Category: Health & Wellness

As we soak up the sun this summer, it’s essential to balance enjoyment with skin protection, especially for seniors who face increased risks of skin cancer. Did you know that UV rays from the sun are the primary cause of skin cancer? But fear not! With practical tips and understanding Medicare coverage, you can stay safe and enjoy sunny days responsibly.

Protecting Your Skin: Practical Tips

1. Seek Shade Strategically During peak sun hours (10 a.m. to 4 p.m.), find shade under an umbrella, sunshade, or in shaded areas to reduce UV exposure. It’s your personal oasis from the summer heat.
2. Fashionable Sun Protection Stay stylish and sun-safe with loose, breathable clothing, a wide-brimmed hat, and UV-blocking sunglasses. Protect yourself from head to toe while looking your best.
3. Sunscreen: Your Skin’s Superhero Always apply broad-spectrum sunscreen with SPF 30 or higher. Reapply every two hours (more frequently if swimming) and opt for waterproof formulas for continuous protection.
4. Embrace Vitamin D Wisely Maintain strong bones with vitamin D-rich foods like salmon and dairy products. Consult your doctor about supplements for additional options beyond sun exposure.
5. Review Your Medications Certain medications can increase skin sensitivity to sunlight. Discuss your prescriptions with your healthcare provider to stay informed and protected.
6. Stay Cool and Hydrated Beat the heat by staying hydrated and wearing lightweight, breathable fabrics. Moisturize regularly to keep your skin healthy and hydrated.

Early Detection Saves Lives

Monitor your skin for changes such as unusual moles or patches. Promptly notify your doctor if you notice anything concerning – early detection is crucial for effective treatment.

Understanding Medicare Coverage for Skin Cancer

The senior population faces significant risks from skin cancer, with over 40% of melanoma cases in the U.S. occurring in those aged 65 and older. Here’s how Medicare supports your skin health:

1. Medicare Part B Coverage
   • Routine skin cancer screenings are not covered for asymptomatic individuals under Medicare Part B.
   • Medicare Part B covers doctor examinations if you notice changes in moles or skin growths. If further evaluation is needed, Medicare may extend coverage for specialist referrals.
2. Coverage for Treatment
   • Medicare Part A and Part B cover outpatient treatments for skin cancer after meeting deductibles. Hospitalization costs are covered under Part A after its deductible is met.
3. Annual Wellness Visits
   • Medicare Part B offers annual wellness visits, providing an opportunity to discuss skin health concerns with your doctor. The visit is covered without applying the Part B deductible.
4. Medicare Advantage and Prescription Coverage
   • Medicare Advantage plans cover the same benefits as Original Medicare (Part A and B) and may offer additional coverage options.
   • Medicare Part D plans cover prescription drugs used for skin cancer treatment, expanding coverage beyond Original Medicare’s limitations.

Whether you’re considering Medicare Advantage or need comprehensive coverage insights, exploring your options ensures you receive the best care for your skin health needs. Stay informed, stay protected, and enjoy the sunshine responsibly this summer!

If you have further questions about your Medicare coverage, or would like to schedule a plan review, please contact our customer support services.

As we journey through life, the health of our brain becomes increasingly important, especially for those of us who are Medicare beneficiaries. June marks Alzheimer’s & Brain Awareness Month, a time dedicated to raising awareness about Alzheimer’s disease, other dementias and emphasizing the importance of brain health. Understanding your Medicare coverage benefits is key to taking proactive steps to support your cognitive well-being.

Understanding Alzheimer’s Disease

Alzheimer’s disease is the most common form of dementia, affecting millions of people worldwide. It is a progressive brain disorder that gradually impairs memory, thinking, and behavior. While aging is a significant risk factor, Alzheimer’s is not a normal part of aging. It affects about one in nine people aged 65 and older, making it a critical issue for the Medicare community.

The Alzheimer’s Association defines three general stages of Alzheimer’s:

Early-stage Alzheimer’s (mild)

Middle-stage Alzheimer’s (moderate)

Late-stage Alzheimer’s (severe)

“Every 65 seconds, someone in the US develops Alzheimer’s.”

Alzheimer’s Association

Early Detection & Brain Health with Medicare Coverage

Early detection of Alzheimer’s can make a significant difference in managing the disease. It’s important to understand what’s included in your Medicare Benefits.

Original Medicare (Part A and Part B) will typically cover the diagnosis, evaluation, treatment, and care planning for Alzheimer’s at every stage. Original Medicare (Part A and Part B) will typically cover the diagnosis, evaluation, treatment, and care planning for Alzheimer’s at every stage.

