Medicarebob

The answer is yes, they do cover breast prostheses after a mastectomy. A breast prosthesis is an artificial breast form. It gives a breast a more natural shape after a mastectomy or breast-conserving surgery. Medicare Part B covers external breast prostheses (including a post-surgical bra) after a mastectomy. Medicare also covers surgically implanted breast prostheses after a mastectomy. Medicare Part A (hospital benefit) covers the surgery if it takes place in an inpatient setting. Part B covers the surgery if it takes place in an outpatient setting. All people with Medicare Part A and/or Part B are covered. You pay 20% of the Medicare-approved amount for the doctor's services and the external breast prostheses. The Part B deductible applies. For surgeries to implant breast prostheses in a hospital inpatient setting, you pay the Part A hospital care costs.

Medicare Part B (medical/doctor benefit) comes with a monthly premium for 2018 of $134.00 a month. There are two ways to pay your Part B premium. • If you are collecting Social Security, they will automatically draft that premium out of your check every month. • If you are NOT collecting Social Security, they will bill you quarterly (every three months)

Medicare Supplement Plan F, or what I like to call the “Full Coverage” Plan, is a Medicare Supplement that pays all the bills that Medicare does not pay. Medicare pays 80% and the Plan F would pay the remaining 20% of your medical bills. You would have no bills except your monthly premium. As with any Medicare Supplement Plan, there is no network for this plan. As long as the doctor or hospital accepts Original Medicare, they will accept your Plan F. • No Copay • No Deductible • Any Doctor / Any Hospital

Plan N is a really good plan. There are 4 differences between Plan F (the full coverage plan) and the Plan N (Not fixed). • Just like Plan G (the greatest value plan) you pay the $183.00 deductible. • Then you have up to a $20.00 copy per Doctor visit. • A $50.00 copay for the ER. • Part B Excess Charges – This just means that if a Doctor charges more than Medicare, you might have to pay up to 15% more.

The Medicare Supplement Plan G, what I like to call the “Greatest Value”, will cover you exactly like the Plan F except for one difference. You will have to pay Medicare’s Part B Annual Deductible, which for 2018 is $183.00. The reason that Plan G is the greatest value is because it is usually $300 to $600 less per year then the Plan F and, again, the only difference is the $183.00 deductible. So why pay an insurance company $400 more a year just so they can pay your $183.00 deductible. Plan G just makes more sense.

When your doctor says you need surgery to diagnose or treat a health problem that isn't an emergency, it's up to you to decide when and if you'll have surgery. Medicare Part B covers a second opinion in some cases for surgery that isn’t an emergency. Medicare also will help pay for a third opinion if the first and second opinions are different. All people with Part B are covered. You pay 20% of the Medicare-approved amount. The Part B deductible applies. If the second opinion doesn't agree with the first opinion, you pay 20% of the Medicare-approved amount for a third opinion. The Medicare Supplement Plan G will pay for the second and third opinion as long as Medicare will pay for it. Once you meet your annual deductible of $183.00, the Plan G will pay for those services. You will pay nothing. If your doctor tells you that you should have certain kinds of major non-surgical procedures, Medicare doesn't pay for surgeries or procedures that aren't medically necessary.

Medicare Part B covers ambulance services to or from a hospital, critical access hospital (CAH), or skilled nursing facility (SNF). Medicare covers and helps pay for ambulance services only when other transportation could endanger your health, like if you have a health condition that requires this type of transportation. Little known fact: If you can walk to the ambulance, Medicare will not pay for the service. So, even if you can walk, DON’T DO IT! Medicare will only cover ambulance services to the nearest appropriate medical facility that’s able to give you the care you need. If you choose to be transported to a facility farther away, Medicare’s payment will be based on the charge to the closest appropriate facility. If no local facilities are able to give you the care you need, Medicare will pay for transportation to the nearest facility outside your local area that’s able to give you necessary care.

Medicare Part B covers medical nutrition therapy (MNT) services and certain related services. A Registered Dietitian or nutrition professional who meets certain requirements can provide these services. But, only your doctor can refer you for these services. MNT services may include: • An initial nutrition and lifestyle assessment • Individual and/or group nutrition therapy services • Follow-up visits to check on your progress in managing your diet If you're in a rural area, you may be able to get MNT through telehealth. A Registered Dietitian or other nutrition professional in a different location would provide the service. If you get dialysis in a dialysis facility, Medicare covers MNT as part of your overall dialysis care. People with Part B who meet at least one of these conditions: • Have diabetes • Have kidney disease • Have had a kidney transplant in the last 36 months People with Part B must get a referral from their doctor for the service.

