Medicare General Information
This blog section contains general information about Medicare. For example, we answer general Medicare question and update you on Medicare changes. Amid the COVID-19 pandemic, you can get Coronavirus tips to stay safe and apply for Medicare Part B from the safety of your home.
Medicare Helps You Quit Smoking
Medicare Part B provides smoking cessation coverage. According to the American Lung Association, Medicare covers four counseling sessions per quit attempt, with two quiet-attempts covered per year. Furthermore, you are eligible for smoking cessation coverage regardless of whether you show signs of tobacco-related disease. Now that you know what Medicare covers, what does it cost?
Counseling to Quit Smoking is FREE
According to Medicare.gov, you pay nothing for the counseling sessions if your doctor or other qualified health care provider accepts Medicare assignment. However, continuing to smoke can cost your life. CDC.gov says, “Tobacco use is the leading cause of preventable disease and death in the United States.”
Besides preventing disease and death, what are other health benefits of quitting tobacco?
Every year, smoking kills approximately 480,000 Americans and costs the nation more than $300 billion a year.Center for Disease Control and Prevention (CDC)
Health Benefits of Quitting Tobacco
Quitting tobacco reduces your health risks. For example, smoking cessation “improves well-being, including higher quality of life.” According to Quit.com, “the longer you stay smoke-free, the more benefits you’ll see.” The Quit Smoking Timeline shows you the health benefits you get after you quit smoking.
Quit Smoking Timeline
- After you stop smoking for two weeks to 3 months, your heart attack risk drops, and your lung function improves.
- Between one month and nine months, your coughing and shortness of breath decreases.
- One year after you quit, your risk of coronary heart disease is half that of a smoker’s.
Furthermore, you decrease your risk of lung cancer and other cancers. You can reduce your risk for cancer of the stomach, mouth, throat, kidney, cervix, pancreas, and bladder. Medicare provides preventive services to detect disease early, so treatment is most effective.
Medicare Preventive Services
Quit Smoking and Save Money
When you quit smoking, you save thousands per year. If you are a one-pack-a-day smoker, smoking costs you on average $6.18 per day. By becoming a non-smoker, you save over $2,200 per year! Furthermore, you can get non-smoker discounts on Medicare Plans. Call Senior Healthcare Direct at 1-855-368-4717 and find out how much you can save as a non-smoker.
According to Medicare.gov, Medicare will provide coverage for the COVID-19 vaccine when it becomes available. Currently, FDA.gov has no FDA-approved or authorized vaccine for the prevention of COVID-19. On December 10, 2020, the FDA will meet with its Vaccines and Related Biological Products Advisory Committee. They plan to discuss the request for emergency use authorization of a COVID-19 vaccine from Pfizer, Inc. in partnership with BioNTech Manufacturing GmbH.
COVID-19 Vaccine Emergency Use Authorization
If FDA approves the Emergency Use Authorization of Pfizer’s COVID-19 vaccine, it plans to distribute the vaccine to “high-risk populations in the U.S. by the middle to end of December 2020.” According to CNN, Pfizer’s Coronavirus vaccine is the first to seek regulatory clearance in the United States. Furthermore, Pfizer’s CEO, Albert Bourla, said, “It took just 248 days to get from the day we announced our plans to collaborate with BioNTech to our FDA submission day.”
How does Pfizer’s COVID-19 vaccine work, and how effective is it?
Pfizer’s COVID-19 Vaccine
The Pfizer COVID-19 vaccine requires two doses a few weeks apart. Furthermore, Coronavirus protection starts 28 days after the first shot. Final analysis of Phase 3 clinical trials found Pfizer’s Coronavirus vaccine 95% effective in preventing infections.
However, another pharmaceutical company, Moderna, has a COVID-19 vaccine that is just as effective.
Moderna’s COVID-19 Vaccine
Moderna’s COVID-19 vaccine shows 94.5% effectiveness in clinical trials. It plans to apply for FDA emergency use authorization later in November. Consequently, the FDA is likely to consider both applications on December 10, 2020.
Now that we know which COVID-19 vaccines may be available in December 2020, which high-risk groups will likely get emergency use first?
