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STILLSOUL HEALTHCARE & WELLNESS RESOURCES & INFORMATION

Exactly What You Need For Senior Healthcare

GREGORY MCCOY & GARY SMITH

 
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SENIOR HEALTHCARE

Hello Gang,


This is Greg McCoy, class of 1974.  Over the past 16 years I  have been working in the Medicare space helping Seniors, us, work their way thru the maze called Medicare. I’ve filled Management, Supervisory and direct sales positions in several companies during this time, Aetna, Wellcare and now Secure Benefits Alliance among them. 

You can expect to see several articles in this space that try to  make Medicare more user friendly and ensure that you take advantage of all the health care opportunities Medicare has to offer.  Of course, as you have questions or want to talk one on one about your situation you can count on my time in the business to give you good, sage advice. Call me or write me with any questions you may have…


Greg McCoy




A short story about Medicare…..


Lyndon B. Johnson created the program in 1964. Original Medicare was considered so successful that it remained unchanged for decades.

Today, Parts A and B continue to cover many of the health costs for millions of Medicare enrollees. How does Original Medicare succeed in this, and what do the parts cover?

Medicare Part A

Medicare Part A can be thought of as your hospital insurance. It helps to pay for your stay at a health care facility, whether that be a hospital, skilled nursing facility, or nursing home, among others.

If you’re admitted as an inpatient, Medicare Part A covers many services like meals, a semi-private room, prescription drugs, and mental health care.

At these inpatient facilities, Part A helps cover many of the services, including meals, a semi-private room, prescription drugs taken during your treatment, and mental health care. Private nursing or rooms are not covered unless determined to be medically necessary.

In some circumstances, Part A can assist with services like hospice or home health care. Contact your doctor to see if you fall into a qualifying category.

Most people are automatically enrolled in Medicare Part A when they turn 65 as long as they’re receiving Social Security benefits. They can also receive Part A premium-free in most circumstances if they paid Medicare taxes while working.

If you elect not to receive Social Security benefits, you won’t be automatically enrolled at age 65. Depending on when you were born, 65 may not be your full retirement age. Instead, you may need to wait to begin receiving full retirement benefits. If you’re not at your full retirement age, but want Original Medicare, you’ll have to apply for Medicare benefits separately.

Medicare Part B

Medicare Part B helps cover medically necessary services, including doctor visits, ambulance services, and physical therapy. Part B covers many preventive and screening services, as well.

If you need any durable medical equipment, Part B can help you pay for it. Durable medical equipment includes items that your primary care physician prescribes to you to use at home, like wheelchairs, blood sugar monitors, or hospital beds. It must be:

  • Able to withstand repeated use, lasting for at least 3 years;

  • Used for medical reasons;

  • Generally, not useful to someone who isn’t ill or injured;

  • Used in your home

In most cases, Medicare Part B enrollees will pay a standard premium.

Unlike Medicare Part A, all enrollees must pay a monthly premium for Part B. If you receive Social Security or similar benefits, these premiums come out of your benefit payment. In most cases, Medicare enrollees will pay a standard premium.

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The benefits of Medicare Parts A and B can make Original Medicare a strong asset in helping beneficiaries afford health services and supplies. To learn more about what Original Medicare covers, visit Medicare.gov. For help navigating your Medicare options, contact a licensed sales agent using the Medicareful Plan Finder.

Just like you, your health is one of a kind. What works for one person may not for another, so the information in these articles should not take the place of an expert opinion. Before making significant lifestyle or diet changes, please consult your primary care physician or nutritionist. Your doctor will know your own health best.


How and When Can I Change Medicare Plans?

If you don't love your Medicare plan or need to change for whatever reason, when are you allowed to make that change and how do you switch plans?

Many people love their Medicare plans. It offers them the coverage they need for a price they can afford. But each year, some people look to make a change with their plans. This isn’t to say that the plans are bad, it just makes sense for that person. There are plenty of reasons why you may be interested in making a change. In fact, we’ve even suggested that you at least review your Medicare plan each year to make sure it still fits your needs. Your medical needs could change. You may find a less expensive plan. You could move, necessitating a new plan network. Whatever your reason, knowing when you’re permitted to change your plan and how to go about it allows you to ensure you’re getting the benefits that best fit your needs.