Medicare Part B covers ambulance services to or from a hospital, critical access hospital (CAH), or skilled nursing facility (SNF). Medicare covers and helps pay for ambulance services only when other transportation could endanger your health, like if you have a health condition that requires this type of transportation. Little known fact: If you can walk to the ambulance, Medicare will not pay for the service. So, even if you can walk, DON’T DO IT! The Medicare Supplement Plan G will cover ambulance rides. Medicare Supplement Plan G covers everything but Medicare Part B’s annual deductible of $183.00, so if you have not met your deductible for the year, you would pay the full or remaining amount of that deductible for your ambulance ride. If you have met that deductible, you pay nothing. You can get emergency ambulance transportation when you’ve had a sudden medical emergency, and your health is in serious danger because you can’t be safely transported by other means.

Medicare Part B covers comprehensive cardiac rehabilitation (CR) programs that include exercise, education, and counseling. Part B also covers intensive cardiac rehabilitation (ICR) programs that, like regular CR programs, include exercise, education, and counseling. ICR programs are typically more rigorous or more intense that CR programs. These programs may be provided in a hospital outpatient setting(including a critical access hospital (CAH)) or a doctor's office. You pay 20% of the Medicare-approved amount if you get the services in a doctor's office. In a hospital outpatient setting, you pay the hospital a copayment. The Part B deductible applies. People with Part B are covered. You must have had at least one of these conditions: • A heart attack in the last 12 months • Coronary artery bypass surgery • Current stable angina pectoris • A heart valve repair or replacement • A coronary angioplasty or coronary stent • A heart or heart-lung transplant • Stable chronic heart failu

Each year more than 480,000 people in the United States die from illnesses related to tobacco use. This means each year smoking causes about 1 out of 5 deaths in the US. Smoking cigarettes kills more Americans than alcohol, car accidents, HIV, guns, and illegal drugs combined. Not only does smoking increase the risk for lung cancer, it’s also a risk factor for cancers of the: • Mouth • Larynx (voice box) • Pharynx (throat) • Esophagus (swallowing tube) • Kidney • Cervix • Liver • Bladder • Pancreas • Stomach • Colon/rectum • Myeloid leukemia Medicare can help you quit smoking. Medicare Part B covers up to 8 face-to-face visits with a healthcare professional for Smoking and Tobacco use Cessation counseling in a 12-month period. A qualified doctor or other Medicare practitioner must provide these visits. All people with Part B who use tobacco are covered and you pay nothing for the counseling sessions if your doctor or other health care provider accepts Medicare assignment.

Medicare does cover medically necessary chiropractic services. According to the CMS, Medicare Part B now covers 80% of the cost for “manipulation of the spine if medically necessary to correct a subluxation.” You can go as many times to the chiropractor as long as it’s medically necessary. There is no cap to those visits. Medicare doesn't cover other services or tests ordered by a chiropractor, including X-rays, massage therapy, and acupuncture Under Medicare Supplement Plan G, you would have to pay your Medicare Part B annual deductible ($183.00 for 2018). After that deductible has been met, the Plan G will pay the 20% coinsurance. Combined with Medicare there will be no charge for any medically necessary chiropractic work.

Medicare does cover medically necessary chiropractic services. According to the CMS, Medicare Part B now covers 80% of the cost for “manipulation of the spine if medically necessary to correct a subluxation.” You can go as many times to the chiropractor as long as it’s medically necessary. There is no cap to those visits. Medicare doesn't cover other services or tests ordered by a chiropractor, including X-rays, massage therapy, and acupuncture Under Original Medicare, without any additional insurance, you would have to pay your Part B deductible ($183.00 for 2018) and 20% coinsurance for all medically necessary chiropractic appointments. Medicare Supplement Plans will pay the 20% coinsurance. Combined with Medicare there will be no charge for any medically necessary chiropractic work. Medicare Advantage plans may cover chiropractic care. Since Medicare Advantage Plans are not standardized, each plan can offer a very different set of fees and benefits.

