Do you have a stash of old or expired medications? Are you concerned about how to dispose of old medications? There are a lot of things you can do with old medications. However, there are also some things you shouldn’t do with unused medications. Let’s look at your options.

What to do With Old Medication?

If you are like most Americans, you probably have a medicine cabinet with medication inside. When is the last time you checked the expiration date for your medications? Everyone is probably guilty of holding on medication past its expiration date.

Many people are probably also guilty of holding onto medication they won’t use before it expires. Maybe you do this because the medicine cabinet is out of sight, and therefore also out of mind. Or maybe you do it because you don’t know what to do with your medications once you’re done with them.

Regardless of why you have old medication hanging out in your medicine cabinet, letting it sit there is not the solution. So, instead of letting it clutter your cabinet, there are some ways you can get rid of your old prescription medications, and even your expired over the counter medications.

Why Should I Dispose of Old Medications?

Disposing of old or unused medications is important for a few reasons. Old medications that are past their expiration date, should be disposed of properly. This is because medication, much like food, has an expiration date. In general, medication should not be used after its expiration date because it could be less effective.

Expired medication can even be harmful because of potential bacterial growth. According to the Food and Drug Administration, expiration dates for medications became a requirement in 1979. These dates play critical part in determining the safety and effectiveness of a medication.

Antibiotics and Expirations for Old Medications

Antibiotics are especially prone to becoming less effective after their expiration date. This can lead to an infection spreading instead of being treated. Moreover, it can also lead to antibiotic resistance. The potency of the an expired antibiotic is reduced. As a result, it allows the bacteria causing the infection to become resistant to the antibiotic.

Finally, when discussing antibiotics, the regime for antibiotics is a critical part in treating infection. Every infection is different, and may require different antibiotics. Relying on unused or expired meds to treat a presumed infection can be dangerous. Always talk to your doctor before starting an antibiotic, and never used expired antibiotics.  

Best Way to Dispose of Old Medicine

The best way to dispose of old medicine is to take it to a drug take-back location. Many hospitals, clinics, and pharmacies have a location where you can drop off old or unused medication. The location will then dispose of the medication properly for you.

The  Drug Enforcement Administration (DEA) hosts a national drug take-back day at least annually. The DEA sets up temporary drop boxes for drugs to be dropped off. The purpose of this national event is to provide a safe place for people to drop off medication. In addition, they DEA can also raise awareness about the abuse of medications.

Locale Take-Back Sites

While the DEA only dedicates one day to setting up temporary take-back sites, there are a lot of year round, or permanent, take-back sites in the United States.

If you are wondering where to take old prescription medications, you can easily find out if there is a permanent drug take-back location near you by using the DEA website. All you have to do is type in your zip code, or city and state. Then, select how far you’re willing to drive to drop off your medication.

The website will tell you every registered drug take-back location in the radius you selected. If you don’t have a drug take-back location, or if the nearest location is too far for you to drive, there are other options.

Local Law Enforcement Take-Back Days

Occasionally, local law enforcement agencies host take-back days. On these days, they set up a site for the local community to drop off their unused or expired medications. From there, the police department handles the disposal process. You can always call your local police department to find out if they will be hosting a take-back event in your community. In addition, you can always call and ask if they can take unused or expired medications.

How do I Dispose of Old Medications?

If you don’t have a local drug take-back location where you can safely drop off your medication, there are other options. First you need to identify what kind of medication you need to dispose of. There are some medications that require special disposal.

Some medications cannot be flushed or put down drains, this is because they might be harmful to the environment and there might be a better or easier way to dispose of it. It is a common myth that no medications can be flushed though. The FDA states there are some medications that should be flushed instead of thrown away.

MEDICATIONS THAT CAN BE FLUSHED

The FDA provides a list of medications that can be flushed down the toilet. It is important to remember that if the medication is NOT on this list, then it should not be flushed. There are other methods of disposals for medications not on the list. The medications on the flush list are medications that should be disposed of immediately.

Holding onto these medications poses a danger to anyone who was not prescribed the medication or is battling addiction. The FDA has determined the risk of keeping these medications in the house exceeds the potential environmental impact from flushing the medication.

The medications they list can cause death to animals and young children if they ingest even just one dose. Because of the serious risks associated with these medications when they are not taken as prescribed, they are better off flushed if they can’t ben taken to a drug take-back location immediately.  

MEDICATIONS THAT CANNOT BE FLUSHED

The FDA has stated that medications not on the flush list, should not be flushed. If you feel you have a medication that needs to be disposed of quickly and you don’t have a local drug take-back location, there are other ways to dispose of the medication. Check to see if the medication you have has special disposal instructions. Typically, if the prescription medication has special disposal instructions, you will be made away by the pharmacist.

Most medications can be safely thrown in the trash, in 4 simple steps.

• First, mix the medication with an unappealing substance. Something such as kitty litter, coffee grounds, or dirty. This will prevent animals, or people, from being attracted to it if they find it in the trashcan. Do not crush tables or capsules. You should also do this with liquid medications as well, just pour the medication in the unappealing substance.

• Next, place the mixture in a sealable bag. Do not just mix it in a grocery bag or trash bag. Being able to seal the bag prevents it from spilling open and becoming easily accessible. Imagine if your trash can got knocked over and your medication fell out and was ingested by an animal. While some medications may not be deadly, others can have harmful side effects. For this reason, it’s important that the bad you place the mixture into, can be sealed.

• Next, throw the sealed bag into your household trash can and take your household trash out to the dumpster or place it in your outdoor trash container. You don’t need to take the household trash out immediately, but it might be wise if you have curious kids and pets in your house that like to get into the trash.

