Information about Medicare.
Dana (C 4-5, 31 years posed, 51, KC)
Note: forwarded message attached.
Start your day with Yahoo! - make it your home page
--- Begin Message ---
www.medicarerights.org | e-newsletters ![]()
Volume 4, Issue 33: Week of August 15, 2005
Welcome to Dear Marci, a free, weekly newsletter designed to keep you in the loop about health care benefits, rights and options for older Americans and people with disabilities.
Dear Marci is a service of the Medicare Rights Center (MRC) (www.medicarerights.org), the nation's largest independent source of health care information for people with Medicare. A national nonprofit founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care.
For reprint rights, please contact [EMAIL PROTECTED]
Topic of the Month: Long-Term Care
Long-term care, commonly abbreviated as LTC, refers to a range of medical, personal and social services designed to meet the needs of people with disabilities, chronic illnesses or ongoing limitations in their ability to function independently. LTC may be delivered at home, in a nursing home, in an adult day care facility or other facility. While Medicare does not pay for most long-term care needs, in this month's issues we will examine the coverage Medicare does provide through the Home Health, Skilled Nursing Facility and Hospice benefits.
Marci's Mailbox
* * * * * * * * * * * *
Dear Marci,
I heard Medicare won’t pay for nursing home care, but my friend said Medicare covered her stay while she was recovering from a heart attack. I’m getting older and considering moving out of my home—will Medicare help pay for me to live in a nursing home?
–Sally (Gary, IN)
Dear Sally,No, Medicare does not cover long-term nursing home care. Medicare only covers limited stays in a nursing home—a skilled nursing facility—to help you recover from an injury or illness. Medicare may help pay for care in a skilled nursing facility if
* you need skilled nursing care seven days a week or skilled therapy services at least five days a week (skilled care refers to services provided by or under the supervision of trained medical personnel, such as professional nurses and therapists); and
* you have been hospitalized for at least three days in the 30 days prior to admission in a Medicare-certified skilled nursing facility.As long as it is medically necessary, Medicare will pay the full cost of the first 20 days and part of the cost of another 80 days of care (you pay $114 a day in 2005) in a Medicare-certified skilled nursing facility (SNF) each benefit period. A benefit period begins the day you enter the SNF and ends when you no longer receive SNF care for 60 days in a row.
If you need help with everyday tasks, you may want to consider home care, usually a less costly alternative to residential care. Research the cost of home and community-based services in your area online using the Eldercare Locator .
If you do need to make the move to residential care, another option is assisted living facilities, which are available for people who are looking for some personal services but don’t require the intensive skilled care that a nursing home would provide. These facilities typically cost less than nursing homes, although costs vary with the residence, room size and the types of services needed by the residents. Most facilities charge month-to-month rates, but a few require long-term arrangements. Visit the websites listed below for more information on assisted living facilities.
If you feel you need the level of care a nursing home can provide, explore what nursing home care costs in your area and how you would pay for it. Extended nursing home stays can easily cost in excess of $5,000 a month, but fees vary widely. If your income and assets are low, find out if you qualify for Medicaid, which covers long-term nursing home care.
If your income and assets are high, you could consider purchasing long-term care insurance. While this type of coverage may limit costs for some people, it is typically not recommended. LTC insurance is expensive and the older you are when you buy it, the higher the cost of the monthly premium. See links below for more information on long-term care insurance.
You can also pay for nursing home care yourself until you have spent down your assets enough to qualify for Medicaid.
Your doctor is a good person to approach about the level of care you should be looking for. Do a little research and then raise the subject during your next visit. Together you can outline what are the best options based on your needs.
Stay tuned next week to learn more about how the new Medicare prescription drug benefit will work for people in long-term care facilities!
–Marci
Have a question for Marci? Click here to e-mail your questions . Please include your city, county and state of residence.
Spotlight on Resources
* * * * * * * * * * * *
Read about long-term care and the financial considerations it poses in the guide, Talking with Your Parents about Medicare and Health Coverage , written by the Medicare Rights Center and published by AARP.
Research local options that are Medicare- or Medicaid-certified to provide skilled care using Medicare’s online nursing home comparison tool . You can search by name, area or proximity to your home.
Not sure what you’re looking for? MyZiva offers consumer-friendly guidance on nursing home facilities, certifications and regulations along with what to look for when visiting facilities. Once you’re ready to look, you can search its database of “every licensed nursing home in the United States.”
For a clear-cut description of the expenses involved in long-term care and advice for those considering long-term care insurance, read An Overview of Long-Term Care Insurance, published by the Pennsylvania Insurance Department. The guide includes helpful hints along with a glossary.
Visit the Assisted Living Federation of America web site for an overview of assisted living and a directory of facilities. You can search by state, residence or brand.
Call your State Health Insurance Assistance Program for more information on Medicare benefits, rights and options. Call Social Security (800-772-1213) for questions about enrolling in Medicare.
Health Tip of the Week
* * * * * * * * * * * *
Smart Travel: Part 1—Traveling with Medications
According to the Centers for Disease Control and Prevention, traveling can be a dangerous undertaking if not approached properly. If you are on medication and planning a trip, just a few extra steps can ensure a safe and enjoyable trip. So when dragging out the suitcase for your next journey—whether it be for a few days or many months—travel smart by following these suggestions:
* Bring your medication in its original containers with you in your carry-on when you travel.
* Because of strict laws concerning narcotics throughout the world, bring along copies of your prescriptions and, if possible, carry a letter from your doctor explaining your need for the drug.
* As an extra precaution, carry the generic names of your medications with you because pharmaceutical companies overseas may use different names from those used in the United States.Log online to Lonely Planet to read about another smart thing to have on hand while you’re traveling: a medical kit. With these essentials, you can brave the wild—or the Big Apple!
If you are traveling overseas, you may need immunizations. Log online to the World Health Organization to search by country and determine which vaccinations you’ll be required to get. Then visit the Centers for Disease Control and Prevention to search by state to locate a clinic near you.
For more tips on travel abroad, visit the State Department’s Bureau of Consular Affairs.
Survey Says
* * * * * * * * * * * *
According to the guide published by the Medicare Rights Center, Talking with Your Parents about Medicare and Health Coverage , women are more likely than men to use long-term care services. In fact, nearly three out of four nursing home residents age 65 and older are women.
Lend Marci a Hand – Volunteer!
We need you! There are 2.7 million New Yorkers with Medicare and only one Marci. Join MRC’s hotline team at its offices in Times Square, NYC, to help others navigate the health care maze. Hotline counselors answer questions about eligibility, enrollment, coverage and other related topics. For more information, contact Volunteer Director Betty Duggan at [EMAIL PROTECTED].
Spread the Word About MARCI
Tell your friends to sign up to receive Dear Marci and other Medicare policy and news updates by visiting www.medicarerights.org/subscribeframeset.html today!
Privacy Policy: MRC will never share your e-mail address with a third party.
Contents are © 2005 by Medicare Rights Center, 1460 Broadway, New York, NY 10036. For reprint rights, please contact [EMAIL PROTECTED].
To remove yourself from this mailing, please click here.
To modify your profile, please click here.
--- End Message ---
