Hospitals can care for Medicare patients at home in pandemic

Hospitals will be allowed to care for Medicare patients in their own homes during the pandemic under a new program announced Wednesday to help hospitals deal with the latest surge.

Some hospitals already offered patients with private insurance the choice of getting care at home instead of in the hospital. The pandemic dramatically boosted use of such programs.

The Centers for Medicare and Medicaid Services said it will let hospitals quickly launch home programs, which will offer around-the-clock electronic monitoring for Medicare and Medicare Advantage patients who are sick enough to be hospitalized, but don’t need intensive care.

COVID-19 patients are eligible. Six health systems already offering “hospital-at-home” care were approved to participate in the Medicare program immediately.

“We’re at a new level of crisis response with COVID-19” and this option will help hospitals increase their capacity to help more patients, CMS Administrator Seema Verma said in a statement.

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Hospitals would need to meet certain standards to participate. Those include providing twice-daily visits by medical workers and equipment such as blood pressure and oxygen-level monitors, and keeping patients connected via an iPad or other device to a command center should they need help. Medicare would pay hospitals the same rate as for in-hospital care.

Earlier in the pandemic, CMS expanded coverage for telemedicine appointments and launched a program paying for care in field hospitals and hotels.

“This will help health systems create capacity to care for patients during the surge,” said Dr. Bruce Leff, a geriatrics professor at Johns Hopkins School of Medicine and a home hospital pioneer. 

He said hospital-at-home programs have proven benefits for patients and can prevent complications they might experience in a hospital. 

Leff helped CMS plan the program, along with experts at major hospitals already running such programs and three companies that contract with hospitals to run programs for them: Medically Home, Contessa Health and Dispatch Health.

Since the pandemic began, all three companies have reported a surge of new, privately insured patients choosing to stay at home, where they can be more comfortable and have family around. 

Medically Home Chief Executive Rami Karjian said he hopes elderly patients who might defer care during the pandemic “will now get the care they need.”


What do you think about receiving at-home care instead of checking in for care at a hospital? Are you for or against this program? Would you try it?

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Trump administration set to announce Medicare and Medicaid will cover Covid vaccine

Trump administration set to announce Medicare and Medicaid will cover Covid vaccine

Trump administration set to announce Medicare and Medicaid will cover Covid vaccine

The Trump administration is set to announce as early as this week that Medicare and Medicaid will cover out-of-pocket costs for a potential coronavirus vaccine that is granted emergency use authorization, according to a person familiar with the matter.

Coming days before the election, the move could help President Donald Trump among seniors and lower-income Americans even though top medical experts don’t expect a vaccine to be approved until well after Election Day. In the run-up to the election, Trump had applied intense pressure on agencies to deliver policy wins that might help his reelection, aides said.

Officials have been working for several weeks on changing regulations to allow for Medicare and Medicaid recipients to receive free vaccines.

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It’s not clear whether Trump himself will make the announcement of the rule change, though he is working to appeal seniors during stops in Florida later this week.

Politico first reported the coming changes.

There are currently four US Phase 3 trials of coronavirus vaccines as part of the federal government’s Covid-19 vaccine program, Operation Warp Speed.

Dr. Anthony Fauci, the nation’s top infectious disease expert, said Sunday that experts will know by early December whether a potential coronavirus vaccine is safe and effective, but widespread availability will likely not occur until several months into 2021.

Operation Warp Speed aims to have Covid-19 vaccines moved to administration sites within 24 hours of emergency use authorization or Food and Drug Administration license– with the goal of providing the vaccine free of charge.

“In terms of a principle and an aspiration, it’ll be that no American has to pay for a single dime out of pocket to get a vaccine,” Paul Mango, deputy chief of staff for policy at the US Department of Health Human Services, said back in September.

The federal government already struck a deal earlier this month with retail pharmacies CVS and Walgreens to help distribute the coronavirus vaccine– once one or more gets authorized– to long-term care facilities like nursing homes, with no out-of-pocket costs.