When and Who Will Get The Vaccine First?
The Hill reports Robert Redfield, CDC director, said today that a COVID-19 vaccine would be released “by the end of the second week of December.” Furthermore, Redfield says the decision to receive the vaccine first (based on risk and exposure) will likely be “nursing home residents and health care providers.” In the meantime, the best way to protect yourself and others from COVID-19 is by wearing a cloth mask.
The vaccine may soon be available, and Medicare provides COVID-19 vaccine coverage.
You can get Medicare coverage for epilepsy when you turn age 65 or before age 65 when a disability limits your physical and mental functioning. Social Security has specific epileptic requirements that qualify you for the disability. Read this article to discover:
What is Epilepsy?
- Generalized tonic-clonic seizures occur once a month for at least three consecutive months despite adherence to prescribed treatment. This type of seizure is also called Grand Mal and involves a loss of consciousness and violent muscle contractions known as convulsions.
- Dyscognitive seizures occur at least once a week for at least three straight months despite adherence to prescribed treatment. This type goes by many names such as partial, focal, absence seizure. For example, the person may appear to be staring off into space for a few seconds.
Having Alzheimer’s disease can increase your risk of seizures.
Alzheimer’s and Your Risk of Seizures
According to the Alzheimer’s Society, people with dementia such as Alzheimer’s “are at risk of having epileptic seizures.” Dr. Alzheimer described this seizure risk himself in 1911. Recent research suggests seizures can occur early-on in Alzheimer’s disease. A research study showed about “1 in 8 patients with dementia described episodes which we believe could have been epileptic seizures.”
So why do people with Alzheimer’s have a higher risk of seizures?
Increased Risk for Seizure
Anything that changes the structure of your brain, such as Alzheimer’s, can cause seizures. Two proteins in Alzheimer’s disease, “amyloid and tau,” build up in your brain and “affect how the brain nerve cells communicate with each other.” In some cases, “these nerve cells can become ‘hyper-excitable.’ ” As a result, these neurons “behave uncontrollably, causing epileptic seizures.”
Now you know why people with Alzheimer’s have an increased risk for seizures, so when does Medicare cover epilepsy?
Medicare Coverage for Epilepsy
According to SSA.gov, Medicare covers people under age 65 who are eligible for Social Security Disability Insurance (SSDI) after a 24-month waiting period. However, if you had a disabling impairment that began two or more years before becoming eligible for SSDI, you will automatically be enrolled in Medicare. Otherwise, you will have to wait two years before Medicare automatically enrolls you.
Medicare does cover Chronic Obstructive Pulmonary Disease (COPD). Part B covers COPD treatment services such as counseling to quit smoking, oxygen equipment, and pulmonary rehabilitation programs. Part D covers COPD prescriptions such as bronchodilators and steroid inhalers. Read this article to learn more about COPD, including:
What is COPD?
Chronic Obstructive Pulmonary Disease (COPD), according to the Mayo Clinic, “is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.” The American Lung Association says, “COPD is the third leading cause of death by disease in the United States.” Furthermore, “More than 16.4 million people have been diagnosed with COPD,” and millions more may have COPD and not know it.
There is no cure for COPD. However, the disease is preventable and treatable. Find out what causes COPD and the preventative actions you can take.
What Causes COPD?
The American Lung Association says cigarette smoking causes 85 to 90 percent of all COPD cases. Furthermore, what you breathe every day at work, home, and outside can cause chronic inflammatory lung disease. For example, secondhand smoke, dust, fumes, and chemicals can cause COPD.
In rare cases, a genetic condition called Alpha-1 deficiency-related emphysema causes COPD. MedlinePlus says this inherited disorder has a SERPINA1 gene mutation that leads to a shortage or abnormal form of alpha-1 protein. Consequently, the deficiency of alpha-1 protein destroys the alveoli in your lungs.
Now that you know what causes COPD, what can you do to prevent it?
3 Steps to Reduce Your Risk of COPD
You can take the following preventative steps to reduce your risk of COPD:
- If you are a smoker, STOP SMOKING. Medicare Part B covers up to 8 counseling visits every 12 months to help you quit smoking. You pay nothing for tobacco cessation counseling as long as your health care provider accepts Medicare assignment.
