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How much would you pay out-of-pocket for a five day hospital stay on Medicare? The majority of people have no idea! The problem with Medicare is there is too much information. An overwhelming amount of information and not enough resources. Medicare Nation solves that problem by educating you on all things Medicare, because there are not enough resources out there! This podcast will educate you about the components of Medicare, the different categories of Medicare Plans and Medicare benefits. On other episodes I’ll interview expert guests in the health and wellness field, about diseases, Medicare issues and current changes to the Medicare program. Medicare Nation is dedicated to answering all your questions about Medicare. Expert information and insights regarding Medicare and you! Further information can be found on www.TheMedicareNation.com Don't Forget to SUBSCRIBE to the show! Give us feedback on Facebook! www.facebook.com/MedicareNation
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Now displaying: 2019
Sep 4, 2019

Hey Medicare Nation!

www.TheMedicareNation.com

How Do I get treatment & prescriptions during a weather emergency?

Hurricane Dorian is moving up the East Coast of the U.S., and MILLIONS of people have evacuated the coastlines, to seek safety.

What happens if you get sick or you need to fill prescriptions while you’re away from home during a weather emergency?

Or….

What happens if you need to move into a Skilled Nursing Facility, but you haven’t fulfilled the “3 Day Prior Hospitalizaton” Rule….due to the weather emergency?

Let’s take a look at these questions for you.

After President Trump Declared Emergencies in Puerto Rico, Florida, Georgia & South Carolina….. Health & Human Services Secretary ….. Alex Azar….Declared Public Health Emergencies in those States.  Secretary Azar also declared a “Blanket Waiver” for Hurricane Dorian.

What that means…… is some restrictions under Medicare are more “Flexible” during the Declaration.

For example…….

You evacuated your home in Savannah Georgia, to go stay with your relatives in Michigan. Prior to evacuating your home, you were receiving home health care for physical therapy…due to a sprained ankle.

If you are on Original Medicare, you can contact “Any” home health agency that accepts Medicare to re-start your physical therapy at your relative’s home. They should be able to contact Medicare to get copies of the orders you had for the Physical Therapy.

If you’re on a Medicare Advantage Plan, you will need to contact your Plan carrier…… advise them you evacuated from a Public Health Emergency area and that you need to “Resume” physical therapy at home ASAP. The plan should contact a home health care vendor in the area you’re temporarily staying in, to resume your physical therapy.

If you have a Medicare Specialist, call them! You WILL need their help in expediting the process. Remember…… MILLIONS of people have evacuated coastal areas! Don’t Delay!!! If you need to use your Medicare benefits…. CALL as soon as possible.

For Prescription Medications……let’s say in the stress of having to “evacuate,” you forgot all your prescriptions at home.

under a Medicare Advantage Plan, call your carrier & tell them what happened. You should be able to get a “Refill” under the “Emergency Waiver,”  for most prescriptions. If you need an Extension for 60 – 90 days for your prescription, due to being out of the area, call your plan and ask them if they “offer” extended day prescriptions.

If you’re on an “opioid” prescription……… call your plan & advise them of your situation. Hopefully, you can get a refill…. for at least a day…. or two…… under the waiver, until you can be seen by a doctor in the area you’re temporarily staying at.

Your carrier will tell you which Pharmacy is “IN” network…. Where you’re staying.  If there is NO pharmacy “In” Network where you’re staying, ask the carrier if they will “reimburse” you for the cost of the prescriptions.

You will need a receipt with the Pharmacy name,  prescription name, and the price you paid for the prescription on the receipt to submit to your Medicare Advantage Carrier for reimbursement.

If you had Durable Medical Equipment …… Orthotics, Prosthetics,  or Oxygen Supplies for example….. that was lost, destroyed, “irreparably damaged” ….. or otherwise rendered unusable…… you should be able to replace it from a vendor in the area you’re staying….. with the “flexibility” to WAIVE the replacement requirements that are normally in place.

If you are on a Medicare Advantage Plan, contact your carrier for assistance in getting a replacement…. And advise them the “Blanket Waiver” is in place.

They will assist you in finding a local vendor to “Replace” your equipment.

 

 For those of you needing to stay at a “Skilled Nursing Facility,”Under “Normal” Circumstances…… if you or a loved one needed to enter a “Skilled Nursing Facility,” you would be required to have a “ 3 Day Prior Hospitalization” … prior to entering the Skilled Nursing Facility.

Under the “Blanket Waiver,” the 3 Day prior hospitalization is “waived,” so that you can enter the Skilled Nursing Facility without further delay.

This rule would be in effect “temporarily,” for those who are …… “ evacuated, transferred, or otherwise…. “dislocated” as a result of the emergency.

So….. if you “evacuated” your home in Puerto Rico, Florida, Georgia or South Carolina, due to Hurricane Dorian….. and let’s say you’re temporarily staying with relatives in Pennsylvania………and you need to enter a Skilled Nursing Facility……you would be able to enter the facility without the 3 day prior hospitalization.

If you are on a Medicare Advantage Plan, you must contact your carrier to assist you in determining which “Skilled Nursing Facilities” has room for you to be admitted into.

 

These are examples of how Medicare “requirements” are more flexible during a Public Health Emergency WITH a “Blanket Waiver.”

 

How long does the Blanket Waiver Last? Until Secretary AZAR signs an order stating the Public Health Emergency is over.

NOW….. let’s take a look at how FEMA affects enrollment into Medicare.

 

FEMA… which stands for the Federal Emergency Management Agency, also declared emergencies in Puerto Rico, Florida, Georgia, South Carolina AND the Virgin Islands (which are St. Croix, St. John, St. Thomas AND Water Island) ….., which creates a “Special Election Period” for Medicare Beneficiaries, who needed to enroll in a Medicare Plan during that time, but were unable to ….. due to the effects of Hurricane Dorian.