• Finally, scratch out all identifying information on the medication bottle and discard the bottle. Prescription bottles contain a lot of personal information, such as your doctor’s name, your full name, the medication you were taking, and possibly even insurance information. Protecting your identity is important, even when disposing of medications.

Can I Donate My Old Medications?

Medication, especially in the United States, is not cheap. Many people might think it would be better to donate the medication instead of throwing it away. Donating medications can be tricky because there are lot of laws that control how medications are distributed in the United States. Some states do have laws that allow for medications to be donated, especially medications used for the treatment of life threatening diseases such as cancer.

Can I give Old Medications to a Friend or Family Member?

Federal law prohibits controlled substances from being distributed by individuals that don’t posses specific licenses to prescribe or distribute medications, such as doctors and pharmacists. For this reason, you cannot just give your unused medication to a friend or family member. However, you might be able to find organizations that are able to take medication and redistribute it to those in need. In these situations though, the medication cannot be expired, and typically has be sealed in the original manufacturer’s bottle, not a prescription bottle.

As of 2018, there are 38 states, and Guam, that have laws pertaining to the reuse and recycling of unused medication. If you are interested in donating your unused medication, you can contact a local pharmacist. They can tell you if there are any programs in your state that accept unused medications.

Conclusions on How to Dispose of Old Medications

Disposing of old medications is a complicated topic as there are many options. Moreover, not all of your options are good and/or legal. This article is a good place to start. However, if you are in doubt of how to properly dispose of a particular medication, please call your pharmacist.

More Reading on Prescription Drugs

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One frequently asked question we get is “Does Medicare pay for dentures?” The short answer is NO.

Teeth are important part of your health. However, dental care is not a covered benefit in Original Medicare. As a result, Medicare does not pay for dentures.

Read on to find out how to get your dentures covered in other ways.

What Dental Services Does Medicare Cover?

Not much at all. In fact, the only time dental work may be covered by Medicare is in an emergency setting such as a hospital. For example, if you were in a car accident that affected your teeth, the emergency doctors and health care providers may need to provide emergency dental care.

In this instance, these services would be covered under Original Medicare Part A. (More at Medicare.gov.)

Options for Dental Insurance for Medicare Beneficiaries

Medicare beneficiaries looking for dental coverages, will need to look for benefits outside of Medicare insurance.

Other than paying for dentures and dental work with cash, there are two options for insurance:

1. Medicare Advantage
2. Dental Insurance

Medicare Advantage Plans (MA/MAPD Plans)

There are select Medicare Advantage (MA or MAPD) Plans that have dental benefits. Most of them have a network of dental offices that participate in their plan. Often, this is a reimbursement based plan.

You can read more about MA/MAPD plans (also called Medicare Part C) in this article.

Dental Insurance

Dental Insurance is especially worth purchasing if you have big ticket dental items or procedures coming up (i.e. dentures). Make sure when you are researching plans that you pick one that has denture coverage included. Plans and premiums can differ dramatically, so take the time to make sure the plan meets your needs.

Conclusions on Medicare Denture Coverage

If you are a Medicare user in need of dentures, I suggest your first step is to look into either a Medicare Advantage plan with dental benefits, or a stand alone dental plan.

Independent Insurance Agents for Dental Benefit Coverage

To find a plan in your area, I also suggest talking to an independent insurance agent that will be able to help you compare the options in your neck of the woods.

• You can find one here.

• Additionally, if you have never worked with an agent before, please read this article on the benefits of working with an agent.

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Is acupuncture covered by Medicare? Only if you have chronic low back pain as defined by Medicare.

Let’s look at what that means and what treatments are available.

This article is part of our series “What Does Medicare Cover?” Click the link to read about more frequently asked coverage questions in that article.

Medicare Acupuncture Coverage for Lower Back Pain

If you have chronic lower back pain, Medicare will cover a certain amount of acupuncture visits for you. It is covered under Medicare Part B.

What is considered “Chronic Lower Back Pain?”

According to the CMS, chronic lower back pain is defined as

– Lasting 12 weeks or longer

– Having no known cause (not related to cancer that has spread, inflammatory, or infectious disease)

– Pain not associated with surgery or pregnancy

https://www.medicare.gov/coverage/acupuncture

How Many Acupuncture Sessions are Covered by Medicare?

If you are diagnosed with chronic lower back pain, you can receive up to 12 acupuncture visits in 90 days under Medicare Part B.

What Does Acupuncture Cost with Medicare?

Remember, there are still costs involved with Original Medicare under Part B.

• If you only have Original Medicare, then you will be responsible for a Part B co-insurance of 20%.
• Medicare pays 80% of the cost of services.

Medicare Co-Insurance Coverage Options

For the 20% you are responsible for, you can either:

• First, cover the cost of the co-insurance yourself “out-of-pocket”.

• Or, if you have a Supplement (Medigap) Plan, then your plan might pick up the rest. This depends on what letter plan you have purchased. The most popular plans pick up the entire co-insurance. These include:
  • Plan F (with no Part B Annual Deductible)
  • Plan G (with a Part B Annual Deductible)
  • Click here to learn more about Plan F vs Plan G and which one you can get.

• Finally, if you have a Medicare Advantage (MA/MAPD) Plan, then your plan may include benefits for acupuncture visits.
  • MA/MAPD plans all structure their benefits differently. However, they are all required to provide AT LEAST what Original Medicare covers.
  • Some may pay for a certain amount of visits or have co-pays for each visit.

If any of this is confusing to you, please see our article on How to Choose a Medicare Plan for help.

Where Can you Get Acupuncture Covered by Medicare?