- If you don’t smoke, don’t start. Smoking causes COPD, lung cancer, and other diseases. Medicare covers a free lung cancer screening every 12 months.
- Avoid breathing secondhand smoke, dust, fumes, and chemicals. For example, you can wear a cloth mask over your nose and mouth to filter environmental particles.
If you already have COPD, Medicare does cover the following treatment services.
Medicare covers COPD Treatment
When you have moderate or severe COPD, Medicare Part B covers a Pulmonary Rehabilitation Program. According to Medicare.gov, this program helps you “breathe better, get stronger, and be able to live more independently.” So what does this program cost?
Pulmonary Rehabilitation Program Costs
Before Medicare Part B covers 80% of your program costs, you must first pay your Part B deductible. Then you pay 20% of the Medicare-approved amount when you get medical treatment in a doctor’s office. Moreover, in a hospital outpatient setting, you pay the hospital a copayment for each session.
However, you can avoid paying 20% and hospital copays when you have Medigap Plan G. Senior Healthcare Direct can find you the most cost-effective Medicare Supplement Plan. Call 1-855-368-4717 or get your quote.
Medicare also covers oxygen equipment in your home.
Oxygen Equipment for COPD
Furthermore, Part B covers the rental of oxygen equipment and accessories. Your doctor can prescribe this Durable Medical Equipment for use in your home. Medicare will pay for oxygen equipment under the following conditions:
- You have a severe lung disease, such as COPD, or you are not getting enough oxygen.
- Supplemental oxygen, aka oxygen therapy, might improve your health.
- Your arterial blood gas has a low oxygen level.
- Other alternative measures have failed.
When you meet the above conditions, Medicare covers the following oxygen equipment:
- Systems that provide oxygen
- Containers that store oxygen
- Tubing and related oxygen accessories
So what does this Oxygen equipment cost?
Oxygen Equipment Costs
After paying the annual Part B deductible, you pay 20% of Medicare-approved costs for oxygen equipment. A supplier will rent you oxygen equipment for 36 months. Then, as long as you have a medical need for oxygen, the supplier must provide you an additional 24 months. Furthermore, your monthly rental payments to the supplier cover the following: tubing or a mouthpiece, oxygen, and machine maintenance, servicing, and repairs.
To help you breathe easier, Medicare Part D covers COPD prescriptions.
Medicare covers COPD Prescriptions
Medicare Part D covers bronchodilators and steroid inhalers to treat COPD symptoms. According to Mayo Clinic, bronchodilators prescribed for COPD “relax the muscles around your airways so you can breathe better.” The prescription typically comes as inhalers and are available in two types: short-acting for quick relief and long-acting for maintenance therapy.
Some people who use bronchodilators may have “flare-ups” and require the use of antibiotics or steroids. For example, inhaled corticosteroids can help reduce the worsening of COPD symptoms (exacerbations).
Medicare Part B covers a free lung cancer screening every 12 months. You can get a Low Dose Computed Tomography (LDCT) diagnostic screening of your lungs if you meet the eligibility requirements.
Medicare Lung Cancer Screening Eligibility
Before your first lung cancer screening, you must schedule a “lung cancer screening counseling and shared decision-making” visit with your primary care physician (PCP). During your PCP visit, your physician will confirm your eligibility, counsel you on lung cancer screening, and assist you in making a decision.
The American Lung Association says your doctor must confirm you meet all the following high-risk conditions:
- Age 55 to 77
- No current signs or symptoms of lung cancer
- You have a tobacco smoking history of at least 30 “pack years” (an average of one pack (20 cigarettes) per day for 30 years).
- Current smoker or former smoker who quit within the last 15 years.
If you meet the above eligibility requirements, your doctor can provide you a written order for the LDCT lung screening. Furthermore, your doctor is required to counsel you on the benefits and risks of lung cancer screening.