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See What Medicare Covers With Free App

Let’s say you go for your annual physical and your doctor recommends that you get a hearing and balance test. Or an electrocardiogram (EKG). Or a Hepatitis B screening.  Does your Original Medicare cover these services? Now there’s a quick way to find out, using your smartphone or tablet.  It’s Medicare’s new “What’s Covered” app and it’s free. You can use the app right there in the doctor’s office, hospital, or anywhere else you use your phone or tablet.

Continue reading “See What Medicare Covers With Free App” »

Am I Required to Sign Up for Medicare When I Turn 65?

While you are not required to enroll in Medicare at age 65 or at any other time, it is advisable in the vast majority of cases to sign up for Medicare when you are first eligible to do so.

For most people, Medicare eligibility begins at age 65, and the best time to enroll is during the Medicare Initial Enrollment Period.

If you are first eligible for Medicare, as most Americans are, at age 65, Enrollment Periods begin. Your primary plan can be Medicare or a Medicare Advantage Plan. These are the two most common paths to take once you are eligible for Medicare. are using Medicare  three months before the month you turn 65 and ends three months after the month you turn 65. If you enroll during the first three months of your Initial Enrollment Period, your coverage should begin the first day of the month in which you turn 65.

It is simple to enroll in Medicare. You can enroll in person at your local Social Security office, but you will almost certainly save a great deal of time if you apply online.

Three Good Reasons to Enroll in Medicare at 65

  1. Enrolling in Medicare will not reduce any other health benefits you are receiving. In fact, it will increase your overall coverage. If you are already enrolled in a private insurance plan, your private insurer will continue to provide the same coverage, and Medicare will become your second payer. This means that Medicare will help pay costs that your private insurer does not pay. If you do not want to pay any Medicare premiums, after enrollment in Medicare you can choose to keep only Medicare Part A (hospital) coverage. Medicare Part A is premium-free to people who over the course of their working years have paid the Medicare tax for at least 40 quarters, or 10 years. While dropping Part B may be the right move for some people, be sure to read on so that you understand the possible risk of dropping Part B.
  2. Penalties associated with late enrollment in Medicare can be substantial. These penalties can apply to both parts of Original Medicare, Medicare Part A and Medicare Part B (medical), and Medicare Part D prescription drug plans. If you opt out of Part B but decide to enroll later, you can expect to pay a penalty of 10 percent of your Part B premium for every 12-month period you could have had Part B coverage but did not. This is not a one-time penalty but one you are required to pay as long as you remain on Medicare. There are exceptions, but late enrollment in Medicare Part B can be very costly. The Part A penalty applies to late enrollees who are not eligible for premium-free Medicare Part A coverage, and the Part D penalty normally applies to late enrollees in Part D who did not maintain creditable drug coverage during the time they were eligible for Part D drug coverage but were not enrolled in a Part D prescription drug plan.
  3. To purchase a Medicare supplement (or Medigap) plan, you need to be enrolled in Medicare. Who wants to wait when it comes to saving money? During your one-time, six-month Medigap Open Enrollment Period, which begins the first day of the first month you are at least 65 and enrolled in Medicare Part B, you can enroll in any Medigap plan available in your area regardless of preexisting conditions or medical history—and once enrolled, you can remain in that plan as long as you want regardless of how your health may change. While Original Medicare certainly has its shortcomings, a Medicare supplement is designed to fill the gaps in Medicare and provide the coverage you need at an affordable cost—and you need to be enrolled in Medicare in order to purchase a Medicare supplement plan.
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Are there any good reasons not to enroll in Medicare at age 65?

There certainly aren’t many. But consider:

If you have COBRA coverage, it is likely to end if you enroll in Medicare. Check with your plan’s administrator to see whether this is the case if you have COBRA coverage and are nearing age 65. If your COBRA coverage will end when you enroll in Medicare, you need to compare the benefits of keeping your COBRA coverage as long as it remains available to the benefits of switching to Medicare. Remember, though, your COBRA coverage is only for a limited period, while Medicare is likely to be your insurer for many years.

If you are contributing to a Health Savings Account (HSA), you cannot add any further contributions to your account if you are enrolled in Medicare. You can take money out, however, usually tax-free, to help cover out-of-pocket Medicare costs, including premiums. But most people with HSAs prefer to build up their accounts rather than drain them. Even with the high deductibles often associated with Health Savings Accounts, some people prefer to opt out of Medicare in order to continue contributing to their HSAs. It is certainly best to seek professional advice before making such a choice.

