Healthcare

Helping Veterans age well after military service

Published in Military Times by Sherman Gillums Jr. and Andrew Greene

When you think of hearing aids, canes, knee pain, memory issues, and heart problems, you might envision a grandparent or elderly person. But these indicators of aging may also describe a military veteran in their late 30s or early 40s who served on numerous deployments, worked on a flight line, or parachuted from aircraft for a living.

While new military inductees are typically some of the healthiest people in our society, many find themselves anything but healthy by the time they end their careers. In fact, many find themselves coping with an accelerated aging process that combines natural aging with the service-related wear and tear on their bodies and minds.

There has always been a national interest in ensuring that veterans receive retirement benefits for serving their country. What hasn’t been emphasized are the specific challenges veterans face as they age. A 2019 study, published in the International Journal of Environmental Research and Public Health, found that Persian Gulf War veterans suffered chronic conditions — such as high blood pressure, heart attacks, diabetes, stroke, and arthritis — about 10 years sooner than non-veterans the same age. This results in lower quality of life, higher mortality rates, and shorter life expectancies, especially for women veterans.

Compared to the overall population, veterans are more likely to be male, older, retired, widowed, educated, and living in the South, according to a report prepared by the LTSS Center in Boston. They also are more likely to report fair or poor health, limitations with activities of daily living, obesity, depression, and chronic conditions. This is despite the fact that there are not stark differences in financial wealth, and veterans pay less out-of-pocket for health care than civilians.

This raises the question: What is the best way to serve aging veterans who report a higher number of health and daily living issues during a greater portion of their lives than civilians?

To answer this, American Veterans (AMVETS) and the National Council on Aging (NCOA) are partnering to understand the specific needs of the nation’s 12.4 million veterans aged 65-plus and ensure that those who served have as fair a shot at aging well as those they defended. The partnership builds on two successful efforts: AMVETS’s HEAL Program and NCOA’s Aging Mastery Program® (AMP).
HEAL — which stands for healthcare, evaluation, advocacy, and legislation — encompasses all necessary steps to intervene directly on behalf of veterans, service members, families, and caregivers to reduce veteran unemployment, homelessness, and hopelessness, particularly for those who are at the highest risk of suicide.

The suicide rate among middle-aged and older veterans remains high, with approximately 65 percent of all veterans who died by suicide being aged 50-plus. Currently, the program has assisted over 600 veterans and families in crisis, with zero suicides following intervention, primarily by coordinating access to care and assisting with VA benefits. AMP helps older adults build their own playbook for aging well. Nearly 25,000 people have taken part either through classes in their community or by using the at-home Aging Mastery Starter Kit. Participants in AMP classes have achieved meaningful, measurable, and enduring changes in their health, finances, life enrichment, and advance care planning. The classes also serve as a gateway to encourage and lead older adults to participate in other community offerings.

An understanding of the aging process — both as a matter of acceleration among younger veterans and ways to make aging more of a comfort than a hardship — is essential to promoting good quality of life for those who served. The AMVETS and NCOA partnership will promote timely access to care and benefits for veterans with unique needs, along with customizable programs that support positive aging.
In addition to active support with obtaining VA benefits, veterans will have access to educational materials through Aging Mastery Starter Kits if they don’t live near an in-person class, are physically or socially isolated, or are caregivers. And with accredited representation and support from AMVETS, AMP will add a session on helping veterans coordinate their veterans benefits with Medicare.
From the time we’re born, we are educated and trained for the next phase of life. There is elementary school, high school, college, and military training. But there is no boot camp for aging. Veterans’ needs are unique, and the AMVETS-NCOA partnership provides a model for helping them age well.

Sherman Gillums Jr., chief advocacy officer, AMVETS, and Andrew Greene, managing director, Aging Mastery Program, National Council on Aging.

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Asset Expert Explains What Long-Term Insurance Covers

Published in SmartAsset by Ashley Chorpenning

While Medicare and Medicaid both help aging adults afford some of their medical expenses, they may not cover the cost of an extended illness or disability. That’s where long-term care insurance comes into play. Long-term care insurance helps policyholders pay for their long-term care needs such as nursing home care. We’ll explain what long-term care insurance covers and whether or not such coverage is something you or your loved ones should consider.

