health insurance

Medicare Benefits That May Help

June 28, 2016 By Twila Van Leer

Medicare Benefits

Learning about the benefits of medicare can be a daunting process. In the words of Jaryn Laengrich, chief service officer at Cariloop, a Medicare service to help people caring for elderly persons, it is a “sprawling, complicated piece of law” that can be baffling. She notes these little known medicare services that the eligible may find useful.

Medicare Annual Wellness Screening

Medicare benefits allow you an annul wellness screening by a primary care physician. The objective is to prevent illness where possible. It includes an extensive appointment with a thorough review of the patient’s medical history. An Alzheimer’s screening is part of the exam if the physicians thinks it necessary. The wellness screening is offered through Part B.

Alcoholism Screening

Screening and counseling for alcohol misuse. Widowers over the age of 75 have the biggest problem with alcoholism, according to the National Council on Alcoholism and Drug Dependence. More of those in this demographic are hospitalized with alcohol-related problems than for heart attacks. Annual screening is allowed by Medicare, if performed by a primary care physician. Four counseling sessions will be compensated, as well.

Balance Screening

Falls are a serious problem among the elderly. Medicare B will pay for 80 percent of a thorough screening to determine if balance is a problem and what might be the cause.

Obesity Counseling

Those enrolled in Medicare Part B. who have a body mass index score of 30 or higher may receive counseling in a primary care setting. The program also will pickup a major part of the cost of bariatric surgery aimed at reducing obesity. The amount depends on a patient’s Medigap supplement plan.

Shingles Vaccination

Shingles is a painful and distressing disease that can strike anyone who had chicken pox as a child. The coverage is included in Medicare Part D, which provides for medications.

Diabetes Self-Management Training

Medicare pays 80 percent of the cost of 10 training sessions, including one one-on-one visit with a specialist. The remainder are small-group sessions. The intent is to improve diabetes management. The disease can be debilitating and cause severe effects.

Hearing Tests

Although Medicare won’t pay for hearing aids, it will cover examinations to determine hearing loss. Efforts to get hearing aid coverage have failed to pass muster in Congress because of the scope of the problem. An estimated 37 million Americans suffer some hearing loss, but only 30 percent need hearing aids.

Hospice Care

Many Medicare recipients are not aware that they are eligible for end-of-life care. It is focused on palliative treatment, and is available only to those who are believed to be within six months of death. The patient must agree to forego treatment aimed at curing. Care usually is provided in the patient’s home and involves a team that includes a physician, nurse, social worker, chaplain and volunteer. The objective is to provide as much comfort care as necessary for the patient in his or her final days.

Be Aware Of Health Insurance Glitches

May 2, 2016 By Twila Van Leer

A large percentage of insured Americans receive unexpected bills. — Check to see if your medical appointments are covered by your insurance company. Don’t let your bill be a big surprise.

If you thoroughly understand every twist and turn of your health insurance, you’re one of a rare minority in America. Insurance plans have become so complex it’s hard to tell when you might be stepping outside your network’s coverage.

Unexpected fees

When you are recovering from a medical procedure is not a good time to learn. Unexpected fees might add to the misery. The problem is huge. Nearly a third of insured Americans who have financial difficulties can blame part of the problem on medical bills they were not anticipating, according to a survey conducted by the Kaiser Family Foundation.

Unexpected bills

Some 70 percent of those who received unexpected bills didn’t understand that they were receiving services outside their insurance parameters. Problems often occur when there is a hospitalization in which a number of health professionals are involved. Payment guaranteed to your primary care physician often does not extend to emergency care doctors, anesthesiologists, radiologists and others who provide services.

Out-of-network services

A New York study in 2011 showed that the average cost of out-of-network services was $7,000. Often, medical costs are accrued in an emergency, so it is not likely the patient will be able to ask if those who take over his/her care are on their covered network. They are at the mercy of the system.

How to protect yourself

If you know you are being hospitalized in advance, call the hospital and try to determine who will be involved in your care and if they are part of your network. It isn’t foolproof, since the hospital may not know in advance which individual in a group of experts will take care of you. Also, ask that necessary tests done outside the hospital be sent to network providers.

Call your insurance carrier

If you’ve made those efforts and they don’t fully protect you from unexpected bills, the first thing you should do is call your insurance carrier and tell them the circumstances. Some employer-sponsored plans have policies that consider charges that were made without the patient’s understanding, particularly if they occur during an emergency. Your insurance company may be willing to negotiate with the providers for a lower charge.

Consumer protection agency

See if your state has a consumer protection agency that deals with medical payment issues. At least 10 states do have a program that will help consumers who are hit with unexpected medical charges.

Changing the laws

Experts who have made in-depth studies of the problem say that it will take changes to several laws, usually at the state level, to address the issue. New York has taken steps to protect patients in such instances. Its’ law does not eliminate the fees, but requires the insurance carrier and providers to negotiate.

As the scope of the problem grows, it is likely that resolutions will be sought. In the meanwhile, the majority of patients who are billed for out-of-network services have little recourse except to pay the bills.

Buying Your Own Health Insurance

October 18, 2009 By Sherry Tingley

Buying your own health insurance is not the easiest thing to do. Because of the economy and the huge number of people who currently do not have health insurance, finding your own health insurance is something you may have to do.

First of all, you probably feel quite vulnerable without health insurance. Being human, we are all just one accident or one major illness away from being rocked off our secure financial boat especially if you don’t have health insurance.

You may have been without health insurance months or possibly even years. Maybe you were let go from your regular job because of company downsizing. Maybe you have tried to get insurance but you weren’t the perfect healthy specimen that insurance companies want to offer individual policies to.

It can take you 30 seconds to have an accident where you can fall and hurt yourself. When you break your ribs with that fall, it can cost you up to $9,500. You’ll need an ambulance ride to the hospital, x-rays, and possibly a CAT scan. You might not even stay at the hospital for more than 24 hours and still have that large bill. Needless to say, going without health insurance could very easily wipe out all of your savings and put you into debt you never dreamed of.

Say you had an accident and fell down your stairs and hit your head. This type of accident might cause internal bleeding in your brain and you might need surgery. You might have to be in the hospital for a month. Your bills will mount faster than you could ever imagine and soon you are owing hundreds of thousands of dollars for your care.

When you buy health insurance, it’s not like going shopping for other types of insurance. There must be hundreds of car insurance offices near you, but health insurance offices are scarce. You might have to ask many people how to find out about buying your own health insurance. A simple solution to your problems is to try out www.ehealthinsurance.com. This company is a referral company that links you with insurance companies that can meet your needs. They are knowledgeable about many different companies offering insurance. If you don’t get accepted with one company they can easily help you apply for insurance with another company.

With one quick and simple application over the internet, you can eliminate your health insurance worries and anxieties. You can get the insurance you need and deserve. Don’t wait any longer to get your health insurance. The longer you wait, the more chances you have of being a victim of an accident or illness that could ruin you financially. Leave it to the experts to help you get what you need. Click on the image below and start protecting yourself today. I have used their services and highly recommend them.