Posts Tagged ‘Office on Aging’

Medicare Hospice Benefit

Monday, February 1st, 2016

Medicare Hospice Benefit

Hospice and other end of life issues are not things we often want to talk about. However, being prepared and knowing all your options is a good idea.

We should start by describing hospice. Hospice is a program of care and support for people who are terminally ill. The focus is usually on providing comfort instead of treatment. It is a choice a patient needs to make with their doctor and family. Hospice programs also offer assistance and services to family members during the process of caring for the patient.

If you have Medicare it will cover hospice services. The Medicare hospice benefit covers your care and you shouldn’t have to go outside of hospice to get care (except in very rare situations).

Once you choose hospice care, your hospice benefit should cover everything you need. All Medicare-covered services you get while in hospice care are covered under Original Medicare, even if you were previously in a Medicare Advantage Plan (like an HMO or PPO) or other Medicare health plan.

Medicare Part A (Hospital Insurance) covers Hospice care if you meet these conditions:

Your hospice doctor and your regular doctor certify that you’re terminally ill (with a life expectancy of 6 months or less).

You accept palliative care (for comfort) instead of care to cure your illness.

You sign a statement choosing hospice care instead of other Medicare-covered treatments for your terminal illness and related conditions.

Palliative care means that the medical team will focus on relieving the patient’s pain and any other symptoms, including mental stress. Only your hospice doctor and your regular doctor can certify that you’re terminally ill and have 6 months or less to live.

To start the process you meet with your doctor to discuss all options. Medicare covers a one-time only hospice consultation with a hospice medical director or doctor to discuss your care options and management of your pain and symptoms. This one-time consultation is available to you, even if you decide not to get hospice care.

Medicare will cover the hospice care you get for your terminal illness and related conditions, but the care you get must be from a Medicare-approved hospice program.

Hospice care is can be given in your home. Although depending on your needs and wishes, there are also inpatient programs available. That is one of the things you will discuss with the hospice program (and your loved ones). Together you will create a plan of care that can include any or all of these services:

Doctor services

Nursing care

Medical equipment (like wheelchairs or walkers)

Medical supplies (like bandages and catheters)

Prescription drugs

Hospice aide and homemaker services

Physical and occupational therapy

Speech-language pathology services

Social worker services

Dietary counseling

Grief and loss counseling for you and your family

Short-term inpatient care (for pain and symptom management)

Short-term respite care

Any other Medicare-covered services needed to manage your terminal illness and related conditions, as recommended by your hospice team

You can find out more information at medicare.gov or by calling them at 1-800-Medicare. Hospice specific information and resources are available at https://www.medicare.gov/coverage/hospice-and-respite-care.html

You can also talk to your physician about your options and care available in your area.

This information is meant to inform you of coverage available to you should you need it. Don’t be afraid to talk openly with your family about end of life decisions.

Medicare Coverage

Tuesday, January 12th, 2016

Medicare coverage

What does Medicare cover? It’s a common, but also complex question. Medicare has 2 basic parts, Part A, which is known as hospital insurance (we’ll define that in a minute) and Part B, which covers services, such as lab tests, doctor visits, etc. Part A and Part B together are known as Original Medicare.

Medicare recipients also have the choice to enroll in a Medicare Advantage plan (also known as Part C) which is delivered by an HMO. This coverage differs from Original Medicare not only in the delivery of benefits but also what is covered. There are many different plan options under Medicare Advantage and you can learn more at medicare.gov

When it comes to Original Medicare, coverage works like this:

Medicare Part A (Hospital Insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. To sum it up, Part A covers:

  • Hospital care
  • Skilled nursing facility care or Nursing home care (as long as custodial care isn’t the only care you need)*
  • Hospice (provided by a Medicare approved program, either at home or an inpatient setting)**
  • Home health services

**Keep a look out for a blog post on Medicare Coverage of Hospice Services coming soon.

*This is where some of the complexity of Medicare comes in. When a patient is sent to a nursing home/rehab facility for rehabilitation, Medicare covers your stay on a short term basis. Medicare does not pay for “long term care” or “custodial care”. If needed, Medicare will cover your rehab stay for 20 days at 100%, on day 21 (should you still need to be there) you will be responsible for a 20% copay. The maximum amount of rehab time Medicare will pay for is 100 days, so from day 21 to day 100 you would pay 20% of the cost. If you or a loved one are in a situation where you have to be in a rehab facility for more than 20 days, you should definitely be thinking about your options and what your plan for long term care is. At that point you should have already had a meeting with the discharge planner if not an interdisciplinary team at the facility.

Medicare Part B (Medical Insurance) covers certain doctors’ services, outpatient care, medical supplies, and preventive services. Part B covers 2 types of services:

  • Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
  • Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

Preventive services include screenings such as, mammograms, colonoscopies, bone mass measurements, and other cancer screenings, if your doctor thinks you are at risk. You also get a Welcome to Medicare visit within your first 12 months of enrollment, during this visit you can talk to your doctor about screenings and review your medical history. In addition to the Welcome to Medicare visit, you are entitled to an Annual Wellness visit. You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.

Part B covers things like:

  • Ambulance services
  • Durable medical equipment (DME)
  • Mental health
    • Inpatient
    • Outpatient
    • Partial hospitalization
  • Getting a second opinion before surgery
  • Limited outpatient prescription drugs

The fourth part of Medicare is Part D, which is prescription drug coverage. With Original Medicare prescriptions are not paid for, therefore you should obtain a separate Medicare Part D plan.

