The Modern Medicare Agency Blog
If you are looking for the best way to take care of your elderly companions or family members at home, you should read this article right away. We will give you some advice on what to look for when it comes to getting medication for the elderly as soon as possible.
Are you interested to learn more? Go ahead and continue reading. You will not regret it.
As a person of a certain age, we need to learn how to protect ourselves from various diseases. This way, we will extend our lives and be with our families for much longer. Are you curious as to how you can do this at 60? Here are some tips as follows:
If you want to get a life insurance policy, you need to know that there are limits to it as much as there are advantages.
You'll have to look at some of the limits you will encounter when deciding to buy insurance. Read on and learn to handle them.
If you want to apply for annuity insurance, it is best to know every aspect of the policy itself. Along with the benefits come the challenges of getting annuity insurance as a whole.
The article talks about the challenges you might face when applying for an annuity. Here are tips on handling these challenges on your own.
Retirement could be one of the most remarkable experiences a person can have. Some retired individuals still want to earn income to protect their assets. Insurance companies offer to have annuities that give financial security to retirees that guarantee payment either for life or a specific period.
Prescription drugs are another area in health that costs a lot of money. Medicare Part D is an optional plan which covers most prescription drugs. Benefits from the Part D Plan are administered through private insurance agencies. People looking to get this type of plan must pay a small monthly premium, a deductible for every year, and coinsurance for each prescription provided.
Medicare Part C, also referred to as “Medicare Advantage,” is the alternative plan for Medical Care Parts A and B. Plans should have similar coverage as the original Medical Care Plans that can include other benefits like hearing ailment, dental, or vision. Another vital factor to consider is that getting this medical advantage Part C provides coverage for prescription drugs.
Medicare Supplement Insurance, also called “Medigap”, shoulders other medical expenses that are not present in a standard Medicare policy. Medigap covers what the original Medical Care Insurance has left off in its coverage. It simply means to fill in the gaps of other costs like copayments, coinsurance, and deductibles. Listed below are basic guidelines for getting Medical Supplement Insurance.
Different Medicare NoticesPaperwork isn't the most fun or exciting topic, and you receive a lot with your Medicare plan already. But some of that paperwork may be important notices and forms that relate to your coverage!
When you’re enrolled in Medicare, there’s a good chance you’ll be receiving plenty of paperwork in the mail. It may seem annoying, but it’s truly a good thing because it means you’re being kept in the loop with your Medicare coverage. Many of these will be notices about how you’re using your Medicare. For example, you may receive a Medicare Explanation of Benefits or Medicare Summary Notice depending on what type of Medicare you have. While these may be among the most common types you’ll encounter, there are others you should at least be aware of as well.
Notice of Denial for Payment or ServicesWhile Medicare plans cover a lot of the services and needs of beneficiaries, they don’t cover everything. If you’ve requested coverage for something that ultimately won’t be covered by your plan, the Centers for Medicare & Medicaid Services (CMS) requires your plan to send you a Notice of Denial of Medicare Coverage (or Payment). This is also sometimes called an Integrated Denial Notice (IDN). The notice must include your plan details (your name, plan number, and the date the notice was issued), along with what your request was and the reason(s) why it was denied. The coverage can be denied in full, partially approved, stopped if it was already being given, reduced, or suspended (for Medicaid services).
The IDN must also list your next steps on how to appeal the plan’s decision.
Reasons you may receive an IDN range from medical reasons to network ones. Your plan may determine that a specific service isn’t medically necessary or is with a doctor outside your plan’s network. For Medicare Part D plans, a prescription may not be on your formulary. Luckily, it doesn’t have to end there. The IDN must also list your next steps on how to appeal the plan’s decision.
Notice of Termination of ServicesIn some ways, a notice of termination of services is kind of like an IDN for specific specialized care. If you’re receiving coverage for the services of a skilled nursing facility, home health agency, or comprehensive outpatient rehabilitative facility, but it’s determined that you no longer require these services, you’ll likely receive two notices from your Medicare plan. These are the Notice of Medicare Non-Coverage (NOMNC) and the Detailed Explanation of Non-Coverage (DENC).
The notice must also include contact information for the provider, member numbers, and effective date of coverage termination.
The NOMNC is effectively advance notice that coverage will be terminated and must be delivered two days prior to the end of coverage. The notice must also include contact information for the provider, member numbers, and effective date of coverage termination. Much like the IDN, the NOMNC must also include an explanation of your right to appeal to the decision and how to file an immediate appeal. The DENC contains provider contact information, member identification, a comprehensive list of services being terminated, and a detailed reasoning why the decision was made.
Medicare Outpatient Observation Notice (MOON)One of the more confusing ways you can have unexpected out-of-pocket costs with Medicare is something called observation status. We’ve discussed this before, but essentially, observation status is when you’re in the hospital, but considered a hospital outpatient. There are a number of reasons this could be the case, but whatever the reason, your care will be covered by Medicare Part B instead of Part A. This means that you’ll have to meet the annual Part B deductible and pay 20 percent of any services you receive after that.
The purpose of the MOON is to inform the beneficiary that they are in observation status, why they are in observation status, and how this can influence their costs.
The Medicare Outpatient Observation Notice (MOON) was created in 2015 by the NOTICE Act and is sent to a beneficiary when they are in observation status. The purpose of the MOON is to inform the beneficiary that they are in observation status, why they are in observation status, and how this can influence their costs. Furthermore, this notice must be followed by a verbal explanation of the MOON, along with a signature from the beneficiary or someone on their behalf to acknowledge the receipt of the MOON. Once you know you’re in observation status, you may be able to request to be admitted into the hospital to have your care covered under Part A coverage.