Long-Term Care Insurance Explained
Long-term care insurance helps individuals pay for a variety of services. Most of these services do not include medical care. Coverage may include the cost of staying in a nursing home or assisted living facility, adult day care or in-home care. This includes nursing care, physical, occupational or speech therapy and help with day to day activities.

A long-term care insurance policy pays for the cost of care due to a chronic illness, a disability, or injury. It also provides an individual with the assistance they may require as a result of the general effects of aging. Primarily, though, long-term care insurance is designed to help pay for the costs of custodial and personal care, versus strictly medical care.

When You Should Consider Long-Term Care Insurance
During the financial planning process, it’s important to consider long-term care costs. This is important if you are close to retirement age. Unfortunately, if you wait too long to purchase coverage, it may be too late. Many applicants may not qualify if they already have a chronic illness or disability.

According to the U.S. Department of Health and Human Services, an adult turning 65 has a 70% chance of needing some form of long-term care. While only one-third of retirees may never need long-term care coverage, 20% may need it for five years or longer. With a private nursing home room averaging about $7,698 per month, long-term care could end up being a huge financial burden for you and your family.
Most health insurance policies won’t cover long-term care costs. Additionally, if you’re counting on Medicare to assist you with these extra expenses, you may be out of luck. Medicare doesn’t cover long-term care or custodial care. Most nursing homes classify under the custodial care category. This classification of care includes the supervision of your daily tasks.

So, if you don’t have long-term care insurance, you’re on the hook for these expenses.
However, it’s possible to get help through Medicaid for low income families. But keep in mind, you may only receive coverage after you deplete your life savings. Just know that Medicare may cover short-term nursing care or hospice care, but little of the long-term care in between.

What Does Long Term Care Insurance Cover
So what does long term care insurance cover, Well, since the majority of long-term care policies are comprehensive policies, they may cover at-home care, adult day care, assisted living facilities (resident care or alternative care), and nursing home care. At home, long-term care may cover the cost of professional nursing care, occupational therapy, or rehabilitation. This may also include assistance with daily tasks, including bathing or brushing teeth.

Additionally, long-term care coverage can cover short-term hospice care for individuals who are terminally ill. The objective of hospice care is to help with pain management and provide emotional and physical support for all parties involved. Most policies allow beneficiaries to obtain care at a hospice facility, nursing home, or in the comfort of their own home. However, most hospice care is not considered long-term care and may receive coverage through Medicare.

Also, long-term care insurance can help cover the costs of respite care or temporary care. These policy extensions provide time off to those who care for an individual on a regular basis. Usually, respite care provides compensation to caregivers for 14 to 21 days a year. This care can take place at a nursing home, adult daytime care facility, or at home

What Long-Term Care Doesn’t Cover
If you have a pre-existing medical condition, you may not be eligible for long-term care during the exclusion period. The exclusion period can last for several months after your initial purchase of the policy. Also, if a family member provides in-home care, your policy may not pay them for their services.
Keep in mind, long-term care coverage won’t cover medical care costs. Many of your medical costs will fall under your coverage plan if you’re eligible for Medicare.

Long-Term Care Insurance Costs
Some of the following factors may affect the cost of your long-term care policy:

1. The age of the policyholder.
2. The maximum amount the policy will pay per year.
3. The maximum number of days the policy will pay.
4. The lifetime maximum amount that the policy will pay
5. Any additional options or benefits you choose.

If you’re in poor health or you’re currently receiving long-term care, you may not qualify for a plan. However, it’s possible to qualify for a limited amount of coverage with a higher premium rate. Some group policies don’t even require underwriting.
According to the American Association for Long-Term Care Insurance (AALTCI), a couple in their mid-50s can purchase a new long-term care policy for around $3,000 a year. The combined benefit of this plan would be roughly $770,000. Keep in mind, some policies limit your payout period. These payout limitations may be two to five years, while other policies may offer a lifetime benefit. This is an important consideration when finding the right policy.

Bottom Line
While it’s highly likely that you may need some form of long-term care, it’s wise to consider how you will pay for this additional cost as you age. While a long-term care policy is a viable option, there are alternatives you can consider.