This means if you needed to enroll in Medicare, or into a Medicare Advantage Plan for September 1st…….. you will be given a Special Election Period to do so….

Under the Emergency “Weather Event.”

So….if you need to enroll into a Medicare Advantage Plan…..OR…. a Stand-Alone Prescription Drug Plan…. you can do so, most likely through the end of October…… or even November in South Carolina & Georgia, under the FEMA Emergency.

You can call Medicare at  800 – 633 – 4227 or your Medicare Specialist for more information.

 

If you feel you are overly “stressed” with all the information on TV & social media, about Hurricane Dorian…… #1 ….. STOP watching the news continuously!  Listen to some music…. Read a book….. play a board game. Go out for a walk.

Continuously Watching the news about the weather is the worst thing you could do!

If you need to speak with someone, you can call the “Disaster Distress Helpline.”

Call  800 – 985  - 5990 to connect with a trained counselor, who can assist you with your distress.

You can even “TEXT” ….. TALKWITHUS   type the letters all together and send it to…. 66746.

You can also go online to get more Public Health & Safety info by going to

https://www.phe.gov/Dorian

Finally….. if you would like to help those affected by Hurricane Dorian in the Bahamas….OR ….any of the other impacted States…..

Call your local TV Station or go onto their websites to find information on how to volunteer or donate supplies.

If you’d like to “donate” money to a cause…..

For Animals. Go to the Humane Society of the United States website…

HumaneSociety.org/Disaster-Relief

The Humane Society is evacuating animals form Animal Shelters across Florida and the other States. They have already helped transport almost 100 animals here in Florida, that they will place in “safe shelters,” with the hope of being put up for adoption.

If you’d like to contribute to a Humanitarian Charity….. or one that is specifically helping those in the Bahamas…… go to the Charity Navigator website & they have a list of highly ranked charities that are providing relief.

Go to   http://charities.foundation/dorian

To donate to one of these funds.

That’s all for this special show and I wish everyone out there, in the path of Dorian…… that you & your loved ones are safe.

Till next time....

Have a Safe & Peaceful week!

Diane 

Aug 2, 2019

Hey Medicare Nation!

www.TheMedicareNation.com

If you are turning 65 or still working on  an employer group insurance plan, you may need assistance in finding the Medicare plan that fits YOUR unique needs.

You may have a loved one in a nursing home or in an assisted living facility, who is not receiving proper care.

Call me! You can hire me as a consultant to assist you with Medicare issues!

Call 855-855-7266

or eMail me at Support@TheMedicareNation.com

Tell me the situation and I'll personally get back to you!

Today, I am speaking to you about Shingles Vaccines!

There are two Shingles vaccines licensed in the United States available.

The first one is the "Zoster Vaccine Live," also known as "Zostavax." Many of you probably have received this vaccine, which is a "Live" vaccine and the CDC reports it as being 51% effective against Shingles.

The second vaccine is the "Recombinant Zoster Vaccine," also known as "Shingrix" has been used since October of 2017.

The CDC reports the Shingrix vaccine is about 91% effective against Shingles.

The cost of the Shingles vaccine is covered under Medicare "Part D."

You can look up the Zostavax vaccine or Shingrix vaccine in your plan's formulary, or you can call the customer service number on the back of your identification card.

Every plan can have a different cost for either vaccine, so it is important you check with your plan, prior to getting the vaccine.

There are side effects that can be associated with either vaccine.

Go to the CDC website to learn more about Shingles and the vaccines 

www.cdc.gov/vaccinesafety

Learn more about how Shingles is transmitted, the sign & symptons and treatment for Shingles here:

www.cdc.gov/shingles

I'm not a doctor!

If you have any health related questions regarding shingles and/or vaccines, due your own due diligence or contact your health care provider for more information.

Thank you for listening to Medicare Nation!

If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation!

If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out!

If you have any questions, send them to Support@TheMedicareNation.com

If I can answer it in one email - I will personally answer you!

If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner.

Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show!

Thanks again for listening!

 

 

Jul 5, 2019

Hey Medicare Nation!

www.TheMedicareNation.com

Help your PARENTS, Spouses and Friends "SUBSCRIBE" to Medicare Nation!

With almost 100 episodes on Medicare and Medicare Resources available, your loved-one will be able to find answers to their Medicare questions!

Use the "Purple" colored icon on an Apple phone or ....

download Stitcher, Himalaya or Player FM when using Android phones.

Search for "Medicare" and "click" on the Medicare Nation logo.

You'll see the "subscribe" button on the page. "Click" subscribe and they'll get the NEWEST Medicare Nation episodes delievered to their phone.

TODAY.... I'm discussing NEW information released from CMS.

 

CMS Decision Summary Ambulatory Blood Pressure Monitoring  Devices

July 2, 2019…..The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to cover Ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension in Medicare beneficiaries.

 What is hypertension (high blood pressure)?

The American Heart Association (AHA) defines blood pressure as…. a force that pushes blood through a network of arteries, veins and capillaries.

The blood pressure reading is the result of two forces:

  1. the systolic pressure occurs as blood pumps out of the heart and into the arteries;
  2. diastolic pressure is created as the heart rests between heart beats (American Heart Association, 2018).

Elevated blood pressure, or hypertension, leads to harm by causing tiny tears in the interior lining of the arteries and coronary vessels…..stimulating a local immune response in the endothelial cells within the atrial walls.

 In these regions, the arterial intima retains apolipoprotein B, which attracts lipid-rich macrophages (foam cells).  

These preatherotic lesions develop into atherosclerotic plaques which become increasingly fibrotic and can form fissures, hematomas, thrombi, and calcifications (Swirski and Nahrendorf, 2013). The end result is stiff, thickened arteries that narrow the flow of blood to organs and limbs….which both increases pressure on target organs and limits oxygenation of them.

