Can You Hear me?

I stopped in Home Depot to pick up a light bulb for my outside lamp post a few days ago. A sales representative helped me to locate the proper bulb. As we exchange information i.e. what I needed?, the different options available e.g. LED, solar, etc. and the price ranges I noticed that the gentleman often leaned to one side and almost always asked that I repeat what I had just stated.

As a volunteer Board Member and Officer of the Hearing Loss Association of America – Rochester (HLAA-Rochester), I suspected that something was not right. So I asked, are you hearing me O.K.? He replied, no, I am deaf in one ear. Immediately, I asked, then why don’t you wear a hearing aid?

His response was a common one especially for Senior Citizens. He said that he did not wear a hearing aid because he could not afford one. The cost of hearing aids can range from approximate $4 to 8 thousand dollars. If you are a senior and live on a fixed income, like Medicare, then, it is likely that you may not be able to afford to purchase one.

Approximately 12% of the U.S. population or 38 million Americans have a significant hearing loss. Thirty to forty percent of people over 65 have some type of hearing loss. Hearing aids can offer dramatic improvement for most people with hearing loss.

Medicare does not provide coverage for hearing test or hearing aids, eye care, dental services, foot care and many other services. Additional Services are available to seniors through Medicare Advantage Plans. Each carrier offers different “additional” services. I was surprised to learn that the gentleman was currently enrolled in a Medicare Advantage Plan; however, it was one that did not offer hearing exams or hearing aids. Lifetime Financial Group specializes in assisting seniors with understanding Medicare, Medicare Advantage Plans, and understanding their needs prior to enrollment.

Persons, who are either disabled or Age 65 and qualify for Medicare Part B, can enroll in an advantage plan. There are no pre-existing conditions. You must be a US Citizen, live in the plan service area, and not currently be receiving dialysis treatment.

Seniors can enroll and or switch plans during the Annual Enrollment Period (AEP) during the Fall (October through December). There is a Special Enrollment Period (SEP) for seniors who might have moved outside of the plan service area, become disabled, or qualify for Medicaid status.

 If the senior is turning 65, and qualifies for Medicare Part B, then he/she will be given an initial enrollment period (IEP) for 7 months. The government will give you 63 days after your IEP to sign up for a prescription drug plan or you will receive a Late Enrollment Penalty (LEP). Contact our office to learn how you can avoid this penalty or sign up for a workshop.  

HLAA-Rochester also has access to Audiologist who dispenses donated Hearing Aids. I asked the gentleman to call us so that we can assist him with receiving a donated hearing aid until the next annual enrollment period (AEP).

If you know a senior who has difficulty hearing, there is help available. Please call us!

© Carmen Coleman, President and CEO

Lifetime Financial Group, LLC
30 W. Broad Street, Suite 300

Rochester, NY 14614

(585)325-2525 

Patient Status in Hospital could lead to Costly expenses for Medicare Beneficiaries

Imagine becoming ill or having an injury and being rushed to the hospital’s emergency room. This is a terrifying experience at any age; for most, it very time consuming and can be costly. You might be surprised to know that after several days in the hospital, that you were never classified as an inpatient. You were considered an outpatient, in “observation” status. Why is this important?

Traditional Medicare requires a three day inpatient stay before it will cover the first 20 days of rehabilitation care in an approved nursing facility. If the hospital classifies you as “observation” status instead of inpatient status, you do not qualify for Medicare services after you are discharged from the hospital and will be responsible for the full bill for rehabilitation services. Traditional Medicare will not cover you. The cost for nursing home care can exceed $400 a day.

You might be wondering, How can this happen? Observation status looks and feels like full hospital admission, but technically you are an outpatient. You might have been assigned to a room on a floor, stayed several days, having doctor and nurse care with several test. You will receive the same care in the hospital if you were classified as “inpatient”, however you will not quality to receive any additional care under traditional Medicare because you were “observation” status or otherwise, never admitted.

Medicare Advantage Plans do not necessarily have the same rule. Excellus, Blue-Cross, BlueShield  reported that hospital status will not affect eligibility for rehabilitation as long as the services are deemed necessary. MVP Healthcare on the other hand, requires a three day qualifying stay in order to be eligible. United Healthcare does not require a 3-day prior hospital stay to qualify for skilled nursing care. However it is important to note that, unless the provider writes an order to admit you as an inpatient to the hospital, you are an outpatient and pay the cost sharing amounts for outpatient surgery. Even if you stay in the hospital overnight, you might still be considered an outpatient. People with private commercial insurance plans are also subject to the terms and conditions of their contract.

