For caregivers of aging parents, insurance coverage is an important topic, especially if your loved one suffers from Alzheimer’s, congestive heart failure, or other common conditions. My last post covered the eligibility requirements for Medicare. Once you determine eligibility, you’ll need to decide which policy or policies to choose.
1. Original Medicare Plan – If you are eligible, you will be automatically enrolled in Medicare A and then you have the option of adding Medicare Part B and Medicare Part D. The federal government manages the Original Medicare Plan. It operates on a fee-for-service plan. Most people pay a deductible and then a co-pay or co-insurance. Original Medicare Plans do not cover everything. Costs that you may incur include co-insurance, co-pays, deductibles, etc. These costs are called gaps. To help cover these costs, you might want to buy a Medigap policy.
2. Medicare Advantage Plan (Plan C) - Seniors much choose to join. The Medicare Advantage Plan or Plan C combines your Part A and B coverage. You have the option of adding Part D if coverage is not already included. Medicare Advantage Plans include HMO, PPO, private fee-for-service plans, and Medicare special needs plans. The main difference in Part C is that it is provided through private insurance companies approved by Medicare. With this program, you may have lower costs and receive extra benefits. With this plan you do not need to buy a Medigap policy.
3. Medicare Part D - Part D is stand-alone prescription drug coverage insurance. Most people do have to pay a premium for this coverage. Plans vary and cover different drugs, but all medically necessary drugs are covered. You can choose what drug plan will be best suited to your needs.
For more information regarding Medicare, contact your Medicare representative or visit
www.medicare.gov and click on “Medicare and You 2009” for more information to help you meet your individual needs (or those of your aging loved one). Also, the Medicare Options Compare website (http://www.medicare.gov/MPPF/Include/DataSection/Questions/Welcome.asp) will direct you through the various types of policies and explain what is covered under your policy. Information is categorized on the home page by the type of plan that you have questions about.
My next blog will explain Medigap policies and Medicaid.
polypharmacy or how many pills or too many? The answer would have to be that different entities in the current health care system define Polypharmacy differently. I have seen it defined as low as two or more medications, but in general it deals with using more than three to five medications or herbal supplements for longer than 90 days in a given year. In my career I have witnessed shoe boxes filled with medications that have numbered over 20 different medications- especially when dealing with multiple chronic diseases, over the counter medications, herbs, and vitamins.
For My Health Care Manager the concept has been extended to caregivers helping aging parents and even seniors looking to improve the health and well-being. Take a look at the blogs listed here - you'll find information on all of the most common heath challenges facing seniors and their families. Some examples include falls, home safety, dementia, congestive heart failure, diabetes, and many more.
George Slater