Medicare, It's Not That Complicated
November 11, 2022
Hosted by Phyllis Ayman, MS/SLP, CDP, CADDCT, CDCM, CMDCP
The Medicare Enrollment period began October15 and continues until December 7th. For many of us the choices seem complicated, especially as we are bombarded with information, robocalls, and television commercials featuring high profile figures, actors, etc. The situation is ripe for people with less than honest intentions. Scammers seek to take advantage of the confusion and successfully dupe older adults out of millions of dollars each year. Where do you turn to get reliable information? Ari Parker has an extremely simple way of explaining it all. He breaks down the supplemental Medigap and Medicare Advantage plans in such simple terms, you'll wonder why it needs to be so complicated. Almost half of the 65 million people who have Medicare coverage also carry private insurance through Medicare Advantage Plans as an alternative to depending on government insurance alone. These plans are supposed to cover at least what Medicare covers which is up to 100 days of skilled nursing home care each year. However, these private plans can make their own decisions on how much nursing home care they are willing to cover.. But is that really clear when you' purchase a Medicare Advantage Plan? And while it all seems rosy when you purchase a plan, there are difficulties people encounter once they have to use the plan benefits. Here's an example that may give you pause for thought when looking into a Medicare Advantage Plan. The plans have a practice of ending coverage for nursing home and rehabilitation services before the person is ready to return home. When people are covered by traditional Medicare, the facility determines when the patient is ready to return home. With Medicare Advantage plans, the plan decides. Therefore, when ending coverage for someone earlier than they are ready, the person and their family can be faced with serious decisions as to whether to take the chance to appeal the decision or remain in the setting possibly amassing thousands of dollars in medical bills. Whose interest does this serve? Certainly not the patient. This situation can be very stressful for a family already stressed with their loved one’s condition. The federal government pays Medicare Advantage a set amount on a monthly basis for each person enrolled in the plan, regardless of how much care the person needs or receives. One could not help but think that this model provides an incentive for insurance companies to deny access to services and payment in order to increase their profits. That most probably isn’t new news to anyone. Listen in to hear Ari discuss this situation and others so that you are making an informed decision about medical care for you or your loved one.
Seniors STRAIGHT Talk
New Shows Weekly on VoiceAmerica Empowerment Channel
Seniors STRAIGHT Talk, formerly Voices For Eldercare Advocacy, is rebranding with expanded content and topics. The podcast will continue to highlight the all-important relevant issues for seniors, their families, loved ones and the population at large, who ultimately are our future selves. Through informative and engaging conversations with thought leaders, professionals, and individuals who share their experiences, listeners will gain insights and information that will be meaningful for their everyday lives. Phyllis’ expertise captures the essence of the topic of the day and translates it into relevant discussion that provides insight into everyday problems. As we transition into elderhood, which Phyllis calls the third act of life, seniors are entitled to have a quality and fulfilling life with dignity, respect and purpose no matter the age, condition or living environment. Seniors STRAIGHT Talk is available to listen and download on all your favorite podcast platforms.
Phyllis Ayman, MS/SLP, CDP, CADDCT, CDCM, CMDCP
Phyllis Ayman, host of Seniors Straight Talk, is a speech and language pathologist, certified dementia practitioner, trainer, and best-selling author who’s dedicated to improving quality life and quality care for older adults in our families, communities and nursing home residents. She’s best known for her communication skills, empathy, unwavering high standards, and believes strongly that care treatment of older adults is a direct reflection of society’s attitudes towards adults the elder years of their lives. She’s passionate about meeting the needs of our culturally diverse senior population and understands the root causes faced by nursing home residents after working in 50 nursing homes. Phyllis is passionate about teaching what she learned from helping your parents to how she can help you. Phyllis is an accomplished author and featured speaker and an accomplished trainer for both the public and private sector. Her latest book Dignity and Respect: Are Our Aging Parents Getting What They Deserve? became an instant Amazon bestseller. She’s published several articles and courses for healthcare workers and caregivers and holds a trademark for the word “IMpathy” (tm).
Phyllis serves as a board member of the Massachusetts Advocates for Nursing Home Reform, is an advisory board member to Olive Community Services based in Los Angeles, California and served as a member of the COVID19 National Health Care Coalition.