Medicare will only cover an acupuncture treatment at select facilities with certain providers. (You can’t just go to any person advertising needle services.)

According to Medicare.gov,

Acupuncture must be given by a doctor, or by another health care provider (like a nurse practitioner or physician assistant) who has both of these:

– A masters or doctoral level degree in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine

– A current, full, active, and unrestricted license to practice acupuncture in the state where care is being provided

https://www.medicare.gov/coverage/acupuncture

There are programs on acupuncture created specifically for doctors and medical providers. If you want Medicare to cover your visit, you will need to find one of these trained providers that actively accept Medicare. (In addition, if you are on a Medicare Advantage Plan, make sure your provider is a part of your network.)

Conclusions

At this time, coverage of acupuncture treatments by Medicare is limited to chronic lower back pain.

If you are looking for Medicare covered treatment for back pain, make sure you find a medical provider that is properly trained and accepts Medicare as payment.

Your full cost for the service will depend on what supplemental Medicare plans you also have in addition to Medicare Part B.

Other Related Coverage Questions:

• What Does Medicare Part B Cover?
  
• What Are my Costs with Medicare Part B?

• What Does Medicare Part A Cover?

• Does Medicare Cover Chiropractic Services?

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The Most Frequently Asked Medicare Coverage Questions

• This is a quick directory answering what Medicare will and will not cover.
• We will list out frequently asked questions, brief answers, and links to more in depth articles if we have them.

Medicare Ambulance Coverage

Medicare does cover ambulance coverage for approved emergency situations. Original Medicare covers 80% of the cost of service. You additional plans will cover all or part of the rest.

• Read more about Medicare ambulance coverage here.

Medicare and Hearing Aids

Does Medicare cover hearing aids? While there might be some Medicare Advantage Plans that have hearing benefits, in general, Original Medicare does not cover hearing aids. Read here for your answers.

• Also, read this article if you are looking for low cost hearing aid alternatives.

Medicare Chiropractic Coverage

In regards to Chiropractic Coverage, what does Medicare cover, if anything? According to our article on Medicare Chiropractic Coverage,

Yes, when deemed medically necessary, Medicare does cover chiropractic services. Original Medicare Part B pays for 80% of the cost of chiropractic services. You will pay the other 20% is the co-insurance – unless you have supplemental insurance.

https://medicarelifehealth.com/does-medicare-cover-chiropractic

Medicare Cataract Coverage

Does Medicare cover cataract surgery? Yes, Medicare Part B covers cataract surgery. Please read more here.

Does Medicare Cover Rehab?

How Long Does Medicare Pay for Rehab? It depends on what Medicare Plan you have.

Medicare often pays for at least part of medically necessary rehab.

However, how it pays, and how much it pays, for your rehab is dependent on what type of care you need and what kind of Medicare plan you have.

https://medicarelifehealth.com/how-long-does-medicare-pay-for-rehab

• Read this article to learn if and how your Medicare plan covers rehab.

Medicare Denture Coverage

Does Medicare cover dentures? No, as a rule, dental services are not covered by Original Medicare – including dentures. As an exception, if dental work is preformed in a hospital emergency setting, it may be covered under Original Medicare Part A. (More at Medicare.gov.)

There are select Medicare Advantage (MA or MAPD) Plans that have dental benefits. You can read more about these plans (also called Medicare Part C) in this article.

Stem Cell Therapy Coverage

Does Medicare Pay for Stem Cell Therapy? Sometimes, yes. However, the cases in which it does pay are very limited. Stem Cell Therapy is expensive and controversial. As a result, Medicare’s list of approved cases is short.

• Read this article to learn if and when Medicare will pay for stem cell therapy.

Medicare MRI Coverage

Does Medicare Cover MRI’s and how much do they cost? Read our article on MRI’s coverage and cost here.

Original Medicare Coverages

Original Medicare refers to the basic coverages put in place by the Federal Medicare Program. The Center for Medicare and Medicaid Services breaks down the coverages into four parts. (Although Part C and D are provided by private insurance companies.)

In addition to the four parts of Medicare, beneficiaries also have the opportunity to add a Medigap Plan. (Also called Medicare Supplement Plans, these plans pick up the extra costs and co-pays that Original Medicare does not.)

• Click the link to read, What Does Medicare Part A / Part B / Part C / Part D Cover?

For more information, here are our detailed articles about each part.

• Medicare Parts A, B, C & D Explained

• What Does Medicare Part A Cover?

• Part B Coverages, Premiums, Deductibles.

• Part A and Part B Yearly Changes to Cost and Coverages

The post What Does Medicare Cover? appeared first on Medicare Life Health.

Does Medicare Cover Chiropractic Care / Services?

Yes, when deemed medically necessary, Medicare does cover chiropractic services. Original Medicare Part B pays for 80% of the cost of chiropractic services. You will pay the other 20% is the co-insurance – unless you have supplemental insurance.

“Medically necessary” chiropractic care is defined as manual manipulation of the spine to correct a subluxation by a qualified provider such as a chiropractor. (Medicare.gov source info).

What is a Subluxation?

A subluxation is when one or more of your bones moves out of position. In other words, your spinal vertebrae are out of position or misaligned. According to experts, this can cause back or neck pain, headaches and immobility.

Chiropractors can manipulate the spine to correct these misalignments and alleviate pain. This is Medicare’s expected use of chiropractic care.

How Much Does Medicare Pay for Chiropractic Adjustment?

When used for a Medicare approved reason, Medicare will pay for 80% of the cost of your chiropractic care. However, since it is part of Original Medicare Part B (Doctor / Professional Services), the Medicare Part B Deductible will apply.