Medicare Lung Cancer Screening Counseling
According to CMS.gov, your doctor or qualified non-physician practitioner may furnish your lung cancer screening counseling. For example, a physician assistant, nurse practitioner, or clinical nurse specialist can provide this counseling. The doctor will counsel you on the importance of follow-up annual lung cancer screenings.
Furthermore, you may learn about the risks of comorbidity – having two or more long-term medical conditions. For example, you may be diagnosed with lung cancer and have another chronic illness, such as Chronic Obstructive Pulmonary Disease (COPD). The practitioner will counsel former smokers on abstaining from smoking and counsel current smokers on quitting smoking. Moreover, Medicare covers up to 8 tobacco cessation counseling visits per year.
Your doctor will consult you on the benefits and harms of lung cancer screening. This consult includes the risks of overdiagnosis, the diagnosis of a condition that would not have caused symptoms or death, and radiation exposure. Furthermore, your doctor will warn you that a false-positive diagnosis could occur. After this consult, you and your doctor can decide whether a Medicare-covered lung cancer screening is right for you.
Medicare Part B Preventive Services
Discover more Medicare Part B preventive services, including free colorectal cancer screenings, vaccine shots, and telehealth counseling. Furthermore, find out how much Medicare Part B premium and deductible will increase in 2021.
Wearing a Cloth Mask Protects You
On November 10, 2020, the CDC reports wearing a cloth mask protects you from COVID-19. Throughout the Coronavirus Pandemic, the CDC has told Americans to wear a cloth mask to prevent Coronavirus transmission to other people. However, for the first time, the CDC says, “Studies demonstrate that cloth mask materials can reduce wearers’ exposure to infectious droplets through filtration.” Furthermore, the CDC says cloth masks with “higher thread counts have demonstrated superior performance.”
The Coronavirus can spread from asymptomatic people who show no symptoms and spread the virus when they speak. Therefore, you can unknowingly spread the Coronavirus by talking with another person while not wearing a face mask. Due to the highly contagious nature of COVID-19, the CDC concludes that “individual benefit increases with increasing community mask use.” Finally, the CDC says, “adopting universal masking policies can help avert future lockdowns.”
Now you know wearing a cloth mask with a high thread count, such as a cotton mask, can protect yourself and others from COVID-19. So, how well have Americans protected themselves?
COVID-19 Cases and Deaths
Since the beginning of the Coronavirus Pandemic, America has led the world with the highest number of COVID-19 cases and deaths. On May 13, 2020, America had 1.4 million COVID-19 cases and 83,115 deaths. Compared to the other top seven countries, the U.S. had more cases and deaths than all these countries combined!
Six months later, on November 12, 2020, the CDC reports 10.3 million COVID-19 cases and 241,069 deaths. America continues to lead the world with the highest number of total COVID-19 cases and deaths (Worldmeters.info). Why is the United States the most infected country in the world? America’s response to COVID-19 will tell you how we got here.
America’s COVID-19 Response
In April 2020, America shut-down to slow the spread of Coronavirus. Upon reopening America in May 2020, businesses required customers to wear face masks. During this time, the CDC advised Americans to wear a cloth mask to prevent the spread of Coronavirus to other people whenever you could not safely social distance.
However, President Trump and many of his followers refused to wear a face mask during political rallies and white house events. As a result, COVID-19 infected Trump. He stayed at Walter Reid Hospital for three days. Subsequently, Coronavirus has infected many of Trump’s staff and cabinet members, including the first lady, Melania, and press secretary, Kayleigh McEnany.
In October 2020, the number of new COVID-19 cases began to skyrocket. On November 5, 2020, CNN reports that the U.S. breaks record with over 120,000 new coronavirus cases in a single day, and more than 234,000 deaths. On November 10, 2020, The Guardian reports the U.S. hit a record number of Coronavirus hospitalizations 62,000 nationwide, the biggest single-day increase since July 10. Furthermore, the U.S. surpassed 1 million new confirmed cases in the first ten days of November.
America’s divided response to COVID-19 has made U.S. world leader in Coronavirus cases and deaths. Moreover, COVID-19 has weakened our national security. November 13, 2020, MSNBC reports in a video, “130+ Secret Service Officers either infected with COVID or under quarantine.”