There is also the risk of atherosclerotic plaque rupture, resulting in distal vascular obstruction and ischemia and infarction of end organs, such as stroke in the brain (U.S. Department of Health & Human Services, 2018).

CMS is lowering the blood pressure threshold for hypertension… from the current policy of 140/90 down to 130/80 to align with the latest society recommendations regarding the diagnostic criteria. 

This will allow more patients to use ABPM and receive appropriate treatment if needed.

  1. General

Ambulatory blood pressure monitoring (ABPM) is a diagnostic test… that allows for the identification of various types of high blood pressure.

ABPM devises are small… portable machines that are connected to a blood pressure cuff worn by patients…. that record blood pressure at regular periods over 24 to 48 hours while the patient goes about their normal activities..including sleep.

The recording is interpreted by a physician or non-physician practitioner….and appropriate action is taken based on the findings.

Diagnosis and treatment of high blood pressure is important for the management of various conditions…. including cardiovascular disease and kidney disease.

 

Ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension in Medicare beneficiaries is covered under the following circumstances:

  1. For beneficiaries with suspected “white coat hypertension,” which is defined as an average office blood pressure of systolic blood pressure greater than 130 mm … but less than 160 mm … or diastolic blood pressure greater than 80… but less than 100… on two separate clinic/office visits …..with at least two separate measurements made at each visit and with at least two blood pressure measurements taken outside the office which are <130/80 mm Hg.
  2. For beneficiaries with suspected “masked hypertension,” which is defined as average office blood pressure between 120 and 129 for systolic blood pressure or between 75 and 79 for diastolic blood pressure on two separate clinic/office visits…. with at least two separate measurements made at each visit and with at least two blood pressure measurements taken outside the office which are ≥ 130/80

ABPM devices must be:

  • capable of producing standardized plots of blood pressure measurements for 24 hours with daytime and night-time windows and normal blood pressure bands demarcated;
  • provided to patients with oral and written instructions and a test run in the physician’s office must be performed; and
  • interpreted by the treating physician or treating non-physician practitioner.
  • For eligible patients, ABPM is covered once per year.

 

CMS has covered ABPM since 2001 only for those patients with documented suspected white coat hypertension. On January 16, 2003, a technical correction for this National Coverage Determination was issued…. to clarify that a physician is required to perform the interpretation of the data obtained through ABPM…. but that there are no requirements regarding the setting in which the interpretation is performed.

CMS received a complete, formal request for a reconsideration of the national coverage determination from the American Heart Association and American Medical Association.

You can view the formal request letter on the tracking sheet on the CMS website.

Benefit Category

Medicare is a defined benefit program. For an item or service to be covered by the Medicare program, it must fall within one of the statutorily defined benefit categories outlined in the Social Security Act.

ABPM may be considered to be within the benefits described under sections:

other diagnostic tests  (§1861(s)(3).

Medicare regulations state in part, that "…diagnostic tests must be ordered by the physician who is treating the beneficiary, that is, the physician who furnishes a consultation or treats a beneficiary for a specific medical problem and who uses the results in the management of the beneficiary’s specific medical problem." (42 CFR 410.32(a))

  

UNDER APPENDIX C

(Current Section 20.19 of the National Coverage Determination Manual)

Item/Service Description

Ambulatory blood pressure monitoring (ABPM) involves the use of a non-invasive device which is used to measure blood pressure in 24-hour cycles. These 24-hour measurements are stored in the device and are later interpreted by the physician.

Indications and Limitations of Coverage

ABPM must be performed for at least 24 hours to meet coverage criteria.

ABPM is only covered for those patients with suspected white coat hypertension.

Suspected white coat hypertension is defined as:

Office blood pressure >140/90 on at least three separate clinic/office visits with two separate measurements made at each visit;

  1. At least two documented blood pressure measurements taken outside the office which are <140/90 and
  2. No evidence of end-organ damage.
  3. The information obtained by ABPM is necessary in order to determine the appropriate management of the patient. ABPM is not covered for any other uses.

 

In the rare circumstance that ABPM needs to be performed more than once

in a patient, the qualifying criteria described above must be met for each subsequent ABPM test.

For those patients that undergo ABPM and have an ambulatory blood pressure of <135/85 with no evidence of end-organ damage, it is likely that their cardiovascular risk is similar to that of normotensives. Patients should be followed over time.

Patients for which ABPM demonstrates a blood pressure of >135/85 may be at increased cardiovascular risk, and a physician may wish to consider antihypertensive therapy

Resources:    Medicare.gov Website  

 

Thank you for listening to Medicare Nation!

If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation!

If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out!

If you have any questions, send them to Support@TheMedicareNation.com

If I can answer it in one email - I will personally answer you!

If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner.

Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show!

Thanks again for listening!

Diane Daniels

Jun 21, 2019

Hey Medicare Nation!

www.TheMedicareNation.com

Today, I'm discussing how the Centers for Medicare & Medicaid Services (CMS) SLAPPED Agewell New York LLC with a Civil Money Penalty of $39,200!

CMS conducts audits to ensure Medicare Advantage Prescription Drug Plans are following conditions of the current contract as well as Medicare rules & regulations. 

From March 9, 2018 through May 15, 2018, CMS Conducted an audit of Agewell's 2016 Medicare financial information.

In a financial audit report issued on September 20, 2018, CMS auditors reported that Agewell failed to comply with Medicare requirements related to Part C (Medicare Advantage) cost sharing.

Specifically, auditors found that in 2016 Agewell failed to comply with cost-sharing requirements by charging "incorrect" co-payments to enrollees for medical services.

Enrollees were affected in the following area:

Bronx, NY; Kings County Brooklyn, NY; Nassua County, NY, Manhattan, Queens and Westchester County, NY.

Agewell's failure was "systemic," and "adversely affected" enrollees or the substantial likelihood of adversely affecting enrollees because they experienced out-of-pocket costs.