To learn more about all the parts of Medicare and to explore your options, such as, Original Medicare (Part A & B), Medicare Advantage (Part C) and Prescription Drug Coverage (Part D) visit https://www.medicare.gov/ or call 1-800-MEDICARE (1-800-633-4227).

You can also contact your local SHIP (State Health Insurance Assistance Program) through you County- find their contact information at: http://www.state.nj.us/humanservices/doas/home/sashipsite.html or call the SHIP Information Center at 1-800-792-8820.

 

medicare

NJFA Founding Trustee Given National Recognition

Thursday, October 1st, 2015

NJFA Founding Trustee Given National Recognition

Trenton— The New Jersey Foundation for Aging (NJFA) is pleased to announce that founding trustee, Carl West was recently recognized by the National Association of States United for Aging and Disabilities (NASUAD). In honor of the 50th Anniversary of the Older American‚Äôs Act, NASUAD honored more than 50 advocates who are dedicated to Aging and Disability Services. Carl West, who is a Founding Trustee and first Board Chair of NJFA, is also the former Executive Director of the Mercer County Office on Aging.

The honorees that were selected are featured in a publication from NASUAD titled, Celebrating 50 Years with 50+ Fabulous Older People, which is available online at http://www.nasuad.org/. Carl was recognized for his advocacy both in New Jersey and nationally. At the time of his retirement, Carl was the longest serving area agency on aging director in the country. In addition to being a founding member of NJFA, Carl has also been involved with and founding member of numerous other organizations. Locally, Carl was an integral part of the NJ Association of Area Agencies on Aging, serving as founding director, legislative chair and president. Nationally, Carl has been a long-standing board member of the National Caucus and Center on Black Aged, where he served as the Chairman of their National Board.

Even in his retirement, Carl continues to be involved, following important proceedings, such as the recent White House Conference on Aging. NJFA joins, NASUAD in saluting Carl for his dedication to the aging network, older adults and caregivers.

Carl West_picture

Social Security Facts

Thursday, August 20th, 2015

Social Security Facts

Recently, NJFA Deputy Director, Melissa Chalker sat down with two representatives from the Social Security Administration for a taping of our half hour TV program Aging Insights.

Given all of the extensive information they shared, we thought it was time to do a blog about Social Security benefits and what you need to know. Be sure to tune into the show in September, in the meantime, here are some facts.

Social Security is a family insurance program. It is meant to be additional income for those who are retired, disabled, widowed, etc. Eligibility for retirement benefits is based on your work history (the # of credits you earned while working and paying into the Social Security system) and your age. Depending on the year you were born, your retirement age could be anywhere between 65 and 67 years of age. You can receive your benefits starting at age 62, however it will be a reduced benefit because you are choosing to receive it early. Reduction amounts are calculated based on when your official retirement age should be.

All of this information and more is available at sss.gov or by calling 1-800-772-1213. You can start a my social security account online, look up information about Social Security and/or Medicare benefits and even apply for benefits online. A my social security account is available for anyone over 18 who is working, it helps you to track your Social Security record, estimate your benefit and much more. Social Security’s website is safe and secure, be sure to sign up for your account and create your own user name and password to protect your identity.

Many people don’t know that Social Security benefits are also for family members of a retired person. If a retired individual has minor children, disabled children and/or a spouse caring for a minor child, those family members may also be eligible for a monthly benefit. More information about those benefits are available by contacting Social Security or creating a my social security account to see what benefits you and your family could receive.

Information about benefits for spouses, survivors, disabled individuals and more is available at ssa.gov or by calling 1-800-772-1213 (Mon- Fri).

 

Announcing NJFA’s 17th Annual Conference!

Thursday, March 26th, 2015

Announcing NJFA’s 17th Annual Conference!

NJFA will hold its 17th Annual Conference on Wednesday, June 3rd at the Crowne Plaza Monroe. The 2015 Keynote Speakers are James Firman, CEO of NCOA and Nora Dowd Eisenhower, Assistant Director of the Consumer Finance Protection Bureau Office of Financial Protection for Older Americans. Jim Firman will address the crowd in the morning. Heis recognized leader and advocate in the field of aging. Mr. Firman will discuss a variety of topics including key aspects of the political and legislative landscape, such as the White House Conference on Aging and the Affordable Care Act. He will also talk about NCOA’s work on Elder Justice, Economic Security, Benefits Check-up, Senior Hunger and evidence based programs.

Ms. Dowd Eisenhower will be the luncheon keynote speaker and will discuss the mission and structure of the Consumer Finance Protection Bureau (CFPB) and the specific role of the Office for Older Americans. She will also talk about CFPB tools/guides on financial decisions such as reverse mortgages or choosing a financial advisor. This will include two programs from CFPB that look at preventing elder financial exploitation and guides created for powers of attorney, etc.

The 2015 conference workshop speakers will include policy makers, direct care & clinical practice specialists. Topics include Dental Health and Oral Cancer Screenings, Addiction and Gambling in Older Adults, New Models of Care, Elder Bullying and more.

More information and registration can be found on NJFA‚Äôs website at www.njfoundationforaging.org Limited vendor space and sponsorships remain, call us at 609-421-0206, email at [email protected].org or check out the website for details.

The New Jersey Foundation for Aging (NJFA) is a public charity with the primary goal to empower elders to live in the community with independence and dignity.slide_01