If you have a Medicare Advantage plan and were denied coverage for a health service or item, you may choose to appeal the decision with your plan’s provider. The appeal process requires documentation for why the service or item should be covered under your plan, and it can take some time to go through the the levels of approval. Here is a quick breakdown of how the process works to file an appeal for a
Not all donut holes are sweet. In Original Medicare Part D, there is a coverage gap known as the “Part D Donut Hole.” This coverage gap for pharmaceutical medications can result in higher drug costs for Medicare beneficiaries, as they get stuck between spending limits on Rx costs and their total out-of-pocket cost limits for a given year. How Does the Part D Donut Hole Work? For beneficiaries enrolled in Medicare Part D, there is
As temperatures increase, so do the risk factors for heat-related health problems with elderly adults and individuals with chronic illnesses. If you are on Medicare or Medicare-eligible, follow these simple summer safety tips to help stay cool and well through hot summer months. Top Summer Safety Tips for Seniors: Protect Your Skin from Too Much Sun Skin cancer is the most common cancer in the U.S. According to the Skin Cancer Foundation, 1 in 5
Summertime often means travel time, especially once you hit the golden years of retirement. Before you travel outside of your home health care network, though, make sure you have a plan for coverage at your destination. Depending on how you receive your Medicare benefits, whether it is through Original Medicare or a Medicare Advantage plan, you might be on the hook for higher costs for medical services while you travel. It also depends on your
Alzheimer’s Disease is a type of dementia that affects memory, thinking and behavior, and now affects more than 6 million Americans, according to the Alzheimer’s Association 2021 report. While it is not a normal part of aging, the greatest known risk factor is increasing age. The majority of people with Alzheimer’s are age 65 and up. If you are Medicare beneficiary, or Medicare eligible, you can get help covering certain costs for Alzheimer’s care through
Mental health for seniors is an important topic. With the population of Americans age 65 and older increasing each year, and the ability to identify and treat mental illness in seniors not always readily available or accurate, it is important for seniors to understand the benefits available to them for mental health services. An estimated 1 in 5 older adults experience a mental illness, substance abuse disorder, or both, according to a 2012 study from
If you are about to turn 65 or just turned 65 in the U.S., you have probably heard about Medicare (and if you have not yet, you will need to). Medicare is health insurance for people 65 and older in the United States. It is also health insurance for certain people under age 65 with disabilities, and people of any age with End-Stage Renal Disease (ESRD). What you might not know or understand are all
Original Medicare does not include routine vision care, which means it generally will not pay for eyeglasses, contact lenses, or eye exams. This means you are typically responsible for 100% of the costs associated with your eyeglasses under Original Medicare. If you have a Medicare Advantage plan or certain Medicare Supplement plans, you might have additional coverage for vision . Talk to a Senior Markets Specialist in your area if you are unsure of your
There are several mistakes people new to Medicare can make that can seriously impact how much money they will have to pay for Medicare. Two of the most common and potentially most expensive involve not signing up for things on time. If you don’t sign up for Medicare Part B (medical benefits) or Medicare Part D (prescription drug) when you first become eligible you could be hit with significant penalties. Medicare Part B Penalty If
Are you currently enrolled in Medicare and considering moving to a new city or state? Before you do, find out what moving means for your Medicare plan and options that you will have when you move to a new state. Notify Your Provider It is important to notify your Medicare provider to avoid any lapse in coverage. When you inform your provider that you are moving, you will be able to change your Part C