One viable choice would be to boost your retirement savings to help compensate for long-term care costs. Ultimately, it comes down to what level of risk you’re comfortable with and how well a long-term care policy fits into your bigger financial picture.

Retirement Tips
If you’re unsure what long-term care might mean to your retirement plans, consider consulting a financial advisor. Finding the right financial advisor that fits your needs doesn’t have to be hard. SmartAsset’s free tool matches you with financial advisors in your area in 5 minutes. If you’re ready to be matched with local advisors that will help you achieve your financial goals, get started now.

The looming costs of long-term care may have you thinking about how much money you’ll need for retirement. If you aren’t sure how much your 401(k) or Social Security will factor into the equation, SmartAsset’s retirement guide can help you sort out the details.

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Ask an Attorney: Understanding Medicare’s hospice benefit in cases of terminal illness

Published in The Middletown Press By Robert Scalise
Caring for a loved one during the final stages of life is difficult both physically and emotionally. Thankfully, Medicare can help ease the burden.

Medicare’s hospice benefit covers any care that is reasonable and necessary for easing the course of a terminal illness. It is one of Medicare’s most comprehensive benefits, and can be extremely helpful to both a terminally ill individual and his or her family, but it is little understood and underutilized. Understanding what is offered ahead of time may help Medicare beneficiaries and their families make the difficult decision to choose hospice if the time comes.

The focus of hospice is palliative care, which helps people who are terminally ill and their families maintain their quality of life. Palliative care addresses physical, intellectual, emotional, social and spiritual needs while supporting the terminally ill individual’s independence, access to information, and ability to make choices about health care.

To qualify for Medicare’s hospice benefit, a beneficiary must be entitled to Medicare Part A, and a doctor must certify that the beneficiary has a life expectancy of six months or less. If the beneficiary lives longer than six months, the doctor can continue to certify the patient for hospice care indefinitely.

The beneficiary must agree to give up any treatment to cure his or her illness and elect to receive only palliative care. This can seem overwhelming, but beneficiaries can also change their minds at any time. It’s possible to revoke the benefit and reelect it later, and to do so as often as needed.

Medicare will cover any care that is reasonable and necessary for easing the course of a terminal illness. Hospice nurses and doctors are on call 24 hours a day, seven days a week to give beneficiaries support and care when needed. Services are usually provided in the home. The Medicare hospice benefit offers:
• Physician and nurse practitioner services
• Nursing care
• Medical appliances and supplies
• Drugs for symptom management and pain relief
• Short-term inpatient and respite care
• Homemaker and home health aide services
• Counseling
• Social work services
• Spiritual care
• Volunteer participation
• Bereavement services

Services are considered appropriate if they are aimed at improving the beneficiary’s life and making him or her more comfortable.
Because the beneficiary is electing palliative care over treatment, there are things the hospice benefit will not cover:
• Treatment to cure the beneficiary’s illness
• Prescription drugs, other than those for symptom control or pain relief
• Care from a provider that wasn’t arranged by the hospice team, although the beneficiary can choose to have his or her regular doctor serve as the attending medical professional
• Room and board. If the beneficiary is in a nursing home, hospice will not pay for room and board costs. However, if the hospice team determines that the beneficiary needs short-term in-patient care or respite care services, Medicare will cover a stay in a facility.
• Care from a hospital, either inpatient or outpatient, or ambulance transportation, unless arranged by the hospice team. The beneficiary can use regular Medicare to pay for any treatment not related to the beneficiary’s terminal illness.

Medicare now has a hospice compare site that allows patients or their families to evaluate hospice providers according to several criteria. Visit the site at medicare.gov/hospicecompare.

To download Medicare’s booklet on the hospice benefit, go to medicare.gov.
Robert A. Scalise Jr. is a partner of Ericson, Scalise & Mangan, PC in New Britain. For information, visit esmlaw.com.

