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Starting the Dialogue with Your Aging Parents: About Medicare

September 16, 2013

Each year a handbook entitled Medicare and You is mailed to every Medicare beneficiary.  It usually runs close to 140 pages, but is relatively easy to read and understand for the average person.  The contents include explanations of various Medicare programs and how they interface with Medicaid and private insurance. As a resource it is unbeatable and shows any changes that have been incorporated during the past year.

If you are not yet eligible to receive Medicare then you may not have seen this handbook. It can be downloaded as a PDF file or read online at http://www.medicare.gov. I highly encourage you to either read through the copy your parents received in the mail or to download it yourself and have your own copy. It is very important that Medicare beneficiaries understand what is covered under their chosen plans and what they may be responsible for in terms of medical co-pays, deductibles, or co-insurance responsibilities.

When Medicare is understood by the majority of participants and their family members there is less confusion, better satisfaction with the overall healthcare system, and savings due to decreased fraud. The decreased fraud is a result of participants acting as sentinels and reporting cases of in appropriate billing, over charging, and other fraudulent activity.

In the 2013 edition of the handbook there are a number of new and enhanced benefits. One of the most important aspects of this is the increased number of preventive services.  Some of the services are fully covered depending on the plan your parents are enrolled in. Another factor that plays heavily into whether something is covered or not is whether the medical provider is a participating provider of Medicare services.

If you are in doubt about whether your parents medical provider is a participating provider of Medicare services you can ask the clinic staff via phone or face to face. You can also usually look up this information online. Asking this important question should be done before any services are provided since in the event the medical provider is not a participating provider the services won’t be covered. When services are billed to Medicare and denied then the secondary insurance (if it is a Medicare supplement) most likely will not pay either. This leaves your parents responsible for paying the bill out of pocket.

I’ve listed some of the preventive services covered by Medicare below, but for a full list see page 51 of the handbook and read the surrounding pages for a full explanation.

  • Yearly “Wellness” visits
  • Alcohol misuse counseling
  • Bone mass measurement (screening for osteoporosis)
  • Cancer screenings (for breast cancer, cervical and vaginal cancers, prostate cancer, and colorectal cancer)
  • Cardiovascular screenings
  • Depression screening
  • Diabetes screenings
  • Flu shots, pneumococcal vaccines, Hepatits B shots

Over the next few weeks I’ll explore and explain some of the contents of this handbook in an effort to make you more aware of the benefits of Medicare. With your increased understanding you will be primed and ready to talk to your aging parents about the coverage they have and areas where they might want to consider making changes.

Remember, the open enrollment period for Part D is from October 15th through December 7th if there is a desire, or need, to change the Medicare drug plans.

Let me know if you have any questions by posting in the comments. It’s a pleasure sharing this useful information.

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