Paying For Home Health Care – What Do Medicare and Medigap Cover?

Prescribed only by a physician, home health care is skilled nursing care that aids in the recovery from illness, injury, or surgery in the patient’s home. And fortunately for many seniors who are now opting for care at home, Medicare insurance covers most costs related to home health care.The government, however, has set some limitations on payouts – you are only eligible if you need intermittent care (usually defined as seven days a week or less than eight hours a day over 21 days or less) (1), physical/occupational therapy or speech language pathology; you are homebound; and the home health care agency providing care is approved by your Medicare insurance program.In addition to medication administration, general supervision, and therapy services, the Medicare home health benefit covers a number of other necessities, including medical aids and supplies to aid in recuperation. On the occasion, though, you may be required to cover some of the costs associated with home health care. But what can you expect to pay out-of-pocket that’s not covered by Medicare dollars?Medicare Insurance: Part A and Part BHospital Insurance (Medicare Part A) helps cover the costs of your inpatient care at hospitals, skilled nursing facilities, or religious non-medical health care establishments. Part A can also help cover hospice and home health care services. Individuals aged 65 and older are usually automatically enrolled in Medicare Part A and do not have to pay a monthly premium if Medicare taxes were paid while working. If you did not pay taxes, you are still eligible, but you will be required to pay a monthly premium.Medical Insurance (Medicare Part B) helps cover services such as those offered by your physician and outpatient care. Many seniors maintain their enrollment in Part A, but elect not to use Part B, which requires a monthly premium that is dependent upon income, the requirements of which change yearly. Unfortunately, if you didn’t sign up for Part B when you were first eligible for insurance, your premium may be slightly higher (2).For questions on your Medicare insurance benefits, you should contact 1-800-MEDICARE or read the handbook mailed to you each year entitled “Medicare and You.”What’s Covered and What’s NotMedicare insurance pays for physical and occupational therapy and speech language pathology services, counseling, some medical supplies, durable medical equipment (which must meet coverage criteria), as well as general assistance with daily activities which include dressing, bathing, eating, and toileting. For most other medical equipment, Medicare insurance will cover 80% of its cost (3).However, Medicare will not cover twenty-four hour care at home, meals delivered to your home, and services unrelated to your care such as housekeeping. Of course, as mentioned above, you will be required to pay 20% for medical equipment not fully covered by Medicare insurance such as wheelchairs, walkers, and oxygen tanks (4).In some cases, your home health care agency may present you with a Home Health Advance Beneficiary Notice (HHABN), which, simply put, means if your agency is ceasing your care services, you will be presented with a written statement outlining the supplies and services the agency believes your Medicare insurance benefits will not cover as well as a detailed explanation of why. Should this situation arise, you do have recourse – the HHABN lists directions on acquiring the final decision on payment issues or filing an appeal if Medicare refuses to cover costs for home health care. In the meantime, you should continue receiving home health care services, but keep in mind that you will be paying for these services out-of-pocket until Medicare accepts your claims and remits past expenses.Medigap and Other Out-of-Pocket ExpensesMedigap, a supplemental insurance policy, is sold privately and covers the services and supplies not paid for by Medicare insurance. When used in conjunction, Medigap and Medicare can often cover a large majority of the costs of your home health care. Insurance companies offer a variety of different Medigap policies (A through L), but since each one comes with specific benefits, you’ll need to compare the highlights closely. Medigap policies vary by cost, and many insurance companies require you to have both Medicare Parts A and B in order to purchase a supplemental plan (5).For seniors with both Part A and Part B Medicare, your home health care situation is usually covered, save for the 20% out-of-pocket expenses for medical equipment. Just remember to keep track of your Medicare insurance benefits (and Medigap if applicable) by verifying with your physician, home health care agency, and insurance representative. Paying for home health care does not have to cost you an arm and a leg, but do be prepared for the occasional (but necessary) out-of-pocket medical expenses.Sources1. Centers for Medicare and Medicaid Services, Medicare and Home Health Care, page 6
2. Medicare website: “Your Medicare Benefits.”
3. Ibid.
4. Ibid.
5. Medicare website: “Medigap (Supplemental Insurance) Policies.”