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VA launches mobile app to streamline veterans’ access to health records, resources

Published in Becker’s Healthcare by Jackie Drees
Department of Veterans Affairs released a new mobile application that aims to simplify veterans’ and caregivers’ access to healthcare information by storing it on a single platform.
Four things to know:
1. The new app, called Launchpad, organizes more than 20 VA health apps into five categories: health management, healthcare team communication, vital health information sharing, mental health improvement and quality of life improvement.
2. Users will be able to view and share their VA EHR data, schedule VA appointments and refill prescriptions, among other functions, on the app.
3. The app also includes free mental healthcare tools for individuals who are not enrolled in VA healthcare services.
4. Launchpad is available for download on Apple and Google devices.

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National Nurses Week Spotlights Most Trusted Profession

Published in nurse.com by Eileen Williamson, MSN, RN

You are celebrated during National Nurses Week for the many contributions you make to the nursing profession and the healthcare of our nation. The word “excellence,” in fact, is one we hear more than any other during Nurses Week.

Hospital executives and administrators, board members, physicians and various healthcare professionals join in the celebrations because they know that without you, their patients would not receive the same level of care.

At each event, you are recognized and applauded for your numerous achievements and accomplishments by your fellow nurses and other healthcare professionals who work closely with you and understand firsthand the excellence you bring to all you do.

Newspapers and TV stations run stories on outstanding nurses and nurse heroes who have gone above and beyond in their patient care.

Grateful patients and family members post their gratitude on social media. Even Hallmark sells nurse-themed greeting cards. My memories and recollections of Nurses Week I can’t recall a May during my four decades of nursing that didn’t include a National Nurses Week celebration. Over the years, the week became an important one for nurses across America, and each of them celebrated in some way, for the same types of reasons, at the same time.

I recall the planning that went on in anticipation and the special camaraderie and professional collaboration we all felt because we were working together. There were special gifts and meals, and each event was important. Everyone got involved and took on some type of assignment to make each event meaningful and memorable.

I remember how much it meant to all of us, and how each one of the days of our celebrations had programs to recognize different things. Who was in charge on what day was an important detail.

Celebrations took place on different shifts, and members of hospital administration came in at different times around the clock to visit patient care units and meet, greet and thank the nurses on duty. There were programs at which awards were given for research projects, poster presentations, advances in safety, recognition of special accomplishments in patient care and leadership, and more. Nurses were honored for leading special initiatives, spearheading change and heading up important projects.

I remember, too, that each year the art and science of nursing was recognized in some way. Since the time of our founder — Florence Nightingale — the art and science of nursing have been defined in different ways, and I think many of us have our own definitions.

To me, the art of nursing is the unique and individual piece of self each of us brings to our practice. The knowledge, theory, skill and experience we share with our patients is the science. Celebrations have changed over time, but the recognition of nurses’ scientific achievements and creative accomplishments have remained.

The two always worked beautifully together and were celebrated — together and beautifully as part of each Nurses Week.

Let’s revel in the meaning of Nurses Week together This week there will be many excellence programs and award ceremonies in healthcare facilities across the country, and each one will reinforce that our nursing careers are gifts for us to hold on to, treasure and nurture.
As you reflect on the meaning of this special week, we hope you will read our special National Nurses Week issue as a keepsake.

Read it, share it, refer back to it and take in all it has to offer.

Nurses, always remember to:
• Stay involved, current and abreast of professional research and advancements.
• Participate in your nursing organizations, conferences, conventions and seminars.
• Advance your education and professional certifications.
• Continue to work and learn together.

In the celebration of each Nurses Week over the course of my career, I’ve seen nurses move from rendering care to planning and designing it. In so doing that, nurses have changed the face of our profession and of healthcare. I’ve seen the public come to know us better as they met us in almost every healthcare encounter they had. It’s not just in the emergency room, operating room, delivery room or patient room, but also in physicians’ offices, ambulatory care, urgent care centers, board rooms, courtrooms and more.

I saw that in the end, the people have come to see us as the most trusted and ethical profession of all. And that gives all of us something really big to celebrate this week.

Happy National Nurses Week!

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New Year is a good time for Veterans to review benefits

The New Year is a time for resolutions and fresh starts. For veterans it’s also a good time to review their benefits with a professional to ensure they are receiving the benefits they have earned through their service and sacrifice.

