Medicare Advantage Programs are Increasing Benefits - Learning Could Be A Future Crucial Addition

In The News Oct 26, 2020

Considering all the shifts this year with healthcare many providers, including Medicare Advantage programs, are looking to increase health and well-being benefits. Medicare Advantage typically covers:

  • Prescription drug coverage
  • Dental care
  • Eyewear
  • Hearing aids

Some states have already or are considering enhancing these benefits further to include:

  • Fitness membership
  • Allowance for over-the-counter (OTC) products
  • Telehealth coverage
  • Meals
  • Learning opportunities focused on health and wellness, neuroplasticity, and more

Specific benefits vary plan to plan and state to state so be sure to check what is covered in your area and plan.

Wellness Programs on Learning and Shifting Habits Improve Mental Health

According to a report from the Center for Medicare and Medicaid Innovation (CMMI) Medicare those who participated in wellness programs reported improved fitness levels, were less likely to be injured in a fall, and were able to maintain their physical health better. In addition, the study found that participation in chronic disease management, fall prevention, and physical activity programs led to positive mental health effects like improved overall confidence.

Highlighted in the study was the fact that

“All three program types were associated with small positive effects in different areas of mental health. . . . An important secondary benefit of participation appears to be enhanced mental well-being, which may result from both lifestyle changes and knowledge gained from programs, or from the social aspects of program participation.”

Strong Social Relationships Decreases Risk of Mortality

Another study from PLOS Medicine found that the strength and availability of social relationships are a strong predictor of mortality - People with stronger social relationships had a 50% increased likelihood of survival than those with weaker social relationships.

Mortality risk factors like smoking and alcohol consumption are comparable to that of loneliness and it is considered worse than risk factors such as physical inactivity and obesity.

These results show that loneliness and social isolation among older adults likely have a quantifiable and critical health impact. So now healthcare providers are seeking to find ways to address wellbeing needs through socialization and learning since clear overall health advantages for those who participate have been shown.

Medicare Open Enrollment is open NOW through Dec. 7 - Are you prepared?

Do you know if you qualify for Medicare or when you qualify? Learning some of the basics is an important way to not miss out on important dates and resources.

Who is medicare for?

Medicare is the USA’s health insurance program for people age 65 or older. Some people younger than 65 may also qualify for Medicare like those with disabilities and those who have permanent kidney failure.

What does medicare NOT do?

Medicare helps offset the cost of health care. It DOES NOT COVER all medical expenses and it DOES NOT COVER most long-term care.

Who Qualifies?

Those eligible at age 65  have worked or had a spouse work and pay Medicare taxes for 10 years or more. Your initial enrollment period begins three months before your 65th birthday includes the month you turn age 65, and ends three months after that birthday.

  1. Some people get Medicare automatically, and some have to sign up (usually who is not getting Social Security needs to sign up).
  2. Otherwise there are certain times of the year when you can sign up or change coverage known as open enrollment periods.

Medicare Comes in Pieces - Pick Your Parts

There are many different pieces to Medicare coverage. Depending on your situation it is important to know what is available so you can pick the best coverage available to you.

Original Medicare (Part A and Part B) coverage - Social Security allows you to enroll in this.

  1. Medicare Part A (hospital insurance) helps pay for inpatient care in a hospital. It may also pay for a limited time for a skilled nursing facility, some home health care, and hospice care. (Many people who have worked or their spouse has worked for 10 years qualify for this for free.)
  2. Medicare Part B (medical insurance) helps pay for doctors, other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services. (There is a monthly premium for this that varies based on income.)

If you choose not to enroll in Medicare Part B initially:

  1. Your coverage could be delayed
  2. You may have to pay higher monthly premiums later
  3. Your monthly premium will go up 10% for each 12-month period you were eligible for Part B, but don’t sign up, unless you qualify for a "Special Enrollment Period" due to being covered by your employer’s healthcare.
  4. If you don’t enroll in Medicare Part B during your initial enrollment period, you have another chance each year to sign up during a “general enrollment period.” Your coverage, though, may start only several months later.

Medicare Supplement Insurance (Medigap) these are policies from private insurance companies that follow rules set by Medicare.

  • Supplemental (Medigap) policies help pay Medicare out-of-pocket co-payment, co-insurance, and deductible expenses.
  • Medicare Advantage Plan (known as Part C) includes all benefits and services covered under Part A and Part B — prescription drugs and additional benefits such as vision, hearing, and dental — bundled together in one plan. Many of these plans are also looking to include benefits around telehealth, plus learning and well-being programs focused on mental and physical health.
  • Medicare Part D (Medicare prescription drug coverage) helps cover the cost of prescription drugs.

How do you sign up?

Signing up is as simple as filling out an Online Application. Be prepared with your current or most recent healthcare information, social security information, and any health documents you think may help you get started.

Do you still have questions about Medicare?

Come to one of GetSetUp’s live informational classes to learn more and ask questions.

If you already are squared away with your Medicare plans consider joining a GetSetUp class on a topic of your interest from meditation to nutritious recipes, because as research shows these are good for your mind and body!

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