Hospital Discharge NoticesA final notice we’ll be discussing, though by no means the last Medicare notice that exists, is the grouping of notices called hospital discharge notices. In essence, there are two notices worth mentioning here. First, is the Important Message from Medicare (IM), which a beneficiary receives upon entering into inpatient care at a hospital. This form simply informs you of your appeal rights for hospital discharges. In other words, it lets you know that, if you’re being discharged from the hospital and you don’t agree with it, you are able to appeal that decision.
A DND will explain why you are being discharged.
The second form is called a Detailed Notice of Discharge (DND). You’re less likely to see this one because it is only given out if you choose to appeal a discharge decision. A DND will explain why you are being discharged. This is an important step in appealing a discharge from the hospital, since your appeal will be reviewed by the local Beneficiary and Family Centered Care Quality Improvement Organization (QIO).
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Paperwork is rarely an exciting topic to discuss, but it’s very important to know about these forms if you’re someone who has Medicare coverage. Whether they’re keeping you from being discharged, letting you know a service won’t be covered so you can appeal, or telling you that you’re in observation status, these notices keep you informed about your coverage so you can be an active participant in ensuring you receive the best care and coverage possible.
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. If you have any questions regarding medical bills, denial of claims ect please feel free to reach out to my office we would be glad to help. 631-358-5793
The Health Benefits of Lemon Lemon is a great ingredient to use in your cooking, but can it also be healthy for you? Yes! Lemons are packed with antioxidants and nutrients that can be great for your health. We’ve discussed the value of using lemon in your cooking — how it can add brightness to a dish or balance out the fattiness. But the benefits of lemon to our health are deeper than just helping to make dinner taste nice. In fact, lemon is rich in vitamins and nutrients that can impact a number of important systems of your health. While there’s also evidence that lemon could help you control your weight, that won’t be the focus of this article. Losing weight isn’t usually the most crucial goal, as your overall health is more important. Besides, one minor change to your diet rarely makes a massive impact on your weight (sorry to disappoint you if you’re trying one of those miracle cure diets). What lemon can do, however, is become a component in an overall healthier diet that offers your body a wide range of health benefits and rich nutrients. Rich Source of Vitamin C Of all the beneficial components found in lemons, perhaps the most prevalent, and famous, is vitamin C. In fact, one lemon contains your daily recommended amount. You’ve likely seen Vitamin C content advertised on things like orange juice cartons or as a quick cold treatment, but how can it actually benefit your body? For example, Vitamin C rich fruits, such as lemons, can reduce your risk of heart disease. There’s a startling amount of evidence that Vitamin C is good for your heart. For example, Vitamin C rich fruits, such as lemons, can reduce your risk of heart disease. Lemons can also help prevent anemia — which can be caused by iron deficiency — as Vitamin C helps the body to absorb iron. Additionally, Vitamin C is thought to be linked to a reduced risk of stroke. Since some argue that there’s no correlation, more independent research is needed to verify this claim. Finally, while Vitamin C may not be as effective as advertised, it can help shorten the duration of a sickness and improve your immune system’s response time. Lots of Fiber in the Pulp Lemons are also a good source of dietary fiber, with one lemon accounting for around 20 percent of your daily suggested intake. Dietary fiber is associated with many different benefits to your health, which we’ve covered in great detail already. Among the big benefits of having a healthy amount of fiber in your diet are that it may reduce your risk of certain cancers, help you feel fuller after meals, and lower your risk of diabetes. Fiber has also been found to significantly reduce your risk of cardiovascular disease and improve the symptoms of a number of digestive disorders. So, it would be accurate to say that dietary fiber can be effective at improving your general heart and digestive health. In order to get the full benefits of the fiber in lemon, you’d need to consume the lemon itself, not just its juice. It’s also important to note that the majority of fiber comes from the actual pulp of the lemon, not just the juice, which only accounts for around one percent of the 20 percent of total daily fiber that a lemon provides. This means that, in order to get the full benefits of lemon fiber, you’d need to also eat the lemon fruit — whether that’s in baked goods or candied lemon slices. You can also get some extra fiber from the lemon peel. The easiest way to do this would be by zesting the peel to add a delicious lemon flavor to your favorite recipes. Gives an Antioxidant Boost One health benefit that often gets overshadowed is the abundance of antioxidants found in lemons. Of course, Vitamin C is an antioxidant, but there’s a type of antioxidants that lemons have in abundance — flavonoids. The most prominent of these flavonoids is the similarly named flavanones. Besides the usual prevention of oxidative stress that may help guard against cardiovascular disease and cancers, flavanones may have anti-inflammatory, antiviral, and antimicrobial properties that have a lot of potential health benefits as they become better understood. Both flavonoids prominently found in lemons can be used to make medicines due to their benefits. Two other flavonoids that are present in lemons are diosmin and hesperetin. Both can be used to make medicines due to their benefits. Diosmin may help with inflammation and blood vessel conditions like hemorrhoids. They’ve also been found to lower HDL cholesterol (the bad kind) in lab studies. Hesperetin similarly has been found to aid in lower cholesterol, but the benefits go beyond that. It may also help with wound healing and heart and cognitive health. While you shouldn’t expect these antioxidants to be curing hemorrhoids and eliminating all your bad cholesterol on their own in small quantities, as part of a healthy diet, they may be able to help. ● ● ● These are only a few of the ways that lemons can be beneficial to your health. We bet you didn’t know that there’s evidence that lemons can help prevent kidney stones, for example. While you may not want to have lemons with every meal — variety is the spice of life, after all — it’s certainly worth adding lemon to your diet. 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.
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