Medicare and Alzheimer’s Coverage
Medicare is a health insurance plan funded by the federal government and covers people who are usually over the age of 65. Beneficiaries must also be receiving Social Security retirement benefits. In some cases, people under the age of 65 may receive financial help from Medicare, such as those who have received disability benefits for 24 months or longer. Medicare, the original program, is divided into parts A and B. Part D was added later. Part A is known as “hospital insurance” and Part B is known as “supplemental insurance.
Medicare Part A provides coverage for inpatient hospital care as well as part of the medical items needed for a patient suffering from Alzheimer’s or dementia, and some of the doctors’ fees. It will cover up to 90 days in a hospital because a temporary “spell of illness”. If a longer stay is needed to recover, there is a “Lifetime Reserve” of an additional 60 days. These days can only be used one time. These temporary stays are considered acute care and also include skilled nursing home care, hospice care, and home health care.
Medicare Part B covers such services as:
- Home health care services
- Durable medical equipment
- Diagnostic x-rays
- Outpatient hospital services
- Physicians’ services
- Blood
- Mental health services
- Laboratory tests
- Physical, speech and occupational therapy
Parts A and B have different insurance co-payments, deductibles and benefits, so be sure to contact the Centers for Medicare and Medicaid Services for details.
Medicare Part D is an additional part of the Medicare health insurance plan, provided only by private insurance companies, that covers specific drugs. When a person who is already enrolled in or is eligible for Medicare, and he or she is suffering from either dementia or Alzheimer’s, they qualify to enroll in Part D. There are some limitations on this program such as a limit on the quantity of a drug you can receive, or the restriction of paying for a more expensive drug only after a less expensive “step-up” drug has been tried first and has been determined by a doctor not to work.
In 16 of the states in America, including Florida, Medicare offers a policy covering training and teaching to families and caregivers of Alzheimer’s patients suffering from behavioral symptoms and Alzheimer’s disease it. These trainings are offered because Medicare understands the need for skilled nursing care to demonstrate to caregivers the proper ways to manage behavioral symptoms displayed by the Alzheimer or dementia sufferer.
According to the Alzheimer’s Association, in the year 2013, Special Needs Plans became available specifically for people who suffer from dementia, including those with Alzheimer’s disease. These Special Needs Plans are offered by Medicare Advantage and specialize in the coverage of care for its beneficiaries with dementia.
These SNP’s are only available in two specific areas including twenty-two counties in Minnesota and twenty-one counties in Florida. The Florida HMO plan is offered by Universal Health Care, while the Minnesota HMQ plan is offered by Medica Complete Solution – Dementia.
If you live in a Florida county covered by a Medicare SNP, be sure to check out Boca Home Health Care Services. BHCS is a care driven company dedicated to superb customer service.
*http://www.alz.org/care/alzheimers-dementia-medicare.asp#managed