There is no cap on the amount of times you can see the chiropractor in a year with Original Medicare. However, you have a Medicare Advantage Plan or a supplement plan, there may be different rules.

Let’s look at each of those extra insurances to see how they work with Medicare Part B.

Does Medicare Advantage Pay for Chiropractic Care?

The US Government and CMS (the Center for Medicare / Medicaid Services) requires Medicare Advantage Plans to cover at least what Original Medicare covers. So yes, Medicare Advantage plans will have some benefit for chiropractic care.

It will depend on each individual plan what that looks like. Some plans have a co-pay or co-insurance due each time you use the chiropractor. Also, some may have a cap on fully covered care. Finally, some plans may require a referral from a PCP (Primary Care Physician), so make sure to check with your plan for coverages and options.

Does Medigap Pay for Chiropractic Care?

Medigap (which is also called Medicare Supplement) Plans help to cover costs where Original Medicare leaves off. Some of them cover all extra costs and co-insurances not paid by Original Medicare.

As mentioned earlier, chiropractic services are covered with Medicare Part B. To see what a particular supplement will cover, you will need to look at how they cover the uncovered costs of Part B. For example:

• Medigap Plan F covers all costs that Medicare does not. (This includes the Part B yearly deductible.) So, if you have Plan F, you will not pay any co-pays or co-insurances to see a chiropractor for approved care.
• Also, read “Is Medicare Plan F Going Away?”

• Medicare Plan G also covers all costs that Medicare does not – except for the Medicare Part B yearly deductible. So, if you have Plan G, you would first pay the Part B deductible for rendered and approved services. Then, once that deductible was satisfied, you would not pay anything else for your services.

• Other Medigap Plans cover some or all of the Part B coinsurances. If you want to see a chart and in depth explanation of each Medicare Supplement Plan, please click here.

A note of warning from Medicare.gov:

“Medicare doesn’t cover other services or tests ordered by a chiropractor, including X-rays, massage therapy, and acupuncture (except for low back pain). If you think your chiropractor is billing Medicare for services that aren’t covered, you can report suspected Medicare fraud by calling 1-800-MEDICARE (1-800-633-4227). TTY: 1‑877‑486‑2048.”

https://www.medicare.gov/coverage/chiropractic-services#

Conclusions on Medicare Coverages of Chiropractic Care

• Yes, if you have Medicare Part B, you are entitled to 80% coverage of your Medicare approved uses of the chiropractor (after your yearly Part B Deductible applies).

• If you have additional coverage, through a supplement or a Medicare Advantage Plan, you may have additional coverage for the remaining 20%.

• If you have questions on whether or not your care will be considered a covered service, you can talk with your primary care physician, directly to Medicare, or if you have additional insurance, to your private insurance company. They can also give you a better idea of your actual costs – including any co-pays, deductibles or co-insurances.

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Yes, Medicare covers cataract surgery.

Medicare Part B covers the costs associated with cataract surgery. This includes if you need corrective lenses as a result from surgery. (Such as glasses or contact lenses.)

Let’s get into the necessary details you will want to know before cataract surgery. (Such as, how much will I pay?) But first, what is a Cataract? And second, why would you need cataract surgery?

What is a Cataract?

According to the National Health Institute:

• Cataracts are a cloudy area in the eye’s lens that affects vision.

• To start, cataracts are a very common eye problem in older people.

“When you’re young, the lens in your eye is clear. Around age 40, the proteins in the lens of your eye start to break down and clump together. This clump makes a cloudy area on your lens — or a cataract. Over time, the cataract gets more severe and clouds more of the lens.”

National Health Institute

• Interestingly, over half of Americans over the age of 80 have either had cataracts (and just lived with them) or have had surgery to remove them.

• According to the Center for Medicare and Medicaid Services, cataract risk increases not only with age, but with long -term exposure to sunlight, diabetes, and smoking. In addition to using some medications, drinking too much, or having a family history of cataracts.

What is Cataract Surgery?

Cataract surgery is the removal of your cloudy eye lens, and then the replacement of your original lens with a new, artificial lens. It is done in an outpatient setting in a hospital or an ambulatory surgical center. This means, you are in and out without an overnight hospital stay.

Why Would You Have Cataract Surgery?

Some people’s cataracts do not bother them enough to do anything about them. If you are trying to stave off surgery, you can try

• getting stronger glasses,
• or a magnifying device or lenses,
• reducing glare with your glasses or sunglasses,
• or just increasing the amount of light in your living areas.

However, if it gets to the point where you are having trouble seeing, you may need surgery. According to the National Health Institute, people who have cataracts may notice:

• Blurry Vision
• Hazy/Halo Vision
• Seeing Dulled Colors
• Trouble Reading
• Poor Night Vision
• Seeing Double

Some people just get cataracts naturally with age. While others will develop them after another eye surgery, eye trauma or glaucoma issues. Source NHI.

How Much Does Cataract Surgery Cost on Medicare?

The CMS Medicare.gov website has a “Procedure Price Lookup” page where you can see the average costs of medical procedures.

Remember, this is not an exact price of what you will pay. It is just an estimate, but it can be very helpful. (Your actual costs will depend on if you have extra insurance, what your doctor charges, any facility charges, where you live, and any other variable medical costs involved with your care.)

How to Look Up Your Cost Estimate on Medicare.gov

If you want to know how much Cataract Surgery costs on average, you can visit their website. Then, type in “Complex removal of cataract with insertion of lens.” (This is under code: 66982.)