“All veterans should occasionally check with a Veterans Service Officer to see if changes in a veteran’s circumstances or changes to benefit policies may have modified the programs a veteran may be eligible to receive,” said Brian Natali, chief, Division of Veterans Services and Programs with the Pennsylvania Department of Military and Veterans Affairs (DMVA). “Veterans should take these important steps to secure their benefits, and there are numerous accredited Veterans Service Officers and organizations eager to help.”

Natali said safeguarding military paperwork, especially the DD-214, which is used to verify military service, is an important first step.

The easiest way to manage military documents is to make sure they are filed in a safe place immediately upon leaving the military. Veterans often find that filing their documents for free at their county courthouse of record is an easy way to secure them until needed, which can often be decades into the future.

Another key step, says Natali, is for veterans to apply for federal health care and state benefits by visiting their local county director of veterans affairs or area accredited service organizations to take a look at what benefits they may be eligible for and to get help applying for those benefits.

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How to Plan, Prepare, and Realistically Pay for Long-Term Care

Published in caringfromafar.com

When you plan for your future, do you include any plans for long-term care? It’s an aspect of life that too many adults fail to properly plan for, and that can leave seniors and family members struggling to find a solution. So, if you really want to prepare beforehand, you need to make some smart plans to cope with and pay for long-term care.

Focus on Your Long-Term Care Strategy First

Use Medicare to Your Advantage

Before you begin setting aside funds for long-term care, it’s important to have a good idea of what that situation may look like for you or a loved one. For many older adults, this means taking a look at how Medicare will offset any long-term care needs. While Medicare and Medicaid offer little long-term care assistance, the former can offer peace of mind through Medicare Advantage plans. These supplemental plans cover more of your future care, but it’s important to know the enrollment dates so you don’t miss out on this opportunity.

Know What Factors Put You at Risk

Another smart way to plan for long-term care is to examine your family history and lifestyle choices. For example, seniors with Alzheimer’s are likely to need progressive long-term care, and this is a condition which tends to be passed on from one generation to the next. But knowing you have a risk of developing dementia or Alzheimer’s also allows you to make changes in your life to potentially halt the impact of these illnesses. You can exercise more, change your diet, and even use puzzles and games to help decrease your need for long-term care in the near future. Cognitive decline is a major risk factor for long-term care, but serious falls can be a culprit as well. Also, dedicate some time to making your home a safe spot to age in place.

Put Together Your Plan to Pay for Care

Photo by Pixabay

Assess Your Insurance Coverage Options

You know that Medicare Advantage plans can help seniors stay better prepared for the future, but do you know how Medicare or health insurance covers long-term care costs? This may be a shock, but Medicare and Medicaid offer minimal long-term care coverage. In fact, the only aspects most health insurance plans will pay for are actions directly related to your health. So, the more routine care that most long-term care seniors need likely won’t be included in your average healthcare coverage. For many seniors, this is where options like long-term care insurance come in handy. If you plan ahead, this supplemental coverage is not as expensive and can offset some of the financial burdens. Understanding this kind of coverage can be a challenge, so make sure you carefully read through and research policies before you commit.

Research Other Viable Ways to Pay for Care

Medicare may not help, and long-term care insurance is not the perfect option for everyone. So, how can seniors find other ways to make sure they get the long-term help needed? Thankfully, there are some smart solutions to help give seniors and their families financial peace of mind. If you have served in the military, you may be eligible for more comprehensive VA coverage for your future care needs. It’s a benefit many veterans and loved ones forget, but this assistance is priceless for those struggling to find ways to afford long-term care. For adults who are not veterans, there may still be tools to help with costs. Financial assistance is available for seniors and family caregivers, but you can also reduce the expenses of care by carefully researching facilities and care providers. In essence, you can cut down your expenses by planning ahead.

Long-term care doesn’t have to be stressful, expensive, or, most importantly, an afterthought. It’s an essential step most adults will likely face at some point in the future. So, you should plan for long-term care just like you do any other important aspect of life and give yourself and your family some needed peace of mind in the process.

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Hospice month celebrates success of nation’s first coordinated care model

Published in The Hill by Edo Banach, Opinion Contributor

While there’s no shortage of partisan disagreements on Capitol Hill, one hopes the combative environment that’s become the norm in Washington might take a brief pause now that midterm elections are behind us. At a time when unity and common ground are sorely needed in our politics and our policymaking, one health care program stands out as a reminder of how bipartisanship works at its best: the Medicare Hospice Benefit.