Annual Enrollment Period

October 15 — December 7

The Annual Enrollment Period (AEP) runs every year from October 15 to December 7. This window of time is the primary Medicare shopping season. During AEP, you can change to a different type of Medicare plan. The only thing you can’t do is enroll in Medicare for the first time, unless your Initial Enrollment Period happens to occur during AEP. Specifically, you can:

  • Enroll in a Medicare Advantage plan if you have Original Medicare (Parts A and B)

  • Return to Original Medicare from a Medicare Advantage plan by not renewing for the next calendar year

  • Move from one Medicare Advantage plan to another

  • Enroll in a Medicare Part D plan

  • Switch from one Part D plan to another

  • Drop your Part D plan completely

This is an excellent time for Medicare beneficiaries to explore their options because everything is on the table. Do you have Original Medicare and love it, but want some additional coverage? Try picking up a Part D plan or Medicare Supplement. Enjoy your Medicare coverage, but want to take it a step further? Look into a Medicare Advantage plan. Whatever your preference, there’s an option out there for you to explore.

Medicare Advantage Open Enrollment Period

January 1 — March 31

Replacing the Medicare Advantage Disenrollment Period in 2019, the Medicare Advantage Open Enrollment Period (OEP) is another window of opportunity to make a change to your Medicare coverage. The new OEP takes everything about the old Medicare Advantage Disenrollment Period and improves it. It is about double the length of the old disenrollment period and allows you to do more. You can still switch from Medicare Advantage to Original Medicare and Part D plan, as well as pick up a Medicare Supplement, if you’re healthy enough. Most importantly, though, you can also use this time to switch from one Medicare Advantage plan to another. This makes the Open Enrollment Period a better “do-over” window where you can hopefully fix any buyer’s remorse.

Special Enrollment Periods

The third window that you may encounter is a Special Enrollment Period (SEP). Unlike the AEP and OEP, an SEP is based on the circumstances that created it. For example, if you’re working when you turn 65 and have creditable coverage, you can begin an SEP when you retire and lose that coverage through your work. Another common reason for an SEP is if you move or change your address and your new address is outside of your current plan’s service area.

There are many different reasons why you may get an SEP and each allows you to do different things. Moving, for example, allows you to switch to Original Medicare or to a new Medicare Advantage plan that’s within your network. If Medicare terminates its contract with your Medicare Advantage plan, you’ll be able to switch to a new Medicare Advantage plan. The length of time also varies depending on the reason for the SEP, but can start as soon as two months before the initiating event and continue a month or two after.

Changing Your Medicare Plan

Okay, so that’s a lot to learn, but here’s the easy part. When you switch from one Medicare plan to another, all you have to worry about is the enrollment. Once you enroll in a Medicare plan, you’ll be automatically disenrolled from your old plan. If you wish to enroll in Original Medicare from Medicare Advantage, simply call your current plan or Medicare directly at 1-800-MEDICARE and explain what you’d like to do. And that’s it! You should receive your new plan information shortly, along with when your plan is active and in-depth coverage information.

 
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HEALTH & WELLNESS

This is Gary Smith. Below you will find information to keep you informed about Health & Wellness. I hope this information will assist you in making easier decisions regarding improving or adding to your health regiment.

In understanding the difference between health & wellness, health is a state of being, wellness is the state of living a healthy lifestyle. Health refers to physical,, social and mental well-being. There are five main aspects of personal health: physical, emotional, social, intellectual and spiritual. In order to be considered "well", none of these areas can be neglected.

For more information refer to the article Dimensions of Wellness/Roger Williams University: https://www.rwu.edu/undergraduate/student-life/health-and-counseling/health-education-program/dimensions-wellness

Health is the absence of illness. Wellness focuses on preventing health problems. The traditional health care view only considers getting you back to a state where there is no injury or illness. Wellness focuses on your entire state of well-being.

For further information about about health and wellness refer to the article "31 Simple Wellness Tips for Healthy and Happy Living."

https://fourwellness.co/blog

You can continue to visit our site for more information on health, wellness, diet/nutrition, exercise and living well.