When we looked up this procedure at the end of 2020, the average cost was:

• Ambulatory Surgical Centers Total Cost of $1,777
  • Patient Pays $355
  • Medicare Pays $1,422
• Hospital Outpatient Surgery Total Cost of $2,786
  • Patient Pays $557
  • Medicare Pays $2,229

Here is a screenshot from the date we looked it up. (However, prices change, so please use the tool for an up to date estimate.)

• This is providing you with an estimate of what Original Medicare will pay for.
• However, you most likely have additional insurance in the form of a Medicare Supplement (Medigap) Plan or from a Medicare Advantage Plan.

Are Eyeglasses Covered by Medicare with Cataract Surgery?

According to Medicare.gov, the only time that Medicare covers eyeglasses or contact lenses is if you need them after cataract surgery for corrective purposes. In this case, you would still be responsible for 20% of the cost.

In addition, the corrective lenses would be under Medicare Part B, so the Part B Deductible would also apply. This is unless you have supplemental coverage (for example, Medigap or Medicare Advantage).

Does Medicare Cover Eyeglasses or Contacts in General?

Typically, Original Medicare will not cover contact lenses or eyeglasses outside of cataract surgery. However, there are Medicare Advantage Plans that have an eyeglass or contact benefit included. The amount varies from plan to plan and from year to year. These are outside of, or in addition to, cataract surgery corrective lenses needs.

Conclusions

Cataract surgery is covered by Medicare Part B. If you are considering cataract surgery, the first thing to do is to talk with your medical providers.

Then, consult with your insurance provider’s information or personnel on cost. Ask them what your financial responsibility is for the costs Original Medicare Part B does not cover (the 20% coinsurance).

Depending on what kind of plan you have, you may be responsible for all, some, or none of the co-insurance costs.

Disclaimer:
This information isn’t intended to replace professional medical advice, diagnosis, or treatment.

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The Center for Medicare Services has announced the costs of Medicare Part B Premium 2021. In addition, they have announced the changes to Part A Premiums and Part A and B Deductibles for 2021.

We have included a helpful chart so you can see the premium and deductible differences from 2020 to 2021.

Medicare Cost Sharing Chart

2021 Medicare Part A Premiums

Most people do not pay a Part A Premium, unless they paid into Medicare taxes for less than 30 quarters. However, if you have worked less than 30 quarters paying into the Medicare insurance program, then you will owe a monthly premium if you want Medicare Part A (Hospital Insurance).

• In 2021, the Medicare Part A Premium is $471 per month.
• Medicare Part A was $458 per month in 2020.

For more information, please visit the Medicare.gov page.

2021 Medicare Part B Premiums

• In 2021, the Medicare Part B Monthly Premium will be $148.50
• In 2020, the Medicare Part B Monthly Premium was $144.60.

Medicare Part B Deductible 2021 / Medicare Part A Deductible & Co-Insurances

Medicare Coverages

For a in-depth look at each what each part of Medicare covers, take a look at this article: Medicare Parts A B C D.

The post Medicare Part B Premium 2021 Changes appeared first on Medicare Life Health.

Does Medicare Cover Ambulance Services?

Yes, Medicare covers ambulance services in approved emergency situations. As with all Medicare covered costs, you will pay 20% of the cost of service, unless you have additional coverage.

Let’s break down in more detail – what is covered and how it gets paid for.

Does Medicare Pay for Ambulance Services?

Medicare Part B covers ambulance services. (Part B is medical insurance. To learn more about what Part A and Part B offers, visit this page.)

What does the government describe as covered ambulance services? Well, they include:

• Emergency ground transportation to a hospital (including critical access and skilled nursing facilities)
• Emergency air transportation (via helicopter or airplane) when ground transportation is not available or is not adequate

Does Medicare Cover Non-Emergency Transportation?

No, Medicare does not typically cover non-emergency transportation. For example, you will not be able to get an ambulance to a doctors appointment.

However, there are certain Medicare / Medicaid programs that do offer non-emergency transportation to people who need it. Also, according to CMS (Center for Medicare Services), there are a few instances where Medicare may provide non-emergency ambulance services:

“In some cases, Medicare may pay for limited, medically necessary, nonemergency ambulance transportation if you have a written order from your doctor stating that ambulance transportation is medically necessary. For example, you may need a medically necessary ambulance transport to a dialysis facility if you have End-Stage Renal Disease.”

https://www.medicare.gov/coverage/ambulance-services

What are My Costs with Medicare Ambulance Coverage?

First, it is good to remember that the reason for your ambulance ride must be considered a “Medicare approved” service. Otherwise, your ride might not be covered at all. Also, CMS states that the ambulance can only take you to the nearest medical facility considered appropriate for your needs. (You can read more about it here.)

Next, if you only have Original Medicare Part B, then you will pay the 20% of the ambulance bill that Medicare does not pay. (If you only have Medicare Part A, then ambulance services are not covered. You will need to enroll in Part B to have them covered.)

However, most people have a supplement or a Part C (Medicare Advantage) Plan in addition to Medicare Part A and Part B. Original Medicare works together with your private insurance options to pay for ambulance services. Let’s look at both options and how they cover ambulance rides.

Medigap Ambulance Coverage

Remember that with Original Medicare Part B, the government pays for 80% of the cost of a Medicare covered ambulance ride. You are responsible for the rest, unless you have a Medigap plan. Also known as Medicare Supplement plans, these plans help you pay for the co-insurances, deductibles, and co-pays that Original Medicare does not pay for.

Coverage By Specific Medicare Supplement Letter Plan

In exchange for a monthly premium, Medigap plans will help you pay for some or all of your personal costs of Medicare approved services. The Part B Co-insurances or co-payments are

• Paid in full by Medigap Plans A, B, C, D, F, G and M.
• Plan K pays for 50%;
• L pays for 75%,
• And N pays for all minus a co-pay.