This extraordinary policy achievement was made possible by lawmakers who put aside their differences in the interest of the Americans they served. Enacted as a demonstration in 1978 and a Medicare benefit in 1982, hospice programs have served millions of Americans and their families with compassionate care to relieve pain, manage symptoms, supported beneficiaries and their family caregivers, and provided bereavement services for individuals following the death of a loved one. The benefit has been invaluable to patients and lifesaving for families. And it never would have happened without lawmakers who were committed to the concept, and to working together.

Democrats, including Sens. John Glenn (Ohio) and Bill Bradley (N.J.), joined with Republican senators like Bob Dole (Kan.) and Chuck Grassley(Iowa) to pass what then-Rep. Leon Panetta (D-Calif.) called a “political miracle.” Sen. John Heinz (R-Pa.) personally collected commitments from 68 senators to pass the Heinz-Dole-Packwood amendment to provide hospice services to terminally ill Medicare patients.

Not only did this bipartisan act show how a diverse group of legislators could come together for the good of the country but the hospice benefit itself has become an example of how our fragmented health care system can – and should – work together for the betterment of patients. As America’s original coordinated care model, hospice brings together a multidisciplinary team of providers to meet all aspects of a dying patient’s physical, spiritual and emotional needs. No other health care sector is required to address all aspects of a patient’s, and their family’s, health and wellbeing.

Those elected to serve in the upcoming Congress should know that hospice is a program that works and a Medicare benefit that matters to their constituents. As seasoned and novice legislators alike consider health policy reforms, they should look to the success of the hospice model as an example of preserving what works, and help expand access to comprehensive, coordinated care and person- and family- centered care to all patients with serious, advanced and life-limiting illness. We should also reinforce the foundation of hospice to ensure access, choice and quality care at the end of life.

Hospice is not only best for patients at the end of life, it is also good for the Medicare program. Study after study show hospice care improves quality of life, delivers on patient and family satisfaction and reduces unnecessary costs for Medicare beneficiaries at the end of life. Thirty-plus years later, hospice is a reminder that there are policy solutions that work for both sides of the aisle and across our nation for all Americans. The fruits of cooperation live on today in a Medicare benefit that serves 1.43 million Americans annually.

It’s sometimes unclear if the dust will ever settle in Washington, and if we’ll ever get back to a place of collegiality and bipartisanship in Congress. If our nation’s remarkable hospice benefit is any indication, great things can certainly happen if it does.

Edo Banach is President and CEO of the National Hospice and Palliative Care Organization (NHPCO).

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Financial planning and Medicare

By Steven Merrell, Financial Planning: Let’s talk Medicare

If you are one of the 44 million Americans currently covered by Medicare, you probably know that Medicare’s annual open enrollment period just started. Between now and Dec. 7, you have the opportunity to make adjustments to your Medicare coverage.

Paying for health care is one of the biggest financial challenges many people face in retirement. If you are 65 or older, Medicare is probably an important part of your financial picture. However, if you are new to Medicare, you may be surprised by Medicare’s complexity and the gaps in your coverage.

You can choose between two general directions for your Medicare coverage: Original Medicare and Medicare Advantage plans. Original Medicare, in turn, is divided into two parts. Part A covers inpatient hospital care, skilled nursing facilities (when medically necessary), hospice care and home health care. Part B covers doctor visits and outpatient care and other medically necessary services like ambulance services, clinical research and durable medical equipment. Optional Part D covers prescription drugs and is purchased from private insurance companies.

Original Medicare does not cover everything. For example, while Part A covers hospitalization and skilled nursing facilities, it only covers acute care. If you need long-term care, also known as custodial care, Medicare will not cover it. Medicare also excludes most dental care, eye exams for prescription glasses, dentures, hearing aids and exams for fitting them, acupuncture and routine foot care. If you want to find out if your particular need is covered by Original Medicare, you can search for your item or service on the Medicare coverage website: www.medicare.gov/coverage.