Medicare does not cover dental, vision or hearing therefore, none of the Supplement Plans cover them either. We have done a lot of market research looking for the best dental, vision and hearing plan and the best we have found is DVH through Manhattan Life Insurance company for around $35 per month for a $1,000 or $1,500 annual benefit. One key element of this plan that sets it apart from other dental combination plans is that you are free to use your annual benefit towards any of those three services, there is no cap per service. For example, if you needed some work done on your teeth one year, you could use your entire benefit towards your teeth. Most plans will give you an allotted amount out of their benefit that you can put towards dental, vision or hearing. We have listed some additional highlights of the plan below: • Choose your dentist - No Networks • Family Rates (includes a maximum of 3 children) • Individual 18 - 85 • $1,000 - $1,500 policy year benefit option available

Medicare Supplement Plan N is also called Medigap Plan N. Medicare Supplement Plan N is a great option for people that want the benefits of having a Medicare Supplement Plan, however want to keep a lower monthly premium. Since the Medicare supplement Plan N has a lower premium than the Plan F and G, it does cover less. There are only 4 out of pocket costs that the Plan N requires you to pay compared to the Plan F. 1. The Part B Deductible. (2018 this is $183.00 for the whole year.) 2. $20.00 Doctor copay. 3. $50.00 ER copay. 4. Part B Excess charges. (NOTE, in Pennsylvania and Ohio, Providers cannot charge Part B Excess Charges. Therefore, especially in PA and OH, Plan N is a GREAT option.) If you are under 70 years old, the price difference between the Plan G and N is usually not enough to choose the Plan N over the Plan G. However, once you are over 70 years old, it might be a good idea to switch from a Plan G to a Plan N.

A Medicare Advantage Plan is not a Supplement Plan, it is a private alternative to Medicare. A Medicare Advantage Plan will not pay the bills that Medicare would normally pay, instead a Medicare Advantage Plan will charge you a different deductible, different copays and different co-insurance compared to Medicare. Medicare Advantage Plan Summary: • Low monthly premium. (Sometimes advertised as $0.00 per month) • You will usually have to pay a fee every time you use the plan. ($15.00 copay for PCP visit, $300.00 per day each day you are in the hospital, etc.) • You have to go to certain Doctors, Hospitals and Providers. (HMO or PPO Network) • You will have to get prior authorizations for some procedures. • You will have to get referrals to go see a specialist.

There is only one difference in coverage between the Medicare Supplement Plan F and the Plan G. That’s right, only ONE. The Plan F pays for Medicare’s Part B annual deductible of only $183.00 and the Plan G does not. However, the Plan G is the most cost-effective plan and I’ll explain why. There are three main reasons Plan G is a better choice than Plan F. 1) Simple Math: Plan F costs, on average, $600 more per year in premiums than the Plan G. Why pay Plan F $600 more when the only difference in benefits is that Plan G has a small $183.00 deductible? That is just giving more money to these big insurance carriers for no reason. 2) Rate Stability: No one that turns 65 after 01/01/2020 will be able to purchase the Plan F. This will cause the Plan F premiums to increase quickly. 3) The Part B Deductible is likely to continue increasing. This will also cause the Plan F premiums to increase at a higher rate than the Plan G.

An estimated 47 million people worldwide are living with some type of dementia, per the World Health Organization, and that number will likely increase to 75 million by 2030. The WHO expects the number to triple by 2050. Contrary to popular misconception, dementia isn’t a standardized syndrome. Different types of dementia affect the brain in very different ways, and as a result, some people ignore the early symptoms in themselves or their loved ones. Generally, dementia is progressive, so it gets worse over time, but early detection can greatly improve a patient’s quality of life. Listed below are some common warning symptoms of dementia or Alzheimer’s disease.

If you are enrolled in Medicare, you may be familiar with Medicare Part B Excess Charges. Some doctors accept what is called the “assigned” rate for their work. Others charge a higher rate, but they cannot charge more than 15 percent more than the assigned rate. For example, Medicare might decide that the fair “assigned” rate for a specific procedure should be $400. A doctor who accepts the Medicare assignment would bill at or below that rate. However, your doctor may decide that $400 is not a sufficient reimbursement. Doctors are allowed to charge up to an additional 15% over and above what Medicare has approved. Therefore, in this case, your doctor could charge you $460 and you would be responsible for paying the additional $60 “excess” charge out-of-pocket ($400 X 15% = $60 excess charge) in addition to any deductible and co-pay.

Each year, you have a chance to make changes to your Medicare Advantage or Medicare prescription drug coverage for the following year. This time frame is called the Annual Enrollment Period. Every year the Annual Enrollment starts on October 15th and ends on December 7th. Below is a list of all the changes you are allowed to make during this period. • Change from Original Medicare to a Medicare Advantage Plan. • Change from a Medicare Advantage Plan back to Original Medicare. • Switch from one Medicare Advantage Plan to another Medicare Advantage Plan. • Switch from a Medicare Advantage Plan that doesn't offer drug coverage to a Medicare Advantage Plan that offers drug coverage. • Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn't offer drug coverage. • Join a Medicare Prescription Drug Plan. • Switch from one Medicare drug plan to another Medicare drug plan. • Drop your Medicare prescription drug coverage completely.