You can read more about the supplement coverage chart in our article: What are Medicare Supplements here.

Medicare Advantage Ambulance Coverage

Medicare Advantage (Part C) plans are private insurance options that “replace” Original Medicare as your only Medicare coverage. They offer everything that Original Medicare offers, and also offer extra benefits are services on top of what is covered in Part A and Part B.

Medicare Advantage plans cover at least what Part B covers for ambulance rides. In addition, they also may cover the 20% that Part B doesn’t cover, but they way they do that is specific to each individual private insurance company.

For example, some Medicare Advantage plans will have a set co-pay for ambulance use, or they may have a percentage they cover. They may also distinguish between air and ground emergency transportation in how they cover costs.

It is important to know that every Medicare Advantage plan has a set max out-of-pocket cost that you can never go above each year. So, for example, if your MA plan had you pay 10% of the cost for air transportation, then you would be responsible for that cost only up to the max out-of-pocket limit set for your plan.

Remember, each Medicare Advantage plan is different, and if you are a MA plan beneficiary, you will need to look at your plan information or “Summary of Benefits” to see how your costs will be covered.

If you want to compare Medicare Advantage vs Medigap plans, you can read more here.

Other FAQ’s

Here are a few other frequently asked questions:

• Does Medicare cover air ambulances?
  Yes, as long as it is a “Medicare approved” service, then it is covered. If you need an emergency air transportation and it is considered a necessary, approved situation, then Medicare will pay for it. Remember, you will be responsible for a 20% co-insurance payment unless you have additional coverage (like with a Medigap or Medicare Advantage plan).
• Does Medicare cover life flight?
  Life Flight or LifeFlight is just a branded name of a company that provides emergency air transportation services. If you use their services for a Medicare approved expense, then it will be covered accordingly.

Conclusions

Yes, Medicare will cover ambulance service for approved and necessary emergency transportation needs. You will still have co-insurance unless you also have a Medicare Supplement Plan or a Medicare Advantage Plan. Do you need help finding coverage in addition to what you receive through Original Medicare (Part A and Part B)? Then please reach out to us.

• If you live in Nebraska, please contact us here.

• If you live anywhere else in the lovely United States of America
  • Read more about Medicare Plans here or
  • Find an agent here.

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Hearing aids are expensive. We are talking thousands of dollars, sometimes even with insurance. In addition, they may be overkill for the amount of hearing support you require.

Fortunately, there are hearing aid alternatives. You just need to know where to look and what to look for.

Hearing Aids are Not Covered by Medicare

One of the main problems is that hearing aids are not covered by Original Medicare. (Read this article to learn more, and how they are sometimes “covered” or subsidized by select Medicare Advantage plans.

Just as a refresher, Medicare Advantage Plans are private insurance plans (Medicare Part C) that are available to Medicare Beneficiaries in certain geographic areas. Some of them do have hearing care benefits.

So, What is a Low Cost Hearing Aid Alternative?

Before 2009, the only solution for procuring a hearing aid was through a doctor. In addition, to make matters worse, these solutions were (and still are) thousands of dollars.

Enter the PSAP…

What is a PSAP?

However, in 2009, a court decision finally allowed sales of OTC (over the counter) hearing aids. They changed the name of these “hearing aid alternatives” to Personal Sound Amplifier Products or PSAP.

What is the Difference Between a Hearing Aid and an Amplifier?

To be frank, the main difference between a hearing aid and a hearing amplifier is FDA regulation. To get a hearing aid, you will

• Need to see a doctor
• Go to follow up doctor visits
• Get a prescription
• Pay a lot of money, or have great insurance to help cover the cost.

To get an amplifier (PSAP), you just need to purchase one online. No doctor or prescription required. However, you may want to see a hearing specialist just to be sure your hearing loss is not connected to another condition.

How do Amplifiers Work?

Personal Sound Amplifiers are basically over-the-counter hearing aids. They “manage” noise around you and help you hear what is important, like the sound of voices directed at you. Some of them even have noise cancelling technologies. (Affiliate Link)

Our PSAP Brand Recommendation

One of the first, and still very popular, brands of PSAP’s is Otofonix. We recommend this brand, and our links for them are affiliate links. The company was started by an ENT (ear, nose and throat) doctor and the company has many different options and price points.

Otofonix has some limited time offers for our readers. They are listed here:

• Get up to 50% OFF | Shop Hearing Aids @ Otofonix Now!

• Free Two-Day Shipping on Orders Over $75!

Otofonix is known for having great customer service, a 1 year warranty and a up to 45 day return window.

Hearing Health Tips for Improving and Protecting Hearing

Finally, we are ending our hearing aid alternatives article with a few tips for naturally improving hearing. They might not be a substitute for an amplifier or hearing aid, but they might make a difference.

To Start, Keep Your Ears Unclogged

There are multiple ways your ears can get plugged up. You could have an infection, allergies, pressure build-up (like from a plane ride), or even too much war wax.

I remember when my mom spent months not being able to hear and thinking she needed hearing aids. However, when she went to the doctor, they found out she just had a prolific amount of ear wax! After they drained her wax out, she could hear again.

There are ways to “irrigate” your own ear canal, but that also might be something to consult your doctor about. It is always a good idea to be safe and gentle your ears. (And stay away from putting things in your ears like cotton swabs.)