CMS determined that Agewell was charging a $30 "specialist" co-pay was applied to "primary care physician" claims instead of a $0 co-pay as stated in the plan's Explanation of Coverage.

Enrollees were NOT Refunded the overcharged amounts until AFTER the financial audit concluded, which was 2 years after the incurred cost.

In 2016, If you paid a $30 co-pay to see YOUR Primary Physician, when you were only obligated to pay $0,  you should contact Agewell at 888-586-8044 and ask to speak to a supervisor, regarding the CMS penalty. Advise the supervisor of the date & time of your appointment with your Primary Doctor and that you have proof of a payment that you made of $30 for your visit. Advise the supervisor that you would like to be refunded the $30 immediately. 

Write down the name of the supervisor, the date & time you called Agewell and what the supervisor stated Agewell would do for you.

If you donot receive your refund within 14 business days, call Medicare directly at 800-633-4227 and advise Medicare of the situation.

If you have any "complaints" regarding the way you were treated by any representative at Agewell, you can make an annonymous complaint to Agewell's confidential hotline - 888-336-7240.

You can also make a complaint to Medicare directly by calling 800-633-4227.

If you have a complaint, regarding any physician or facility in the Agewell network, you can call the Agewell confidential hotline to make your complaint - 888-336-7240.

If you are uncomfortable making a formal complaint and you would like assistance with your complaint you can :

1. contact the Insurance Agent or Medicare Specialist who enrolled you into the Agewell plan 

or

2. contact your local "SHIP" (State Health Insurance & Assistance Program) representative by "clicking" on your State here - https://www.shiptacenter.org/

when the page opens, go all the way to the bottom of the page and you'll see an "orange" button that reads -

Find Your Local SHIP

"Click" on that ORANGE buton and a list will come up of all 50 States.

"Click" on the State where you reside, to contact your local SHIP center.

If YOU need help with finding the Medicare Advantage Plan that is right for your UNIQUE needs, contact me at either:

Support@TheMedicareNation.com

or 

call me at 855-855-7266

If I can answer your question in ONE paragraph in an email, I will directly answer your question!

If it takes more than one paragraph to answer your question or I need to do research to answer your question....then....I will respond by advising you that you will need to contact me and request my consultative services. 

I currently charge $199.00 an hour, and I consult with Medicare beneficiaries and the Adult Children of beneficiaries ALL over the country!

Please SUBSCRIBE to Medicare Nation so that you will receive EVERY NEW episode that is published!

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When the page opens, "Click" on the Review tab and leave your review!

Thanks so much for listening!

If you'd like to hear about a specific topic on the show or you'd like a specific guest on the show...... send me an email to Support@TheMedicareNation.com

I appreciate your Support!

Diane Daniels

 

Jun 14, 2019

Multi Target Stool DNA Test  vs. Fecal Occult Blood Test

 Hey Medicare Nation!

www.TheMedicareNation.com

Have you subscribed to Medicare Nation? Don’t know how?

If you have an Apple iPhone……. Click on the “Purple” icon…. With the white microphone. When the page opens….Click on SEARCH. Type in Medicare. Medicare Nation comes right up… WHY……BECAUSE….. it’s a TOP 100 APPLE PODCAST Nation!

Click on that Beautiful Flag “Medicare Nation” Logo. When the page opens….Click on the SUBSCRIBE button! That’s it. You’ll get the latest information on Medicare and you can search through the almost 100 episodes on Medicare Information!

Are Your Parents subscribed to Medicare Nation? Come On “Sandwich Generation” Show your parents HOW to Subscribe to Medicare Nation! Once they subscribe…. They will STOP asking you questions about Medicare, because they WILL Find the answer by listening to Medicare Nation episodes!

Let’s give YOU back some time…. So that YOU can have more time for yourself

 

Today…..I’m going to be talking to you about the Differences Between Multi Target Stool DNA Test  vs. Fecal Occult Blood Test

Medicare offers these Preventative Tests to determine if you have blood in your stool and/or suspected cancerous characteristics.

ColoRectal  cancer (CRC) is the second most frequent cause of cancer DEATH in the United States.  The Most Frequent Cause of Cancer Death is…… Lung Cancer.

This year, an estimated 145,600 adults in the United States will be diagnosed with colorectal cancer.

According to Cancer.net…… an estimated 51,020 of the 145,600 adults will die this year…..due to ColoRectal Cancer.

When colorectal cancer is found early, it can often be cured. CURED Nation!

This is due to improvements in treatment and increased screening….. which finds colorectal changes before they turn cancerous and cancer at earlier stages.

Medicare Part B offers TWO Preventative Screening Tests

The First…. Is a Fecal Occult Blood Test

“Fecal Occult” Blood Test is just a scary way of saying….. “ Looking for Blood in your Poop.”  The test ONLY detects the “presence” or “absence” of blood in your stool. The test does not indicate potential sources of bleeding and it does not “Diagnos” disease.

“Fecal” means……“Stool” or “Poop”….and…. “Occult Blood” means you can’t see the blood in your stool with the “naked eye,” so….. the specimen is sent to the lab for a closer look.

Blood in the stool may indicate polyps…. or it may indicate cancer in the intestine or rectum….though not all cancers or polyps bleed.

If blood is detected through the “Fecal Occult Blood Test,” additional tests may be needed to determine the source of bleeding as well as “diagnosing” an ailment or disease.

Blood in the stool could also mean Hemorrhoids….which are swollen veins in the lowest part of your rectum and anus.

Sometimes the walls of these blood vessels stretch so thin….. that the veins bulge and get irritated, especially when you poop! Straining while pooping is a major factor in Hemorrhoids.  EAT more Fiber Nation! Eat More Vegetables….try Metamucil or Miralax. Straining to poop is not good. Drink more water! You should try to drink at least 96 oz. a day. I use a 24oz bottle I fill 4 x a day….. to get my 96 oz of water. You can do it. It’s important.

