CDIS Blog

A healthy lifestyle is a key to staying vibrant and strong into your golden years. But eating right, getting plenty of exercise,s and avoiding bad habits are only part of the solution. Seniors need to be proactive when it comes to maintaining health and well-being. Luckily, Medicare offers a variety of preventive care and screening services that are included as part of your benefits package. 

Preventive services are designed to prevent you from getting sick or ill. Typically, they include exams, lab tests, shots, and screenings that help detect problems early on when treatment is most successful. In addition, preventive care includes counseling that can help seniors make more informed decisions about lifestyle choices as they age. If you’re looking to learn what preventive and screening services Medicare covers, the following information can help.

Preventive Services Provided By Medicare

For seniors enrolled in Medicare, a key benefit is preventive services or those exams, tests, and screenings that provide a snapshot into the state of your health and well-being. Staying current with all of the required exams and screenings is the most effective way to ensure you stay healthy and strong. In addition to a “Welcome to Medicare” visit, seniors can expect to receive an annual wellness visit along with routine glaucoma tests, bone density tests, flu shots, and even tests for identifying sexually transmitted diseases.

Covered Preventive Services

  • One-time “Welcome to Medicare” preventive visit
  • Glaucoma tests
  • Bone mass measurements
  • Sexually transmitted infection testing
  • Yearly wellness visit
  • Flu, Hepatitis B, and Pneumococcal shots

Cancer, diabetes, and cardiovascular disease affect thousands of seniors each year, and Medicare offers regular screenings as part of preventive care benefits. Treatment is most successful when illness is detected early, which is why screening services are prioritized as an important preventive benefit. 

Covered Screening Services

  • Multiple cancers
  • Hepatitis C
  • Diabetes
  • Depression
  • Obesity
  • Alcohol
  • Cardiovascular
  • HIV

Finally, Medicare recognizes that seniors often struggle with making healthy lifestyle choices. Original Medicare provides a variety of counseling services designed to help interested seniors learn about important lifestyle choices. Important information on alcohol use, smoking, and even tips on how to prepare nutritious meals are provided as part of Medicare preventive counseling services. By giving seniors the tools and resources they need to make more informed decisions, Medicare encourages health and wellness for well-deserving seniors.

Covered Counseling Services

  • Alcohol
  • Obesity
  • Sexually transmitted infections
  • Tobacco use cessation
  • Nutrition therapy

 

References:

https://www.medicare.gov/coverage/preventive-and-screening-services.html

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CDIS Blog

Most people have enrolled automatically in Original Medicare (Part A and Part B) as they approach the age of 65 with coverage start dates based on birthday month. For those who need to enroll manually, effective coverage dates could be earlier or later, depending on the situation. Knowing exactly when your coverage starts can help you make the right decisions about your medical care.

Automatic Enrollment—Coverage Starts Near Your 65th Birthday

Here’s the good news: most people have enrolled in Original Medicare automatically, and receive a red, white, and blue Medicare card by mail approximately 3 months before turning 65. In this case, Medicare benefits begin on the first day of your birthday month. For example, if you were born on July 24, July 18, or even July 31, your benefits begin on July 1. There is one exception. For those born on the 1st of the month, benefits begin on the 1st day of the month prior to the birthday month. For example, if you were born on December 1, your benefits begin on November 1.

If You Sign Up Manually During Your Initial Enrollment

In the event you have not enrolled automatically and choose to enroll in Medicare yourself, effective coverage dates vary based on the month you sign up. If you sign up during your Initial Enrollment Period (the 7-month period of time beginning 3 months before your 65th birthday and ending 3 months after your 65th birthday) effective start dates are shown below.

If you sign up for Medicare:

  • The same month you turn 65, coverage begins 1 month after you sign up.
  • 1 month after you turn 65, coverage begins 2 months after you sign up.
  • 2 months after you turn 65, coverage begins 3 months after you sign up.
  • 3 months after you turn 65, coverage begins 3 months after you sign up.

If You Sign Up Manually  After Your Initial Enrollment Period

You may enroll in premium-free Part A (most people are eligible) anytime during or after your Initial Enrollment Period starts with coverage start dates based on when you sign up. However, if you do not qualify for free Part A, and need to buy it or need to sign up for Part B, and miss your Initial Enrollment Period, you may have to wait until General Enrollment Period, Jan 1-Mar 31, with coverage starting on July 1. 