Finally, Prevent Further Hearing Loss

Hearing Loss Prevention is the Key to hearing health! Make sure you are protecting your hearing by:

• Wearing ear plugs when you know you will be experiencing loud sounds. For example, at a concert or fireworks show.
• Give yourself some quiet time. Your ears and brain work hard together to interpret sounds. Make sure to give them a break every once-and-a-while.
• Turn down the volume on the TV and on your music.
• Take care of your whole self. Exercise and a healthy diet will help to keep all your body’s systems in proper working order, including your ears.
• In addition, foods rich in magnesium may help bolster hearing health. Studies have been inconclusive in how other vitamins and minerals help hearing health.

The post Best Hearing Aid Alternatives appeared first on Medicare Life Health.

Insurance has changed a lot over the last 20 years, and there is no better example than the way we define and use provider networks. When you are looking at insurance plans, it’s important to compare HMO vs PPO. Which is better for you?

We are here to clear up the confusion, and quickly answer the most frequently asked questions in regards to what is HMO and PPO insurance, how the plans work, and where you will find HMO and PPO insurance plans.

If you are a Medicare user, you will run into HMO vs PPO in regards to choosing a Medicare Advantage Plan. You can learn more about Medicare Advantage Plans here.

What is an HMO?

To start, what is HMO health insurance? A HMO is a network of health care providers, set-up by a health insurance company, to offer services and benefits to its customers. (More at Healthcare.gov.)

What does HMO stand for? Health Maintenance Organization

How does an HMO work?

• To start, when you are a beneficiary/member of an HMO, you have access to a specific set of healthcare providers in a specified geographical area. (For example, a city, counties or defined state(s).) These providers include doctors, healthcare professionals, specialists and hospitals.
• You must use the HMO’s contracted providers to have your care paid for by your insurance plan. Moreover, if you go outside the plan for care, you will often have to pay the full cost of your care.
• You can only go outside of your plan’s provider list in the case of an emergency.
• With most HMO’s you need to have a Primary Care Physician (called a PCP). Your PCP takes care of your general health care and then refers you to specialists as needed.
• So then, as a member of an HMO, if you need to see a specialist, your PCP with often have to refer you, to use one. However, in some states, and with some plans, the insurance companies have take away this requirement. As a result, it is important to check your specific plan’s requirements for seeing a specialist.
• Finally, HMO’s are often concerned about prevention and keeping their member’s as healthy as possible to keep everyone’s costs down. For this reason, health maintenance organizations will often provide prevention based benefits and services to encourage safe and healthy behaviors among their members.

What is a PPO?

So, in regards to insurance, what is a PPO? A PPO is a type of insurance plan that uses a defined network of medical providers to meet your health care needs.

You pay a contracted rate (less than full price) to see network providers. However, unlike an HMO, with a PPO you can use doctors, clinics and hospitals outside the network at a higher cost. (More at healthcare.gov.)

What does PPO stand for? Preferred Provider Organization.

How Does a PPO Work?

• First, with a PPO, you still have a network of providers to use that offer contracted prices to members of the PPO.
• In contrast, you have more flexibility to go outside the network if needed to use uncontracted providers. You will most likely have to pay a higher percentage of the costs to use these providers, but the insurance companies will still pay something.
• You can use any provider when the circumstance is deemed an emergency.
• With most PPO’s, you do not have to have a referral to see a specialist.

What is the Difference Between HMO and PPO Insurance Plans

Both HMO’s and PPO’s have contracted networks of healthcare providers, clinics and hospitals where they will pay for some or all of your care. However, there are differences to consider:

• First, HMO’s and PPO’s treat their out of network costs differently.
  • With an HMO, if you go “out-of-network” to see a provider, they may not cover any of your costs. Unless, it is an emergency situation.
  • With a PPO, the plan will most likely cover “out-of-network” provider/hospital visits, but at a lower percentage rate than their “in-network” providers/hospitals.

• Second, the networks treat visits to healthcare specialists differently.
  • With an HMO, you will often need a referral to see a specialist.
  • With a PPO, you can most often just choose a specialist from the network provider list and make an appointment to see them without a referral.

• Third, the PCP is usually the person making referrals in an HMO network. As a result,
  • The HMO’s often require having a primary care physician (PCP) on file for its members.
  • While the PPO’s usually do not have a requirement to name a PCP.

So, HMO vs PPO Which is Better?

After reading about the differences between HMO’s and PPO’s, it may seem like the PPO sounds hands down better than the HMO. Regarding, its freedom to see both in-network and out-of-network providers, and its options to see specialists without a referral, it does seem more flexible.

So then, why do people like HMO’s as well as PPO’s, and which one is right for you?

• To start, HMO’s have changed a lot over the last years. Their networks have become more robust and their requirements less strict. In certain geographical areas, the HMO might include all the major hospital systems and the majority of providers. As a result, it may not matter to a person if they have a PPO or HMO, in regards to providers available.

• Second, in some states, it is not necessary to get a provider referral to see a specialist in an HMO’s network. State laws often dictate how HMO’s work in this capacity, so it is important to learn how your area’s plans work.

• Third, their may be a cost difference paid by members between an insurance company’s HMO and PPO plans. These costs include monthly premiums, max out of pocket costs, deductibles, and co-pays/co-insurances. When picking a plan, it often comes down to what is the more affordable option.

• Finally, since HMO’s are often more focused on the wellness of their members, they might have other prevention benefits and services available to their members. PPO’s can sometimes have these services too, you will just need to do your homework to see what is included when shopping for a plan.

Going Deeper: HMO vs PPO Which is Better FAQ’s.

For those of you that have further questions, here are the most asked questions in regards to HMO and PPO insurance.

What does HMO POS mean? / What is HMO POS Medicare Advantage?