Medicare Part A will cover:

• Inpatient medications (prescription drugs you may get during an inpatient stay)
• Medicare covers inpatient hospital care and some of the doctors’ fees and other medical items for people living with Alzheimer’s or another dementia who are age 65 or older.
• Home health care can be covered up 35 hours of in-home care per week depending on the circumstances.  To receive this coverage, the patient must be “homebound” and need part-time skilled nursing care.
• Hospice care will be provided under Medicare Part A, with very little in out-of-pocket costs. In most cases, hospice care is provided in a patient’s home.

Medicare Part B provides coverage for a range of essential medical services, including:

• Annual Wellness Visits: Medicare offers a comprehensive annual wellness visit, including cognitive impairment assessments to catch early signs of dementia for timely interventions and better symptom management.
• Part B also covers a separate visit with a doctor or health care provider to fully review your cognitive function, establish or confirm a diagnosis like dementia or Alzheimer’s disease, and develop a care plan.
• Durable medical equipment such as a hospital bed or a wheelchair for in-home use.

Medicare Part A and Part B may also cover different mental health services including inpatient psychiatric are and outpatient services such as counseling and behavioral health specialist care.

If you or a loved one notice memory loss or cognitive changes, don’t hesitate to discuss it with your healthcare provider. Early diagnosis can lead to better treatment options and support services!

Medicare Part D Benefits:

If the person living with dementia has Medicare, then he or she can enroll in Medicare’s Part D prescription drug plan.

Medicare collaborates with insurers and private companies to provide a range of prescription drug plans, each differing in cost and covered medications. During the Medicare Part D annual open enrollment period (October 15th to December 7th), Medicare beneficiaries have the opportunity to enroll in a drug plan. Those already enrolled in a Part D drug plan can also switch to a different plan during this period.

Tips for Choosing Your Part D Plan:

1. Check if the plan covers most or all of the drugs you currently take.
2. Ensure your Alzheimer’s drugs are on the formulary.
3. Confirm the plan covers the doses you need.
4. Review if the plan’s rules restrict coverage of your Alzheimer’s drugs or require prior approval.
5. Check if the plan requires you to try a cheaper drug before covering your current one (step therapy).
6. Look for any quantity limits on pills covered in a given period.
7. Compare all costs, including deductibles, copayments, and coinsurance, not just monthly premiums.
8. Verify if your local pharmacy is in the plan’s network, as mail order may be an option, offer incentives, or be required for prescriptions.

Promoting Brain Wellness Through Healthy Habits

While there is currently no cure for Alzheimer’s, research shows that a healthy lifestyle can help reduce the risk of cognitive decline. Here are some tips to keep your brain healthy:

• Stay Physically Active                          
• Eat a Brain-Healthy Diet
• Stay Socially Engaged
• Keep Your Mind Active
• Get Quality Sleep

Alzheimer’s & Brain Awareness Month is a reminder that while aging is inevitable, we can take steps to protect our brain health. As Medicare beneficiaries, we have access to essential resources and services that can help us maintain cognitive function and quality of life. Let’s embrace this month as an opportunity to educate ourselves, support others, and commit to brain-healthy habits.

Contact us to learn more about your Medicare coverage benefits that can assist you with preventative services to promote your brain and cognitive health.  You can also learn more about what’s included in Medicare Part A and B, and Part D, at Medicare.gov.

Exploring the 3 Ways You May Qualify

Medicare offers Special Enrollment Periods (SEPs) that allow individuals to enroll in or switch Medicare plans outside of the standard enrollment periods. These SEPs are crucial for individuals who experience certain life events or qualify for specific circumstances. Let’s explore what qualifies you for a SEP and how you can take advantage of them.

Qualifying for a Special Enrollment Period

There are three main reasons why you may qualify for a Special Enrollment Period:

1. Qualifying Life Events (QLEs): If you experience a QLE, such as moving to a new area, losing health coverage, or other life-changing events, you may be eligible for a SEP.
2. 5-Star Special Enrollment Period: Medicare rates plans on a scale of 1 to 5 stars, with 5 stars being the highest rating. If a 5-star plan becomes available in your area, you can switch to it during a SEP.
3. Working Past Age 65: If you delayed enrolling in Medicare because you had employer-based coverage, you have an 8-month SEP to enroll in Medicare once that coverage ends.

Qualifying Life Events and Special Enrollment Periods

If you have Medicare and experience a QLE, you may qualify for a SEP to change your Medicare Advantage or Prescription Drug Plan. These events include:

• Changing your primary residence
• Losing your health insurance
• Being eligible for other health insurance

*Each QLE has a specific timeframe within which you must act to qualify for a SEP. For example, if you move, your SEP is typically 60 days after your move.

5-Star Medicare Special Enrollment Period

If a 5-star Medicare plan becomes available in your area, you can switch to it during the 5-star SEP, which runs from December 8 to November 30 of the following year. It’s important to compare plans to ensure the new plan meets your needs.