Most people do not pay a premium for Part A, but they do pay a deductible of $1,340 for each benefit period and coinsurance for hospitalization. Part B premiums start at $134 per month but can be higher depending on your income. In addition, for Part B you will pay a deductible of $183 per year and coinsurance above that amount equal to 20 percent of the Medicare-approved charge for most doctor services, including the services provided by your doctors while you are in the hospital.

In a catastrophic scenario, there is no limit to the amount you can owe under Original Medicare. Consequently, many people purchase a supplemental policy, also known as Medigap insurance. Medigap insurance is issued by private companies, but the policies are standardized by law to comply with Medicare requirements. There are 10 standard Medigap policies available each with different coverage limits.

If you find this confusing, you are not alone. In fact, this confusion is why Medicare Advantage plans have become so popular in recent years. By law, Medicare Advantage plans are required to provide everything that is covered by Original Medicare. The only exception is hospice care, which continues to be provided by Original Medicare Part A.

Steven C. Merrell is an investment adviser and partner at Monterey Private Wealth Inc. in Monterey, CA. 

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5 advantages of early election of hospice benefits in assisted living and skilled nursing

Published in McKnight’s Senior Living by Rhea Go-Coloma, LMSW

For many, hospice care is associated with care received in the home. When provided early enough for residents in assisted living facilities and nursing homes, however, hospice care can provide important benefits for the resident and facility operator alike.

Hospice care, which is covered by Medicare and most private health insurance plans, eases pain and alleviates discomfort when a resident’s illness no longer is responding to treatment.

In fact, about one-third of assisted living residents receive end-of-life care at the community they have made their home. When residents become terminally ill, however, operators must provide care that may go beyond their capabilities.

When this happens, residents may be better served in a hospital or nursing home setting, but frequently it’s in the best interests of the resident to remain in the assisted living community. This is largely because residents have grown accustomed to the people and environment and feel the most at home.

When an assisted living community resident opts for hospice care, he or she also may be able to remain in the facility during the last months of life. This is best achieved when the assisted living community operator partners with an outside hospice provider. In this situation, it’s important for both organizations to work closely together to provide the best possible care for the resident.

Whether the hospice care is being provided in an assisted living community or nursing home, good communication between the family, staff, hospice staff and caregivers is important. Equally critical for success is early adoption of hospice care.

Early adoption of hospice makes all the difference

When adopted early, hospice care offers significant benefits for residents and families. Significantly, hospice healthcare specialists help residents and their families prioritize wishes and goals, creating a greater sense of ease and comfort.

Team-oriented hospice healthcare specialists work with the staff members of the assisted living community or nursing home to coordinate and plan care. Here’s a look at the five most important advantages of early election of hospice care for residents, families and facilities striving to meet the needs of these individuals:

Family support. Early involvement of an interdisciplinary team of hospice specialists helps families on many fronts: teaching family members how to care for the person who is ill, providing support and counseling to family and friends, offering education about the care process.

The hospice team also is there to help families clarify patient wishes, establish physician and patient relationships and balance family dynamics during this stressful time. Bottom line: hospice provides a way for residents to have a diverse group of committed professionals advocating for their needs.

Care goals. Hospice gives families the time they need to discuss goals of care, including an advance directive, a legal document that spells out end-of-life care ahead of time. The hospice team — including doctors, nurses, therapists, healthcare aides, clergy and social workers — addresses every aspect of a resident’s illness, with emphasis on controlling and reducing pain and discomfort. Team members provide symptom management and pain relief, increase quality of life and relieve patient suffering.

Family counseling. Guidance and support are a crucial feature of hospice, helping families deal with the range of emotions that surround this difficult time, offering guidance from social workers and chaplains. Hospice also offers bereavement and grief counseling after a loved one has passed, and it helps with some of the after-death tasks that need to be completed. Ultimately, choosing hospice care early makes end-of-life a calming and successful experience during a difficult time.

Dignity for the resident. Hospice offers the resident a chance to die with dignity. Hospice patients are not hooked up to loud machines, their vital signs are not constantly checked by medical personnel and they do not undergo invasive procedures to prolong life. It’s about respecting patient wishes.

By making arrangement to provide hospice care, operators of assisted living communities and nursing homes can make it possible for residents and families to focus on spending time with their loved one and not dealing with the red tape and medical procedures associated with hospital care.

 

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