Hemorrhoids can cause itching & pain.  Hemorrhoids can also bleed.

There are several types of Fecal Occult Blood Tests,

I’m going to discuss the “newer version,” which is called a “ Immunochemical Fecal Occult Blood Test,” (aka iFOBT or FIT)

The IFOBT or FIT test is less of a mess and easy to administer.

Typically, you have a “spoon-like” device to collect the sample of stool and you place the device into a collection container then seal it.

You either return the collection container to your doctor’s office, or you mail it.

There are no dietary restriction with the iFOB-IT and the test can be performed on any random sample of your stool.

Your Doctor will review the results and there are just two options:

  1. Negative Result, which means no blood was detected in the stool sample you provided.

OR……..

  1. Positive Result, which means blood WAS detected in the stool sample you provided.

 

This type of test ISN’T ALWAYS accurate.

Your fecal occult blood test could show a negative test result when cancer is present (false-negative result) if your cancer or polyps don't bleed.

If you had the test to screen for colon cancer and you're at average risk — you have no colon cancer risk factors other than age — your doctor may recommend waiting one year and then repeating the test.

 If you have a “positive result,” You may need additional testing — such as a colonoscopy — to locate the source of the bleeding.

Under Medicare…… The Fecal Occult Blood Test…. can be given ONCE every 12 months if you’re 50 or older, at ZERO Cost to you.

 

     Now….. let’s take a look at Mult-Target Stool DNA Tests.

You will know the “Multi-Target Stool DNA Test” more commonly known as “ColoGuard.”

ColoGuard …….   addresses several barriers to colorectal screening.

  1. Patient concerns with colonoscopy. Include…having to schedule a separate and lengthy appointment at the testing facility.
  2. The need to undergo a “Stay Close to my Bathroom” bowel preparation
  3. the exposure to sedation or anesthesia……and
  4. the discomfort associated with an invasive imaging process…. Of sticking either the “colono-scope” during a colonoscopy or a flexible sigmoud device up your butt.

 

By comparison, the “Multi Target Stool DNA” screening test is a noninvasive, “multi-marker”, stool-based ColoRectal Cancer screening test…..

that detects altered De-oxyribo-nucleic Acid (DNA), , as well as a fecal immunochemical test (FIT)… for blood released from cancer and precancerous lesions of the colon.

The presence of fecal hemoglobin….. even in the absence of elevated DNA markers…..can lead to a positive result given the weighted nature of the Multi Target Stool DNA algorithm.

Patients may collect and mail stool specimens from their homes with no bowel preparations and no dietary or medication restrictions.

 

Medicare covers this at-home multi-target stool DNA lab test…. once every 3 years…if you meet ALL of these conditions:

 

  • You’re  between the age of  50-85.
  • You show NO CURRENT symptoms of colorectal disease including, but not limited to one of these:
  • Lower gastrointestinal pain
  • Blood in stool
  • Positive Guaiac fecal occult blood test….which is an older version of the Immunochemical Test… where you “smear” stool onto a TEST Card with a wooden applicator or brush. The Guaiac test has dietary restrictions and you are required to collect “TWO” or more samples from the same Stool Sample for the test. Much Messier than the Immunochemical Fecal Blood Occult Test.
  • OR……
  • A Positive Result from a Fecal Blood Occult Test

ALSO    YOU NEED TO BE…..

  • at average risk for developing colorectal cancer, meaning:
    • You have no personal history of  (adenomateous ) polyps”  which are …..  a common type of polyp. They are gland-like growths that develop on the mucous membrane that lines the large intestine. They are also called adenomas:

You have no personal history of  … colorectal cancer, or inflammatory bowel disease, including Crohn’s Disease and ulcerative colitis.

OR……

  • You have no family history of colorectal cancers or adenomatous polyps, familial adenomatous polyposis, or hereditary nonpolyposis colorectal cancer.

 

If you meet the above criteria….. You pay nothing for this test if your doctor…. or other qualified health care provider accepts Medicare.

 

So that’s the difference between Multi Target Stool DNA Tests vs. Fecal Occult Blood Test.

 

If you haven’t had one of these preventative tests, speak to your primary doctor and get one. It could very well SAVE YOUR LIFE!

 

If you have any questions about Medicare…. Send me an email to –

Support@TheMedicareNation.com

 

I answer ALL my emails. As long as I can answer your question in a paragraph, I’ll answer your question.

If my response involves any research or it will take more than one paragraph to answer you….. I’ll send you a suggestion to hire me as your Medicare Consultant.

 

I charge $199.00 an hour. I’m one of the TOP Medicare Experts in the Country Nation…… I could easily command $400 or $500 an hour, but I CARE about each and every one of you! My time is extremely valuable and I want to help as many of you as I can with your Medicare problems and Medicare Plan Comparisons.

 

Also…..if you’d like to have me speak about Medicare … go to the website…  www.TheMedicareNation.com and click on the Contact tab and send me your information.

I’ve already started booking speaking engagements for the Annual Enrollment Period…. Starting in October…so contact me now to schedule me for your corporation or event.

 

Thanks for listening to Medicare Nation! I appreciate your loyalty and referrals.

Until next time…. I want YOU to have a Peaceful, Happy & Prosperous Week!

 

Diane  

 

 

 

 

 

May 31, 2019

Hey Medicare Nation!

www.TheMedicareNation.com

I'm not an expert on Reverse Mortgages......in fact, I don't know much about them.

I have heard about Reverse Mortgages on commercials, in newspapers and on FaceBook feeds. I never had the need to learn about Reverse Mortgages, so...... I never did......until...... a client asked me about them.

When a client asks me a question about Medicare..... I know the answer. I'm a Medicare Expert....I'm in the business of knowing as much as I can about Medicare. 