Do I need to enroll in Medicare if I’m getting Veterans Affairs health benefits?

While Veterans Affairs (VA) benefits are very good, VA benefits combined with Medicare coverage can be even better.

One of the disappointments some veterans express concerning their VA benefits has to do with long waiting periods for many VA healthcare services. If waiting periods are a concern of yours, enrollment in Medicare can greatly reduce your waiting time for treatment and services.

As when combined with private insurance, Medicare will not reduce VA benefits in any way. It simply allows for greater flexibility and fuller coverage. For example, Medicare allows you to expand your options to facilities outside the VA network. Medicare can also offer additional protection in the event of VA benefit reductions, which can take place from one year to the next.

If you do not want to pay Medicare premiums, you can opt out of Medicare Part B. If you are a VA beneficiary enrolled in Medicare Part A but not Part B, you will need to use VA facilities for all but your Part A-covered services. In other words, you will still have to use only Dept. of Veterans Affairs facilities for any outpatient medical services you need. You will be able to receive Medicare Part A-covered services from providers accepting Medicare or at VA facilities. If you choose to receive Part A-covered services outside VA facilities, you will be responsible for paying Medicare Part A deductible and copay costs—unless you have a Medicare supplement plan that takes care of those.

Medicare fully satisfies all requirements of the Affordable Care Act (aka Obamacare) and lays the groundwork for the vast majority of Americans 65 and over when it comes to healthcare. A fast-growing number of people are playing it safe by investing in Medigap and Medicare prescription drug plans, but remember, for tens of millions of older Americans, a secure healthcare foundation begins with voluntary enrollment in Medicare—and in the vast majority of cases, the sooner you enroll, the better. Contact MedicareMall to learn more about the benefits of prompt enrollment in Medicare and ways to maximize both coverage and savings.

Do you think 65 is the ideal age for Medicare enrollment? Please leave a comment!

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What You Need To Know About 2018 Medicare Part B Rates and IRMAA

If you have higher income, the law requires an adjustment to your monthly Medicare Part B (medical insurance) and Medicare prescription drug coverage premiums. Higher-income beneficiaries pay higher premiums for Part B and prescription drug coverage. This affects less than five percent of people with Medicare, so most people don’t pay a higher premium. Continue reading “What You Need To Know About 2018 Medicare Part B Rates and IRMAA” »

What You Need To Know About Medicare’s Annual Election Period and Open Enrollment Period

Most Medicare beneficiaries look forward to Medicare’s Annual Election Period and Open Enrollment Period. However, there are also some who might be new to Medicare and may need clarification on a few issues.  Continue reading “What You Need To Know About Medicare’s Annual Election Period and Open Enrollment Period” »

Why The Most Popular Medicare Supplement Is Plan F

While there are ten different Medicare Supplement (Medigap) plans to choose from, over 50% of seniors choose Plan F. Plan F has benefits that are not included in other plans. Continue reading “Why The Most Popular Medicare Supplement Is Plan F” »

The Most Expensive Prescription Drugs in America

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The amount Americans spend on prescription drugs has nearly doubled since the 1990s, a 2017 government investigation found, meaning the United States spends the most of any high-income nation. List prices rose 6% over the past 12 months alone, according to the prescription website GoodRx. Medicare drug prices soared 10 times the rate of inflation. Continue reading “The Most Expensive Prescription Drugs in America” »

Medigap or Medicare Advantage: Which Should You Choose?

Those who are eligible for Medicare but aren’t fully satisfied with Original Medicare (Part A and Part B) alone are faced at a crossroads. One way leads to Medicare Advantage. The other to Medicare Supplement Insurance. The hope is that whichever one you choose will end at a destination booming with comprehensive and affordable health care. Continue reading “Medigap or Medicare Advantage: Which Should You Choose?” »

2018 Medicare Changes You Need To Know

2018 has brought many new changes for Medicare patients. If you have a Medicare plan, you should be aware of these changes. Here are some of the biggest changes that you will see this year, including information and resources regarding new Medicare cards that will begin to be mailed out in April. Continue reading “2018 Medicare Changes You Need To Know” »