 

 

References:

https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-coverage-starts/when-coverage-starts.html

https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-how-to-sign-up-for-part-a-and-part-b.html#collapse-5769

https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-sign-up-parts-a-and-b/when-sign-up-parts-a-and-html

https://www.medicare.gov/your-medicare-costs/part-a-costs/part-a-costs.html

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CDIS Blog

As a Medicare recipient, you can travel anywhere in the United States and still be covered, as long as you use doctors and hospitals that accept Medicare. However, if you travel outside of the United States, your Medicare coverage is limited. But what about Medicare Supplement Insurance? How does your plan work when you travel in the U.S. and out of the country?  

Coverage In the U.S. 

Like Original Medicare, Medicare Supplement plans typically do not require that you use specific doctors or hospitals from a network. Medical care you receive anywhere in the U.S. is usually covered. However, there are exceptions. If you have a Medicare Select plan with a defined network, different rules apply, and you may not be able to use your insurance outside of your plan’s network. In addition, some plans with benefits above Original Medicare, like vision and dental, may make these benefits available only in the state where you bought the plan. 

Coverage Outside of the U.S. 

Depending on the Medicare Supplement plan you choose, you may have coverage for services or medical supplies you need while out of the country. Currently, plans C, D, F, G, M, and N offer foreign travel emergency health care coverage when traveling outside of the United States. Plans E, H, I, and J, while no longer available for sale, also offer coverage. If you purchased one of these plans before June 1, 2010, you can keep it, along with your foreign travel emergency care benefits.

With any plan offering foreign travel benefits, care must begin sometime within the first 60 days of your trip, and cannot be covered by Original Medicare. After you meet a $250 deductible, your Medigap plan will pay 80 percent of the billed charges. Note: Foreign travel emergency care provided by plans have a lifetime limit of $50,000.

 

Resources:

https://www.medicare.gov/supplement-other-insurance/medigap-and-travel/medigap-and-travel.html

 

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CDIS Blog

Sometimes, even when you think you’ve made the right choice in a Medicare Advantage plan (Part C), you need to make changes. Whether it’s because you’re moving out of your plan’s service area, or you simply want to change plans or return to Original Medicare, there are rules for when and how you can adjust your Part C coverage.

While Annual Enrollment in the fall is typically the time when most seniors make changes, there are other times throughout the year when you can change your Medicare Advantage plan.

2023 Annual Enrollment (October 15 – December 7)

Annual Enrollment extends from October 15 to December 7 each year and is the best time to make changes to an existing Medicare Advantage plan. During this time, you can add, drop or switch Medicare Part C plans without any penalty or restrictions. You can also join or drop a Medicare Prescription Drug Plan, or switch from one Medicare drug plan to another during Annual Enrollment. All changes you make during Annual Enrollment will become effective on January 1.

The Annual Enrollment period isn’t just for Medicare Advantage or Part D recipients. All Medicare beneficiaries are allowed to make changes to their coverage during this time. Some people join Medicare Advantage or enroll in a prescription drug plan for the first time.

Even if you are satisfied with your Medicare Advantage plan, Annual Enrollment is the time to look at other options in your area to make sure all of your needs will continue to be met the following year. Comparison shopping is smart and may help you find better coverage at a more affordable price.

Note: if you are currently enrolled in a Medicare Supplement plan, you can make changes to Medigap anytime throughout the year, and you are not restricted to the Annual Enrollment period. However, underwriting may apply.

Medicare Advantage Disenrollment Period (January 1 – February 14)

If you’re interested in dropping your current Medicare Advantage plan to return to Original Medicare, a specific disenrollment period has been created for you to do so. Medicare Advantage Disenrollment period extends from January 1 through February 14. This is the time for you to drop Medicare Advantage and return to Original Medicare.

Note: You cannot join a new Medicare Advantage plan or switch prescription drug plans during this time. The Medicare Advantage Disenrollment Period is for dropping Part C only. However, if you have prescription drug coverage with your Part C plan, and will lose it when you disenroll, you have until February 14 to join a new Medicare Prescription Drug Plan.

All changes made during the Medicare Advantage Disenrollment Period will be effective on the first day of the following month. For example, if you drop your Part C plan on January 22, your new coverage will begin on February 1. Note: Coverage for a new prescription drug plan will begin the first day of the month after the plan gets your enrollment form.