Quitting Gambling

Why do you gamble? Most people do it to get ahead financially. I am here to remind you that it will not work for you. Key Point #1 If you slip back into gambling keep precise written records of time spent, wins and losses. The fact is (95-99% of people lose) and the tiny percentage of people who win usually average under minimum wage over the course of the year. But of course you are going to hit the jackpot.But, almost no one really understands their odds of hitting the jackpot. Yeah you are only one in 44 million to win but wouldn’t it be great if you did? To understand what those odds mean is, imagine you are in a high school football stadium with 1000 people. They are going to drop a Nerf ball and whoever catches it gets 30 million dollars. How many football stadiums do they need to fly over to make the odds 1 in 44 million? The answer is 44,000 stadiums all jammed with people.That’s also the odds (one in 44 million) of an ugly guy like me meeting their favorite movie star out of the blue and finding out that they are so excited about meeting me that they drop everything and want to start a relationship. Okay I apologize; I really didn’t mean to crush two of your favorite fantasies in one sitting. She really is going to like you when you meet her.The second reason many gamble is for fun. Most of us like to take a moderate amount of money we can afford to lose and have a fun night at the casino. The question is, once we go over the line of moderation can we increase our pleasure. The answer is you never can increase your pleasure with out of control gambling because even if you win, all you are doing is what I call “selling our pleasure back words”. When you win you get extreme pleasure because you beat the system. However when you lose it all a week later, plus some money you needed to buy necessities, you crash and have extreme pain with the situation you are now in.What happened is you gambled with money you could not afford to lose and won on Friday. This brought you increased pleasure. But when you lose it all the next Friday you have destruction and pain. A person who does not gamble has less pleasure then you on Friday #1. But then they have much more pleasure than you on Friday #2 because you got wiped out. They also do not get the destruction and pain you get on Friday #2 when you go broke. Please see my article Pleasure + Addiction = Pain for more information on how addiction never brings us more pleasure over the course of the month, year, and usually not even over the course of two weeks.If quitting gambling is hard for you it may help to get a photo of the person/persons you love most in life, on the back write how you feel when you have lost all your money and how your gambling would affect them and your relationship with them. Put it by your computer, or in your wallet when out, when you feel the urge coming have a good look and read what you have written.Ex gamblers say that they enjoy life more after quitting gambling. But when you tell yourself that you will be happier after quitting gambling be very specific. You will be happier for the month when you are clean but some days will be tough. I think that avoiding a couple of trips to the casino per month is worth it because I can be happy every day now. My new activities and passions give me less pain and more happiness and more money over the course of the whole month than gambling did. After after quitting gambling we are no longer a slave to being driven always by the addiction (which brings the stress with it). We understand that abstinence is healthier in all ways; financially, spiritually, emotionally and relationally.Gambling ruins your spirituality. Either permanently, or temporarily when you have a big loss. Out of control gambling is sometimes worship. You would have to tell me if you are worshipping greed, excitement, pleasure or something else. But what we do know is that when we are out of control we are not then worshipping God. I recommend you learn new habits about how to worship God who will bring you real joy. Not a manufactured, short term thrill which ends in destruction. You can read about how you can learn to worship God in my article called “addictions real issue.”One of the biggest keys to quitting gambling is to know (and have organized) what mental exercises you need to do to overcome the addiction. The following are examples of some types of exercises you may want to learn.1: Form a habit to say to yourself 5 times a day that “my gambling causes me financial destruction. It has in the past and it will in the future.”2: Have a list of the benefits of quitting gambling. Write down all the benefits then memorize the top 3 and top 6 benefits. This will allow you to say the benefits multiple times each day until you get on more solid footing in your recovery.3: Pray often each day “Lord keep me from temptation” (This is part of the Lord’s Prayer from the Bible). Pray about why you gamble. Is it for greed? Then pray a lot about that because the Bible says that the greedy will not inherit the kingdom of heaven. Is it for excitement? Then pray about what alternatives you can do to find excitement.4: Start a journal so that you can include all of the quitting gambling idea’s you find in one place so that you can review them often.I have over 25 articles about quitting addictions at my website.

Gambling Addiction

First we have to know what is addiction. It is a big issue in present era and most of people are suffering from it. An addiction is nothing but only a psychological craze or dependence towards anything specially any activity. Addiction occurs when someone fails his or her control and continuously by any mean that activity is making some harmful effect to him or her. Accordingly it can take place in anything like drugs, alcohols, food, and sex and when it comes to gambling field; it becomes really a serious issue among the gamblers.Unlike any other type of addiction this addiction is hard to identify. But generally it is seen when a person experiences win in several gambling and accordingly feels that they cant control their deep impulses to gamble and they can make a nice deal and gain more and more money through that type of activity without facing any trouble, that mainly play role in making addiction towards gambling field. Gambling addiction makes the gambler so impulsive that they can’t give any single thought to be involved again in this activity and in the winning stage the gamblers become so excited with their earnings that they don’t want to quit gambling by any mean. With that they feel their increasing intensity to gambling field. Even sometimes it is found that they are deterred by recurrent losses as they think that they can win again and get their money back. The addicted gamblers forget to think although it is a form of harmless entertainment and fun yet that can become a devastating illness too and can affect them negatively. It can lead the players very badly to big financial problems (when they start to borrow huge amount of money), mental restlessness, relationship stress and many other activities related to their lives.Thus a recreational sport gambling turns out to be a denting experience to any gambler when he gets addicted to this betting field. Like winning phase and losing (as discussed above) there is also desperation stage which can lead a gambler to get addicted horribly. Keeping hope in mind that they can earn more and more through this betting process and eliminate their losses which they may even face on every alternative day of their playing they become mentally fatigued. Unmanageable state of their increasing debts makes them desperate to face gambling every day. Desperately the gamblers are found engaging in illegal activities to finance their gambling. They may suffer badly by hopelessness, suicidal thoughts, even arrest, divorce and any other drug exploitation. That surely leads to a complete breakdown of an addicted gambler.Although gambling addiction cannot be identified so easily, there are some signs which can denote that addiction a little bit. That includes constant discussion about gambling, making gambling plan, gambling at any odd time, getting into a long debt circle, giving priority to only gambling not even to personal life and responsibilities and feeing the need to gamble to wipe off any practical issue or stress. It is only a concept but deliberately the sign of addiction is not confined among such behaviors only. There may be many other signs which assign gambling addiction.There are some treatment programs also for the addicted gamblers. The therapies and medication are supposed to be the most successful way to be cured from this addiction. Counseling with various support groups can also help to remove this type of addiction. But above everything for successful result in this treatment firstly it is required that the addicted person has to admit that he or she is facing restlessness with such type of activity and is feeling to give it up as soon as possible, unless and until the recovery process will not go make any further step.