Medicare.
Acceptable reasons to file a complaint:
- File against a doctor, hospital, or provider.
- Quality of your care.
- Durable medical equipment.
- Your health or drug plan.
- Your dialysis or kidney transplant care.
What is the difference between a complaint and an appeal?
In situations of improper treatment from a facility, you can file a complaint. You can file an appeal if you have an issue with a plan’s refusal to cover a service, supply, or prescription.
What Are My Rights in Medicare?
As a member of Medicare, you have certain rights and protection. Medicare gives you protection against discrimination from any providers, and facility. Medicare protects you from discrimination from any provider or facility. Under Medicare, no one is discriminated against race, nationality, disability, age, religion, or sex. You have the right to be treated with courtesy, dignity, and respect throughout your treatment.
Providers are also responsible to protect your personal and health information by keeping it private. Your provider is also responsible to make your treatment options clear, in a language you understand. This can help you stay involved throughout your treatment.
What can Physical Therapy do for me?
Physical Therapy can be an asset for Seniors in managing their weaknesses and ongoing ailments. It can protect you from many risks that come with age-related issues. Senior patients are often part of the fall risk group due to balance and stability issues. Arthritis is also a major concern for seniors that we can help you treat at Physical Therapy. Here at Jeevam Therapy, we treat senior patients for several conditions such as Dementia, Alzheimer’s, Vertigo, Balance/Gait disorders, neurological disorders, and any pre/post-op cases. We also provide home and teletherapy care, which is convenient for Seniors with transportation issues. Our motto at Jeevam Therapy is to make treatment smooth and accessible to our patients while providing the proper care. We give our Medicare patients the individualized, one-on-one attention and care they need while providing them with a better understanding of their treatment options.
If it is difficult for you to come out of your house, we have a therapist that can come to you with our medical equipment to give you the care you need. Call us today for your senior physical therapy needs or for a loved one.