So what can we do to make America safe again?
Wear a Cloth Face Mask
You can help Make America Safe Again by wearing a cloth mask to protect yourself and those around you from COVID-19. By unifying as one nation and following CDC guidelines, we can we save ourselves from COVID-19.
Medicare Part B covers Annual Wellness Visit (AWV), during which your doctor can make assessments for Alzheimer’s and other cognitive impairments. You can get this health risk assessment during the first 12 months of having Medicare Part B. After that, you can get subsequent Annual Wellness Visits every 12 months. Now that you know how Medicare covers Alzheimer’s, what exactly is it?
What is Alzheimer’s?
The Alzheimer’s Association defines the disease:
Alzheimer’s is a type of dementia that affects memory, thinking, and behavior. Symptoms eventually grow severe enough to interfere with daily tasks.Alzheimer’s Association
The National Institute on Aging says Alzheimer’s disease is irreversible and results in the progressive destruction of memory and thinking skills. Furthermore, most people first develop symptoms around the age of 65. Thus, it’s critical you get a Wellness visit every year.
Now that you know seniors are at risk for Alzheimer’s disease, what are some of the warning signs?
3 Warning Signs You May Have Alzheimer’s
The Alzheimer’s Association provides a list of ten early signs and symptoms of Alzheimer’s. The following are three warning signs you may have Alzheimer’s disease:
- Memory Loss disrupts your daily life – in the early stages of Alzheimer’s, “you forget recently learned information.” For example, you might forget what you ate for breakfast or repeat yourself in conversation. However, as Alzheimer’s progresses, you slowly lose your long-term memory. For example, family members – sons and daughters – become strangers to a person with late-stage Alzheimer’s.
- Confusion with time or place – you can lose track of dates and the passage of time. For example, a person with Alzheimer’s may not know the current day, month, or year. Furthermore, you may not know where you are or how you got there.
- New problems with words in speaking or writing – you may stop in the middle of a conversation, not knowing how to continue. In other cases, you may have trouble naming a familiar object. For example, a person with Alzheimer’s may call their son or daughter by a different name.
Now that you know some of the warning signs of Alzheimer’s disease, what can you do to prevent it?
How to Maintain Cognitive Health
The National Institute on Agings provides a list of steps to maintain cognitive health. The following are five healthy habits to reduce your risk of cognitive decline:
5 Healthy Habits
- Exercise regularly – clients of Senior Healthcare Direct can join the Active&Fit Direct fitness program. Watch a video and find out who qualifies for the program and how this gym membership can save you money!
- Eat a nutritious diet that is rich in fruits and vegetables.
- Keep your mind active – engage in personally meaningful activities such as hobbies. For example, you can take a class or learn a new skill. Likewise, you can read books or play games.
- Avoid drinking a lot of alcohol – too much alcohol can cause seniors to be forgetful and confused. Furthermore, your doctor could mistake these symptoms for signs of Alzheimer’s.
- Get plenty of sleep – 7 to 9 hours each night. If you do not get a good night’s sleep, the next day, you may feel irritable, have memory problems or be forgetful, and feel depressed.
Changing your habits can be challenging. Medicare provides telehealth counseling to help you make lifestyle changes.
Medicare Telehealth Counseling
Certain life events such as senior retirement or losing a spouse can lead to trouble sleeping, alcohol abuse, malnutrition, and weight gain. Fortunately, seniors can get Medicare telehealth counseling that includes:
- Alcohol misuse counseling
- Medical nutrition counseling
- Obesity counseling
Furthermore, Medicare covers psychotherapy with a clinical psychologist. You can get help with anxiety and depression in person or through telehealth services.
Counseling services can help you make healthy lifestyle changes and reduce your risk of cognitive decline. Moreover, engaging in the above healthy habits can slow the progression of Alzheimer’s disease.
Medicare Part A Deductible 2021
In 2021, your Medicare Part A deductible will increase $76 from $1408 in 2020 to $1484 in 2021. You must pay the Part A deductible before Medicare covers your hospital expenses. However, if you do not become a hospital inpatient in 2021, you do not pay the Part A deductible. When you pay the Part A deductible of $1484 in 2021, you can receive the following hospital coverage.