Because my clients trust me with their Medicare needs and concerns, they ask me all kinds of questions. When I know the answer.... I tell them. When I don't know the answer..... I get the answer for them!

So....when my client asked me about Reverse Mortgages.... I started reading about them.

When I was introduced to Michael Banner, President of Professional Mortgage Alliance, LLC, I had many, many questions.

Michael Banner was very patient and answered every question I had..... truthfully.

An hour and a half later..... I had a much better idea about reverse mortgages, and I invited Michael Banner to come onto The Medicare Nation Podcast to share his knowledge with our Medicare Beneficiaries and Sandwich Generation!

Here are the highlights of my interview with Michael Banner:

* What is a Reverse Mortgage?

*  Do I pay a higher intersest rate with a Reverse Mortgage?

*  If I "Will" my home to my children.... what happens to the      Reverse Mortgage?

*  What is a Non-Recourse Loan?

* What does it mean if the value of my house is "upside              down?"

*  What is No-Debt Service?

*  Is a Reverse Mortgage Safe?

*  If a person leaves the home to live in an assisted living          facility, what happens to the Reverse Mortgage?

*  Can a person "out live" a Reverse Mortgage?

* What are the "5 Ways" payments are made with a Reverse     Mortgage?

Want to learn more about Reverse Mortgages?

Reach out to Michael Banner at :

MBanner@PMAnow.com

Website for Professional Mortgage Alliance, LLC

Professional Mortgage Alliance

Michael Banner's Phone Number -  (727) 224 - 3859

Where to purchase Michael Banner's Book -

MBanner@PMAnow.com

 

The 62 Who Knew Show

www.WeBeamTV.com

 

Have Questions About Medicare?

Send me an email to - Support@TheMedicareNation.com

If you'd like to hire me as a Medicare Consultant, starting 

June 1, 2019.... my rate is $199.00 an hour.  Contact me by either email at .... Support@TheMedicareNation.com

or ... call me ..... 855 - 855 - 7266.

Thanks for listening to Medicare Nation!

SUBSCRIBE to Medicare Nation and get the latest episodes delivered to you!

Give us a Rating & Review on iTunes!

This helps others find Medicare Nation so that they can have their Medicare questions answered too!

www.TheMedicareNation.com

Until next time.... have a happy, peaceful & prosperous week!

Diane Daniels

May 17, 2019

Hey Medicare Nation!

www.TheMedicareNation.com

On the Last episode.....I spoke to you about Medicare Supplement Plan "F" and High Deductible Plan F.

Today....I'm going to talk about Medicare Supplement Plan "G" and Plan "N"

Plan "G" allows you to "purchase" an insurance policy, where you pay a monthly premium to the carrier......

in return...... Medicare Supplement Plan G, will pay ALL your Medically necessary out-of-pocket deductibles, co-insurance and co-pays...... EXCEPT for ..... The Annual Part B Deductible. YOU will be responsible for the Annual Part B deductible each year.

Currently.... in 2019, the Annual Part B Deductible is $185.00.

So..... when you seek medical care in the beginning of the year.... you will pay out-of-pocket until you hit the $185.00 Part B Deductible.

After you pay the $185.00 Part B Deductible....you will NOT be responsible for ANY other deductibles, co-pays or co-insurance under Medicare Supplement Plan G, that are medically necessary under Medicare.

Plan "N" allows you to "purchase" an insurance policy, where you pay a monthly premium to the carrier......

in return...... Medicare Supplement Plan N, will pay ALL your Medically necessary out-of-pocket deductibles, co-insurance and co-pays...... EXCEPT for .....

1. The Annual Part B Deductible ($185.00 in 2019)

2. A co-pay of up to $20.00 for each doctor visit.

3. A co-pay of $50.00 if you go to the Emergency Room and you are "Discharged" from the Emergency Room.

If you are "admitted" to the hospital from the ER... you will NOT incur a $50.00 co-pay.

If you have paid all of your Part B Deductible, you will have NO other out-of-pocket costs while you are an inpatient in the hospital.

4. If you seek treatment, testing or diagnostic testing from a physician or facility that does NOT accept Medicare, you WILL be responsible for 100% of the cost of that service.

The provider or facility can legally charge you 15% above and beyond the Medicare Allowable charge.

It is vital that you always ask prior to receiving care, a test or doctor visit....if the physician or facility "accepts Medicare." 

If they do.....your charges are outlined above.

If they do not accept Medicare..... you may be responsible for ALL of the charges, up to 15% of the Medicare Allowable charge.

ASK BEFORE YOU SEE A DR or RECEIVE TREATMENT!

Prices for Medicare Supplements VARY by zipcode!

Get quotes from MANY different insurance carriers prior to enrolling in a plan. You could save hundreds....sometimes over a thousand dollars a year!

HAVE a Question for ME?

Send it to me at  Support@TheMedicareNation.com

I will answer ALL emails I receive.... personally!

If the answer to your question will take me more than 1 paragraph to answer... or .... it is necessary to do some research for you in order to answer the question.... I will respond and advise you to hire me as your consultant.

Many of your questions may be answered on the official Medicare website - www.Medicare.gov

Always do YOUR Due Dilligence before you enroll in a Medicare Plan!

Consider leaving a review & rating on the Medicare Nation Podcast page in iTunes. 

http://nation.reviews/medicare8

 

Thanks for listening to Medicare Nation!

Show your Parents how to "Subscribe" to Medicare Nation. With over 100 episodes... most of their questions will be answered by listening to my episodes.

This way... your parents are NOT bothering YOU for information about Medicare! Enjoy time for yourself and your family!

Teach people how to "subscribe" to Medicare Nation!

YOU will be responsible for the Annual Part B deductible each year.

Apr 15, 2019

Hey Medicare Nation!

www.TheMedicareNation.com

More than 10,000 people a day are turning 65!