An HMO POS is a type of HMO network that allows more flexibility in seeing providers outside of the specified HMO provider list. POS stands for Point of Service.

According to Healthcare.gov, with an HMO POS, you will still need to choose a PCP (primary care physician) and they will still make specialist referrals for you. However, with a POS, if they want to refer you to a specialist outside of the HMO network, they can do so with the POS designation. Keep in mind, specialists and providers outside of the HMO network may still have higher out-of-pocket costs than in-network providers.

In a HMO POS Medicare Advantage Plan, you also have this ability to use providers who are “out-of-network,” but they may incur an increased cost.

What is Medicare PPO? / What is Medicare HMO?

PPO’s and HMO’s come into play in Medicare when you are using Medicare Part C – aka Medicare Advantage Plans.

Medicare Advantage (MA & MAPD) Plans are alternative plans offered by private insurance companies to take the place of Original Medicare. They often include drug coverage or Part D coverage (MAPD plans). They are approved by the Federal Government and cover everything that Original Medicare covers. In addition, they often offer benefits and services beyond what Medicare offers such as dental, vision and hearing benefits.

So then, what is a Medicare Advantage PPO plan or HMO plan?

Medicare Advantage plans are often HMO, PPO, or PFFS plans. (Additionally, they have special plans set up for people with special needs.) When you are choosing a Medicare Advantage Plan, you will need to consider everything we discussed about HMO’s and PPO’s as they will apply to these private insurance plans and how they set-up their provider networks.

Ok, then what is a PFFS Plan?

PFFS is a Private Fee-for-Service Plan. These plans also have networks that include a list of providers that have agreed to accept the plan. Moreover, you can see other providers, not on the list, as long as they agree to the plan’s terms and conditions and bill the plan directly. Original Medicare is an example of a PFFS plan.

What is HMO Medicaid?

Medicaid is provided to its recipients at a state level. Each state has to decide how to manage their Medicaid programs. These “managed care” options include choosing an insurance administrator to deliver healthcare services to Medicaid beneficiaries in a way that will “manage cost, utilization, and quality.” Often times the contracted insurance company will use an HMO model to structure their network of providers.

In addition, if you are a “Dual Eligible” beneficiary – meaning that you qualify for both Medicaid and Medicare – then you have the option of finding a private insurer to manage your health care insurance. Each state has DSNP Medicare Part C (Medicare Advantage) providers that offer plans to dual eligible beneficiaries to help them manage the care between Medicare and Medicaid. These plans can also be HMOs or PPOs.

What is an EPO?

An EPO is an Exclusive Provider Organization. According to Healthcare.gov, “EPOs generally limit coverage to care from providers in
the EPO’s network (except in an emergency).”

What is PPO Dental Insurance? / What is HMO Dental Insurance?

Dental Insurance Carriers (aka Insurance Companies) set-up their provider networks similar to how medical companies set-up their networks. They have both DHMO and DPPO plans.

Just like in medical insurance, both DPPO’s and DHMO’s have provider networks, but HMO’s will typically only pay for services rendered by providers in the network. In addition, PPO’s will pay more of the costs for services provided by network providers, but will pay some percentage of costs out-of-network. For this reason, Dental HMO’s are usually less expensive than PPOs.

What is Better HMO or PPO Dental Insurance?

There are other differences between Dental PPO’s and HMO’s including deductible costs, and co-pays/co-insurances. When you are looking at dental plans in your area, you will need to decide what type of plan most affordably meets your dental care needs.

Sometimes this will be an DHMO and other times, this will be a DPPO, so compare costs, provider networks and types of dental services covered before buying a policy. Here is a good article for more detail on dental insurance network types to help you decide what is best for you.

What is Preferred Provider Organization?

Also known as a PPO, a Preferred Provider Organization is a type of insurance plan that provides a network of healthcare providers, offices and hospitals for its members to use at contracted costs. In addition, it provides the flexibility to use providers outside of its networks if needed, but at a higher cost to the members.

Then, what does preferred provider mean?

Preferred provider means that a particular doctor, specialist, clinic, hospital or other healthcare professional or facility is a part of your insurance provider’s network. They will offer a contracted (most likely discounted) rate for you to use their services while on your PPO insurance plan.

What is the largest PPO network?

The largest PPO Network in the United States is MultiPlan.

What is MultiPlan PPO?

Multiplan is not a “type” of healthcare insurance. They are a third party company that helps insurance companies “manage the cost of care, improve their competitiveness and inspire positive change.” You do not have a Multiplan PPO, you have a PPO that uses Multiplan.

What is a Regional PPO?

We often hear the questions, “what is a Regional PPO?” and “what is a Regional PPO Medicare Advantage Plan?” Regional just refers to the service area for the PPO. Members will have access to providers in the PPO’s specified region.

What is Health Maintenance?

“Health Maintenance” refers to a system of prevention. In insurance terms, it refers to an insurance network plan with a focus on keeping medical costs down by keeping members healthy with lower cost preventative care options.

The thought is “an ounce of prevention” will lead to significant cost savings on unused healthcare dollars down the road.

So then, what are the benefits for providers who use HMO model?

Providers who are a part of the HMO model have benefits of being a part of a network that pays them based on a contracted fee. Each network will arrange the contracts differently. However, the providers will know that they have access to the insurance carrier’s pool of members to service for their healthcare needs.

HMO vs PPO Which is Better Summary

In conclusion, whether a PPO or a HMO is “better” all depends on your needs and the plans available in your area.

If we missed any questions in “HMO vs PPO Which is Better” you may have, please drop us a note in the comments and we will do the best to answer them!

All the best. Carly and the MLH Team

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