A study in the June 2012 issue of the journal Health Affairs reported the ratio of observation stays to inpatient admissions from 2007-2009 among fee-for-service Medicare patients increased 34 percent. Local data reflect national trends.

Increased “observation” stays might be a result of payment policies. Medicare routinely performs audits on hospital billing practices and flags patients where it is determined that an outpatient procedure would have sufficed over a hospital stay. In some cases, the hospital loses the revenue billed, even after an appeal process is completed. It is good to note that recently, The Center for Medicare Services will permit hospitals to re-bill in cases where hospital admissions are not deemed to be justified.

Hospitals therefore are being creative to insure that they receive payment for services provided.

Senator Charles Schumer, D-N.Y., announced early in March his plan to introduce a bill that would have observation stays count toward the three day requirement.

In the meantime, know that patients admitted through the emergency department are considered in observation status in many hospitals. Once there, be certain to have the conversation with the doctor so that you are not blindsided once discharged. 

For more information, read: Patient Status in Hospital can lead to a jolt, http://www.democratandchronicle.com/article/20130324/NEWS01/303240034/?nclick_check=1

Carmen Coleman, is a trusted Medicare Advisor and Consultant. She owns Lifetime Financial Group in Rochester, NY offering an array of insurance products including Medicare Advantage Plans. Visit her webpage: http://www.rochesterseniors.net

For continuous updates, Like us on Facebook:  https://www.facebook.com/pages/Lifetime-Financial-News/331728193589113

© Carmen Coleman, President and CEO

Lifetime Financial Group, LLC
30 W. Broad Street, Suite 300

Rochester, NY 14614

(585)325-2525 

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© Carmen Coleman, President and CEO

Lifetime Financial Group, LLC
30 W. Broad Street, Suite 300

Rochester, NY 14614

(585)325-2525 

How to Choose the Right Medicare Plan For You

http://youtu.be/nwRe-jI03Ns

© Carmen Coleman, President and CEO

Lifetime Financial Group, LLC
30 W. Broad Street, Suite 300

Rochester, NY 14614

(585)325-2525 

Elder Care: How to Help Your Parents Manage

It's a decision most adults dread: having to take over the financial and day-to-day living decisions for parents who can no longer manage on their own. When caring for your parents, you may need to plan on three levels: managing finances, making health care decisions, and making sure their daily household needs are met. Finding qualified experts who can advise you in these areas may make it easier to manage the situation.

 

Managing Finances

If your parents currently are able to communicate, try to initiate a conversation about how they would like their money to be managed. Rather than telling them what to do, be clear that you would like to help and to make sure that their wishes are met. Access to bank and brokerage statements, insurance policies, and other financial documents may help you to safeguard your parents' assets.

If your parents work with a financial advisor, try to arrange a joint meeting where all parties can review the situation. If you pay your parents' bills and manage their checkbook, arranging for direct deposit of Social Security or pension benefits, as well as electronic delivery of recurring bills, could expedite the process.

Arranging for Health Care

If your parents are mentally competent, ask them about consulting a lawyer who can draft a health care proxy, a legal document designating you (or another person) to make decisions about medical care when they are no longer able to do so. If your parents have opinions about end-of-life care, their wishes can be incorporated into a living will, another legal document.

Even without these documents, the medical establishment is likely to look to you or other siblings to make decisions about health care, which could include arranging for long-term care or making end-of-life decisions. As part of this process, determine the type of medical insurance that your parents have and what it covers. 

Overseeing Daily Living Activities

If your parents are able to remain in their home, you may need to consider helping them to manage medication, to conduct daily tasks such as bathing or meal preparation, and to make arrangements for assistance with household chores. A visiting nurse and home care agency may provide assistance in these areas.

You may want to consider consulting a Professional Geriatric Care Manager, a professional who may help arrange for home care, provide crisis intervention, and help you identify solutions to potential problems. You can learn more at www.caremanager.org.
Managing a parent's affairs can be complicated, but arranging for support from qualified people may help you care for parents in a way that meets their needs and does not create too much stress on you.
 © 2011 McGraw-Hill Financial Communications. All rights reserved.
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