Enrollment in Medicaid or Extra Help

Most people with Medicare can only make changes to their drug coverage at certain times of the year. If you have Medicaid or receive Extra Help, you may be able to make changes to your coverage one time during each of these periods:

• January – March
• April – June
• July – September

If you lose benefits from Medicaid or Extra Help, you will have a one-time opportunity to adjust your Medicare Advantage enrollment.

Disenrollment from your initial Medicare Advantage plan

If you initially enrolled in a Medicare Advantage plan upon becoming eligible for Medicare, you have a 12-month window to disenroll from the plan and return to Original Medicare.

If you previously dropped a Medicare Supplement Insurance plan to join a Medicare Advantage plan but now want to switch back, you also have a 12-month period to do so (as long as this was your first enrollment in a Medicare Advantage plan).

Working Past Age 65 and the Special Enrollment Period for Medicare Part B

If you or your spouse work past the age of 65 and delay enrolling in Medicare, you have an 8-month SEP to enroll in Medicare Part B once you retire or lose employer coverage. This helps you avoid late penalties.

Avoiding Gaps in Coverage and Part D Late Enrollment Penalties

To avoid gaps in coverage, enroll in Medicare before you lose employer-based coverage. If you anticipate retiring, contact your employer’s human resources department one or two months in advance to time your Medicare enrollment correctly.

Understanding Medicare Special Enrollment Periods is crucial for individuals to make informed decisions about their healthcare coverage. Whether you’re experiencing a QLE, have access to a 5-star plan, or are working past age 65, knowing your options and timing is key to maximizing your Medicare benefits.

If you would like more information on the SEP, or to find out if you may qualify, please contact our office today and we would be happy to assist you.

Let’s show our HEART a little more Love!  Cardiac health is a vital aspect of overall well-being, and Cardiac Rehab Week serves as a poignant reminder of the importance of maintaining a healthy heart. This annual celebration not only highlights the significance of cardiac rehabilitation but also emphasizes the important role your Medicare coverage can play at maintaining heart health. Join us as we explore Cardiac Rehab therapy and ‘heart healthy’ benefits under Medicare, and tips on how to show your heart a little extra love through a healthier lifestyle.

Understanding Cardiac Rehab Week

Cardiac Rehab Week, observed annually, aims to raise awareness about cardiac rehabilitation and its positive impact on individuals recovering from heart-related conditions. Did you know that cardiac rehabilitation can reduce the risk of death from heart disease by up to 25%?  It also provides an opportunity to acknowledge the efforts of healthcare professionals, support systems, and patients who contribute to the success of cardiac rehabilitation programs.

Medicare’s Role in Supporting Cardiac Health:

• Medicare covers cardiac rehabilitation programs for eligible beneficiaries.
• Cardiovascular Disease Screenings Coverage
• Cardiovascular Disease Treatment Coverage
• Cardiovascular behavioral therapy (Medicare Part B)
• Medical Equipment: Medicare may cover durable medical equipment like blood pressure monitors or cardiac monitors prescribed by your doctor.
• Medications: Medicare Part D provides coverage for medications prescribed to manage heart conditions, such as high blood pressure or cholesterol.

Your costs in Original Medicare: You pay nothing for the tests if your doctor or other health care provider accepts the assignment.

Costs under Medicare for cardiac rehab vary depending on the location and will include the Part B deductible.  The costs under Medicare often depend upon where you are participating in cardiac rehab. The Part B deductible will apply.

What Diagnosis Qualifies for Cardiac Rehab?

Medicare will cover the costs of cardiac rehabilitation, providing you have a certain medical diagnosis. These include:

• Having had a heart attack in the past 12 months.
• History of coronary artery bypass surgery
• Currently stable angina (chest pain)
• History of a heart valve repair or replacement
• History of coronary angioplasty to open a blocked artery or place a stent
• History of a heart or heart-lung transplant
• Stable, chronic heart failure

Heart-Healthy Lifestyle Choices for Seniors:

Tips on how to show your HEART a little extra LOVE!

According to a recent 2024 study by the American Heart Association, the average age at first heart attack is 65.6 years for males and 72.0 years for females. This highlights the critical importance of maintaining heart health as we age

By taking advantage of Medicare’s coverage for cardiovascular screenings and wellness visits, along with adopting heart-healthy lifestyle choices, we can empower ourselves to lead healthier, happier lives.

Let’s continue to prioritize our heart health, not just during this special week, but every day of the year. Together, we can make a difference in our cardiovascular health and inspire others to do the same. Here’s to strong hearts and healthier tomorrows!

To learn more about your Medicare benefits, please contact our office today and we would be happy to schedule a plan review with you to ensure you are getting the most out of your benefits! You can also visit our website to schedule an appointment with us.