While qualifying for Medicare Part A and Part B, Medicare Beneficiaries are VERY confused as to what type of plan to enroll in, to "supplement" Original Medicare.

By zipcode, a Medicare Beneficiary may have over "100 Plans" to choose from to help supplement their Original Medicare.

That's an ENORMOUS amount of research to do!                  If you have the time and enjoy doing all that research.......go for it!

If you're like most Medicare Beneficiaries, you are retiring and you want to ENJOY LIFE! You don't want to "waste" time researching Medicare Plans.

Call a "Medicare Consultant" or "Medicare Specialist" to assist you in finding the plan that will fit YOUR unique needs.

How do you do that? 

"Google" "Medicare Consultant" or "Medicare Specialist" and add your city or zipcode to that search.

As an example, you would search....Medicare Consultant Tampa FL......or........Medicare Specialist Dallas TX.......

Google will then populate the "Ads" first. Businesses PAY to be on the top of the 1st page of Google.

SCROLL down past the "ADS." Just because a business "Pays" for an ad DOES NOT mean they are the best option for you.

You will start seeing local businesses and names of Medicare Specilaists. 

You should be checking out these "Brokers" and "Medicare Specialists" or "Medicare Consultants."

I'm speaking specifically about Medi-Gap Plan F and the High Deductible F Plan.

The Supplement F Plan to Medicare, is an Insurance Policy you take out on yourself.

Medi-gap Plans are NOT part of Medicare. Medi-Gap Plans are an insurance policy that an Insurance Carrier sells to you.

You are "purchasing" a policy, where you pay a monthly premium to the Insurance Carrier to protect some or all of  your out-of-pocket costs associated with Medicare.

Medi-Gap "F" Plan pays the out-of-pocket costs YOU are responsible for. The "F" Plan will pay your "medically necessary" out-of-pocket costs.

Plan F pays for your Part A In-Patient Hospital Deductible. Plan F pays your co-pay for being in a Skilled Nursing Facility.

Plan F pays your Annual Part B deductible and Plan F pays your 20% co-insurance under Part B.

Plan F pays for all of this, for one monthly premium.

ALL Medicare Plan F Plans have EXACTLY the same benefits. It doesn't matter if you live in Tampa, FL......San Francisco, CA.....or Salt Lake City, Utah.....The BENEFITS under Plan F are the SAME!

What IS different..is the MONTHLY PREMIUM!

In YOUR ZipCode.......there may be up to 50 DIFFERENT Insurance Carriers that offer Plan F....EACH one of those Insurance Carriers offer a DIFFERENT Premium for the SAME Plan F Plan.

You should find the LOWEST Monthly Premium from the Insurance Carrier that has an "A" Financial Rating.

An "A" financial rating means the company WILL pay your claims. That's the Insurance Carrier your looking for.

Plan F is the "Peace of Mind" Medi-Gap Plan. There is NO Network of Doctors and Facilities....because......Plan F is NOT part of Medicare. 

Original Medicare has NO Network.....Original Medicare allows you to see ANY Doctor....or go to ANY Medical Facility in the U.S. that ACCEPTS Medicare!

YOUR Health Insurance IS......Original Medicare.....NOT your Plan F!

So.....if you're looking for a Medicare Supplement Plan that will cover ALL your Medicare Necessary out-of-pocket costs...Then Plan F is for you.

Now.....let's take a look at the High Deductile F Plan.

The High Deductible F Plan.....has a DEDUCTIBLE!

For 2019.....the annual deductible is $2,300.00

That means......you WILL pay-out-of-pocket until......you reach the $2,300 DEDUCTIBLE. When you reach the $2,300 deductible, the plan will then pay all your "medically necessary" out-of-pocket costs that you are responsible for under Medicare, for the remainder of the calendar year.

You will NOT pay the "Cash" price......you will be paying the Medicare Allowable price....BIG difference.

If you go to a cardiologist, and the visit under Medicare, costs a total of $150, Medicare will pay 80% of that amount.... which is $120. you would pay the remaining 20%, which $30.

You would continue to pay out-of-pocket until you reach $2,300.

If you don't see many doctors or have any diagnostic tests, you will ONLY pay for the services you use.

For a healthy person, this could be a very viable option.

If you are a person with a chronic illness, let's say for example...Diabetes......Asthma.....or high cholesterol with high blood pressure.....this plan may NOT be a good choice for you.

It's important for you to take into consideration your own health history, what medications you take, your financial status and what doctors you see, before enrolling in a Medicare Plan.

Next time, I will go over the differences between Plan G and PLan N.

If you are turning 65....or.....you are getting ready to come off of your employer plan and you need to figure out what Medicare Plan will suit your needs best.....

Contact Me!

Reach out to me by email -

Support@TheMedicareNation.com

or.....

by phone....... (855) 855 - 7266.

I will help you find the plan that fits YOUR unique needs.

Go to my website..... www.TheMedicareNation.com

for more information.

Until next time.....have a very happy, a very healthy and Prosperous week!

 

Diane Daniels

 

Mar 15, 2019

Hey Medicare Nation!

www.TheMedicareNation.com

It's almost Spring time! For many people, this has been a terrible winter. Many Medicare Nation listeners have been emailing me to find out if Medicare covers "Emergencies" while traveling across the U.S. or abroad.

That's a great question!

Original Medicare and Medicare Advantage Plans Do cover "Emergency Care" AND  Urgent Care ANYWHERE in the United States and it's Territories.

An "Emergency" is Life-Threatening. An example would be if you were having chest pain and you believed you were having a heart attack. In this situation.....you would go to the nearest hospital to seek emergency care.

Even if it turns out you were diagnosed with "heart burn," Original Medicare AND Medicare Advantage plans will cover the medically necessary treatment for this situation because you believed you were in a "life-threatening" situation.