Other Reasons to Change a Medicare Advantage Plan

What happens if you need to make changes to your Medicare Advantage plan outside of Annual Enrollment or the Medicare Advantage Disenrollment Period? Special Enrollment periods were created for people who need to make changes to Part C at other times throughout the year. For example, if you move out of your current plan’s service area or your plan leaves your area, you can switch to another Part C plan or return to Original Medicare at any time during the year. New coverage typically begins the first day of the month after you disenroll from a previous Medicare Advantage plan.

Another qualifying reason to use the Special Enrollment period is if you want to join a 5-star Medicare Advantage plan. You may switch from your current Part C plan and join a new plan at any time during the year if the new plan has an overall performance rating of 5 stars. Note: you may only use this Special Enrollment option once during the year.

Resources:

Switching from Medicare Advantage to Original Medicare https://www.medicareinteractive.org/get-answers/overview-of-medicare-health-coverage-options/changing-medicare-health-coverage/switching-from-a-medicare-advantage-plan-to-original-medicare

Medicare Advantage Disenrollment https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/when-can-i-join-a-health-or-drug-plan.html#collapse-3192

5-star enrollment period https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/five-star-enrollment/5-star-enrollment-period.html

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CDIS Blog

Understanding the ins and outs of Medicare Supplement insurance can be challenging. So, we decided to put together a list of the top ten most asked questions about Medigap coverage. If you need a quick refresher, or you’re simply looking for an answer, you may find it here. 

1: Do I have to buy Medicare Supplement insurance to keep my Original Medicare?

A: No. Medicare Supplement insurance is optional insurance designed to help pay for some of the out-of-pocket expenses associated with Medicare, like deductibles, coinsurance, and copays.

2: Can I Combine Medicare Supplement with a Medicare Advantage Plan?

A: Unfortunately, no. It would be nice to combine the extra benefits of an MA plan with the cost-saving benefits of Medigap. However, it is not allowed. In fact, it is against the law for private insurers to sell you a Medigap plan if they know you have Medicare Advantage.

3: If I have Part A, but choose to delay Part B, can I still purchase Medicare Supplement insurance?

A: No. You must have both Part A and Part B coverage (Original Medicare) to be eligible for Medigap.

4: Does Medigap cover both my spouse and me?

A: No. Medigap covers one individual at a time. If both you and your spouse wish to have Medicare Supplement coverage, you each need to have your own plan.

5: Can my Medigap policy be canceled if my health deteriorates?

A: No. Standardized Medigap policies are “guaranteed renewable”. That means that even if your health deteriorates, as long as your premiums are paid on time, you cannot be forced out of your policy.

6: Do any Medicare Supplement plans include prescription drug benefits?

A: No. In the past, some Medigap policies included drug coverage. However, policies sold after Jan 2006 do not.

7: When should I enroll in Medicare Supplement?

A: The best time to buy a Medigap policy is when you are first eligible, during your Open Enrollment period. This is a 6-month period of time that begins the month you turn 65 and enroll in Part B. If you wait until after your enrollment period, you may not be able to buy a policy, or it could end up costing you more.

8: Medigap policies are “standardized”. What does that mean?

A: All Medigap policies must follow federal laws. Standardized plans, named for letters of the alphabet, must offer the same basic benefits, regardless of who sells them. For example, a Plan “F” at one company must include the same basic benefits as a Plan “F” at another company.

9: How much does Medicare supplement insurance cost?

A: Cost varies significantly, and insurance companies often charge different premiums for the same exact policy. The key to getting a good rate is to compare the same policies at a few different companies. Premiums differ between plans, but some states offer the Medicare SELECT option as a way to save money—you agree to use doctors and hospitals in the network in exchange for a reduced premium.

10: What if I travel outside of the country. Does my Medicare Supplement insurance travel with me?

A: Plans C, D, F, G, M, and N include foreign travel emergency benefits. Medigap pays 80 percent of medically necessary emergency care outside the U.S. after you pay a $250 deductible. If you purchased Plan E, H, I, or J before June 1, 2010, you also have coverage.

 

 

References:

https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html

https://www.medicare.gov/supplement-other-insurance/when-can-i-buy-medigap/when-can-i-buy-medigap.html

https://www.medicare.gov/supplement-other-insurance/medigap/costs/medigap-plan-costs.html

https://www.medicare.gov/supplement-other-insurance/medigap-and-travel/medigap-and-travel.html

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