GAME CHANGERS MAGAZINE | 26
LET ’ S TALK
HEALTH & MEDICARE INSURANCE
At GEL Health Advisors , we constantly remind ourselves that we are in the business of getting wealth . Our health is our wealth . Our main focus is to educate and then serve . ‘’ People suffer because of the lack of knowledge .”
As ‘ Agents with a Servant ’ s Heart ’, we have specific goals that have to be done . First , we access our client ’ s unique situation . Second , design a Health Insurance Program and assist in choosing a plan that fit their health and financial needs . Our main goal is to improve the quality of life for our clients and even people that are not our clients .
We take care to get as many benefits as we can for the least amount of money . However , we do want to design a complete Health Insurance Program and sometimes a Gap Plan need to be added . Gap plans help reduce the cost of copayments and deductibles .
For our Medicare Clients we have a Program we call ‘ A LongTerm Care Clone Using Medicare Advantage ’ to keep our clients safe at home as long as possible , especially our chronic conditioned clients .
LongTerm Care Clone : Medicare actually does not cover long-term care , but using the benefits that are a part of some Medicare Advantage plans will help more beneficiaries to live at home . We use the term beneficiaries when we talk about Medicare Clients instead of Seniors , because not all Medicare Clients are Seniors . People who have been on disability for 24 months qualify for Medicare . In addition , people with certain chronic diseases such as Lou Garrison Disease and End Stage Renal Disease qualify for Medicare .
Before we explain the topic , keep in mind that to qualify for a Medicare Advantage plan , the plan must
1 . be available in the beneficiary ’ s service area , meaning the beneficiary ’ s permanent address , not POB , that is listed with Medicare .
2 . a beneficiary must have Medicare Part A and Medicare Part B and have their new Medicare Card that was issued approximately 2 years ago . All of the recent issued cards will have the new number . You can give us a call if you need assistance in getting this card . 817-381-1500 .
Some of the benefits in these plans can keep people at home longer and sometimes they never to go to the nursing home . Not in all cases now but some . Remember , I ’ m not a doctor ; we are Health Insurance Advisors .
In addition , there are some Gap Plans outside of Medicare like Hospital Cash , Home Healthcare Short-term Stay Plans , that can assist also .
So , let ’ s talk about the services that Traditional Medicare provide .
• Nutrition services
• Home safety devices , such as grip bars for your bath .
Medicare will only cover long-term care if a beneficiary requires skilled services or rehabilitative care under Part A . This start with acute hospital care , and can transition to skilled nursing care and hospice care .
These are the steps required to receive traditional LongTerm Care through Medicare : 1 ) a beneficiary must be an inpatient at an approved hospital for at least three days ; 2 ) they must be admitted into a Medicare-certified nursing facility within 30 days of the inpatient visit ; 3 ) beneficiary must require physical or occupational therapy along with a medical condition that demands skilled nursing services . Remember it is important to note that coverage is limited and only available on a short-term basis . long-term care benefits carry a 100-day cap . Once this is exceeded , the beneficiary is responsible for 100 % of the costs .
Now this is how our LongTerm Care Clone works . Medicare Advantage plans were design to cover everything that traditional Medicare plans cover and can add other valuable supplements . In Addition , due to legislation passed in 2018 , Medicare Advantage plans include benefits for supplemental home care services for chronically ill beneficiaries as well .
Now , Medicare does not provide for Assisted Living Expenses , but some of the benefits are awesome when it comes to living at home with a chronic condition and the expenses associated with them . These services will not be needed by everybody , but for those that need them , they are great .
Adult daycare service : It is exactly as the name says , Adult Daycare Services . These centers are designed to keep the beneficiary engaged in a wholesome environment with their on Medicare and put emphasis on memory care and physical ability . This is a valuable access for the Caregiver .
In-home personal care services :
Beneficiaries receive assistance with daily activities such as getting dressed , eating , using the bathroom , etc . The length of time and days vary on these benefits .
Call a Doc Services : Beneficiaries can call a doctor ’ s office by phone or computer and not have to get up , get dress , get to the car , go in the doctor ’ s office , waiting for 3 hours , see the doctor for 10 minutes , get back in the car , go get a prescription filled , get back in the car , go back in the house , get undress and take a nap for this activity . You get the picture .
Prescription Delivery Services :
This service is available to everyone on a Medicare Advantage or Prescription Drug Plan .
Over the Counter Products :
Beneficiaries can shop at their own drug store by viewing a catalog of items in the Over The Catalog or on phone or Computer . Beneficiaries order those items and they are delivered to their front door . These include non prescription items such as aspirin , cold medication