 "Urgent Care" is defined by Medicare as:

Care that you get outside of your Medicare health plan's service area for a sudden illness or injury that needs medical care right away but isn’t life threatening. If it’s not safe to wait until you get home to get care from a plan doctor, the health plan must pay for the care.

An "Urgent Care" example would be if you were walking in St. Peter's Square at the Vatican, and you slipped on a banana peel and fell onto the ground, breaking your ankle. That's an injury that isn't life threatening, but requires immediate medical care.

So......if you are traveling ANYWHERE in the U.S. or it's Territories, AND you have an Urgent Care or Emergency situation.....you can go to the nearest hospital or Urgent Care Center to receive care AND it will be covered by Original Medicare and Medicare Advantage Plans.

If you are traveling outside of the U.S. Medicare generally DOES NOT cover emergencies or urgent care needs.

There are a few circumstances where Original Medicare WILL cover Emergency Care AND Urgent Care.

www.TheMedicareNation.com

1.  If you are on a CRUISE and you require EMERGENCY care from a doctor who is stationed on the ship while the ship is in a U.S. port.....Your Emergency Care WILL be covered by Original Medicare.

2. If the ship is Departing or Arriving to/from a U.S. port within 6 hours and you have a medical emergency and require to be treated by the ship's doctor......Your Emergency Care will be covered by Original Medicare.

3. If you are in Alaska and you are traveling directly to another State without unreasonable delay, and you require Emergency Care at a hospital in Canada, because it was the closest hospital at the time of the emergency......Your Emergency Care will be covered by Original Medicare.

If you have a "Medicare Advantage Plan," you may have coverage for Emergency and/or Urgent Care Coverage on your plan.

You must do your own due dilligence to understand the benefits of your plan while you are traveling abroad.

Some Medicare Advantage Plans have a deductible for emergency care outside the U.S.

Some Medicare Advantage Plans have a deductible and a co-pay for emergency care outside the U.S.

There is an annual maximum out-of-pocket amount for your plan. Some are around $1,500.00 all the way up to $6,700.00 

READ Your Plan's EVIDENCE OF COVERAGE Booklet.

Some of you have "Medi-Gap" or Supplement to Original Medicare Plans.

Plans "C" through "G" and also plan "M" and "N" have coverage for Emergency Care while traveling abroad.

Some Medi-Gap plans have a deductible. Some plans have "Maximum Lifetime Amounts." It is important to READ your Medi-Gap Policy to determine coverage while traveling abroad.

Travel Insurance

www.TheMedicareNation.com

 

I always recommend purchasing "Travel Insurance," while traveling abroad.

I use these different websites to look for policies:

1. www.TravelGuard.com

2. www.AllianzTravelInsurance.com

3. www.TravelInsurance.com

Cost will depend on -

a. Total Cost of the Trip

b. Your Age

c. What country you're visiting

d. Types of coverage you're adding (ex: Air evacuation, cancel for any reason etc.)

If you have ANY questions, and I can answer your question in ONE paragrapn, send them to me by email.

Support@TheMedicareNation.com

If I need to do research or write more than one paragraph, I will let you know that I am available for a consultation to solve your problem at $150.00 an hour.

Reach out to me.....I answer all emails personally!

Thanks soo much for listening to Medicare Nation!

I appreciate your time and I love to educate you on all things Medicare!

Diane Daniels

 

 

Jan 11, 2019

Hey Medicare Nation!

htpps://www.TheMedicareNation.com

 

Today, I'm going to speak with you about the Medicare Advantage Open Enrollment Period.

CMS...Centers For Medicare & Medicaid Services has issued a new regulation that began January 1, 2019.

Under 42 CFR 422.62(a)(3)....CMS published the following:

During the MA OEP, MA plan enrolles may enroll in another MA plan or disenroll from their MA plan and return to Original Medicare. Individuals may make only one election during the MA OEP.

Who can use the Medicare Advantage Open Enrollment Period?

1. Individuals enrolled in Medicare Advantage plans as of January 1.

2. New Medicare beneficiaries who are enrolled in an Medicare Advantage plan during their Initial enrollment into Medicare

      a. The month of entitlement to Part A and Part B up until the last day of the 3rd month...after the month of their entitlement to Part A and Part B.

Can Medicare Advantage beneficiaries add or drop their Part D coverage during the Medicare Advantage Open Enrollment Period?

Yes. Individuals who are already enrolled in a Medicare Advantage Plan with Prescription Drug Coverage can switch to:

a. Another Medicare Advantage Prescription Drug Plan

b. A Medicare Advantage Plan ONLY (with NO prescription drug coverage)

c. Go back to "Original Medicare" and add a stand-alone prescription drug plan or don't add one.

d. Go back to "Original Medicare" and add a Supplement to Original Medicare Plan. 

 

 How long is the Medicare Advantage Open Enrollment Period?

It runs from January 1st through March 31st each year.

 

How many times may a Medicare Beneficiary change Medicare Advantage Plans during the MA OEP?

A Medicare Beneficiary may make only ONE change during the MA OEP.

 

If you have ANY questions regarding the MA OEP....

and you would like me to answer it in ONE paragraph, send me an email to 

Support@TheMedicareNation.com

I ALWAYS answer emails if I can answer them in ONE paragraph.

If I can not answer your question in one paragraph, you may hire me and I charge $150.00 hr.

I can answer ANY question about Medicare and I can solve ANY problem you have with Medicare.

Looking for more information on Medicare?

Go to www.TheMedicareNation.com  website.

Looking for a SPEAKER at your conference or event?

Just click on the "Contact" tab on the website.

 

Thank you so much for listening to Medicare Nation. I appreciate it very much!

If you feel I'm delivering important content, I would love it if you would leave a rating & review on the Apple Podcasts review page (formerly iTunes).

Until next time Nation.....I want each of you to have a Happy, Peaceful and Prosperous week!

Diane Daniels

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