Part A Hospital Coverage and Costs 2021
Your Part A deductible covers a 60-day benefit period. For example, a hospital admits you as an inpatient in 2021. According to Medicare.gov, for the first 60 days, you have $0 coinsurance. Between days 61 and 90, your coinsurance will increase $19 per day from $352 in 2020 to $371 in 2021. Furthermore, for days 91 and beyond, your coinsurance will increase $38 per day from $704 in 2020 to $742 in 2021.
In addition to Part A deductible and coinsurance costs, you may pay a monthly premium.
Part A Premiums 2021
Most Medicare beneficiaries have already paid their Part A premium before age 65 by having worked 40 quarters. However, for those people who worked less than 40 quarters, you will pay the amounts shown in the table. For example, if you have less than 40 quarters worked, you pay $471 in 2021. Furthermore, if you have between 30-39 quarters worked, you pay $259 in 2021.
Your monthly Part A premiums do not cover medical services outside a hospital setting. Find out what’s not covered by Part A.
What Part A does not cover
Part A does not cover outpatient medical services. For example, Part A does not cover ambulance transport to a hospital or outpatient doctor’s office visits. Discover the free preventive services covered by Part B, as well as the increased premiums and deductible in 2021.
Medicare Part B Premium 2021
In CMS.gov press release, Medicare Part B premium will increase $3.90 from $144.60 in 2020 to $148.50 in 2021. If you enroll in Medicare Part B after November 1, 2020, you will pay the $148.20 Part B premium in 2021. However, most Medicare beneficiaries will not have this 2.7% Part B increase.
For most Medicare beneficiaries who had Medicare Part B before November 1, 2020, and had their Part B premium withdrawn from their Social Security benefits, you will only have a 1.3% increase in 2021. Learn more about COLA – Cost of Living Adjustment – and the Medicare Hold Harmless Provision restricting Part B premium increases.
Did you know your Part B premium pays for FREE preventive services?
Medicare Part B – FREE Preventive Services
Medicare Part B covers outpatient preventive services to detect health conditions early, so treatment is most effective. The following preventive screenings are FREE. You pay no deductible and no co-insurance costs unless the doctor performs a biopsy.
- Colorectal cancer screening: fecal occult blood tests
- Colorectal cancer screening: sigmoidoscopies
- Nutrition therapy services
- Welcome to Medicare
- Yearly “Wellness” visit
However, most preventive services are free after you pay the Part B deductible. Some of these FREE Part B services include vaccination shots and counseling:
- Alcohol misuse screening and counseling
- Diabetes screening
- Flu shots
- Hepatitis B shots
- Obesity screening and counseling
- Pneumococcal shots
- Sexually transmitted infections screening and counseling
- Tobacco use cessation counseling
Medicare Part B Deductible 2021
In addition to the Part B premium increase, the Part B deductible will rise $5 from $198 in 2020 to $203 in 2021. Furthermore, all Medigap Plans after January 1, 2020, require you to pay the Part B deductible. If you are new to Medicare in 2021, the most comprehensive Medicare Supplement you can get is Plan G.
Senior Healthcare Direct can help you find the most cost-effective Medicare Supplement Plan. Call 1-855-468-4717 or get your quote.
If you were a high-income earner, your Medicare Part B premium will increase in 2021.
Medicare Part B Premiums in 2021
The chart shows 2021 Part B premiums for all income levels. Individuals or married couples filing separately who earned $88,000 or less will pay the standard premium of $148.50. Furthermore, if you and your spouse both had modified adjusted gross income (MAGI) of $176,000 or less, you also pay this standard premium.
In all cases, your IRS tax return is from the previous two years. Thus, your 2019 tax return is the basis for your 2021 Part B monthly premiums. For high-income earners whose MAGI is greater than $88,000 per person, you will pay the standard Part B premium of $148.50 plus an Income Related Monthly Adjustment Amount (IRMAA).
For example, with a 2019 MAGI is $120,000, you pay $148.50 + $297 IRMAA for a total monthly payment of $445.50.