Each year, the Centers for Medicare and Medicaid Services (CMS) revises its guidelines for coverage to make way for inflation and the changing demands of the times. That said, seeing changes to how much is covered for a certain healthcare services (or if that something is still even going to be included at all) shouldn’t be much of a surprise. Still, we need to keep ourselves updated of such shifts so that we know what our entitlements are for the year. Typically, the changes would involve the cost of premiums, level of coverage, and deductible and coinsurance amounts.  Here’s what’s new for Medicare, Medicare Advantage, and Medicare Supplements for 2021. 

Standard Medicare Premiums

In 2021, standard monthly premiums for Medicare part B (medical) will increase by $3.90. This is good news, especially that the CMS predicted a more or less $50 per month rise in consideration of the unexpected expenses when the pandemic broke out. Fortunately, the US Congress decided to help and offset the projected increase, finally placing 2021 premiums at $148.50 monthly, instead of the nearly $200 originally planned. 

Medicare Part A premiums are also rising to $471 in 2021, though many citizens actually quality for premium-free coverage. Most people do not need to pay for Part A because they already paid the Medicare tax during their working years (those who worked more than 40 quarters). Those who paid 30 to 39 quarters in tax will need to shell out $259 per month for Part A in 2021(up by $7 from $252 in 2020), while those who have not paid a minimum of 30 quarters will be billed $471 monthly (from $458 in 2020).

Medicare Deductibles 2021

The deductible amount for Part A will rise by $76 to $1,484 in 2021, while the monthly Part B deductible will be up by only $5 to $203. 

Medicare and Acupuncture

Good news for those who undergo alternative health treatments: Medicare now covers up to 12 acupuncture visits within a 90-day period for people who suffer from chronic low back pain only. Medicare defines chronic low back as follows:

1. Pain that lasts over 12 weeks
2. Pain that has no known cause (not related to an infectious disease, inflammatory condition, or cancer that has spread)
3. Pain that’s not related to pregnancy or surgery

If you show improvement, Medicare will cover an additional eight sessions. However, if your physician says that your ailment is getting worse or isn’t showing signs of improvement, then there will no extension of coverage. The maximum number of acupuncture treatments you can get in a year will be 20. 

Medicare Advantage 2021: Lower Fees and More Choices

The CMS announced that Medicare enrollees will have more than 4,800 Advantage policies to choose from during the 2021 open enrollment period—which takes place from Oct 15 to Dec 7 annually. OEP is the time when beneficiaries are allowed to make changes to their current coverages for the next year. Additionally, the prices for monthly Medicare Advantage premiums have been adjusted to a historic low. For 2021, they are generally expected to drop by $21 across the country (the lowest since 2007).

Aside from huge price drops for Advantage plans, Medicare is also now offering more extensive telehealth services (in response to the changing needs due to the global pandemic). Telehealth benefits enable beneficiaries to obtain services that generally occur in person (like consultations with a health care provider or doctor) using real-time video and audio technology. This doesn’t just apply to general healthcare consults but also include specific areas such as cardiology dermatology, and psychiatry among others. Other similar channels that Medicare now recognizes are online services, like virtual check-ins and e-visits. 

ESRD Needs and Insulin Coverage

Patients who have been diagnosed with End-Stage Renal Disease (ESRD) can also join an Advantage plan during Annual Election Period. Policy coverages will begin on January 1, 2021. 

Also, if you are part of Medicare plan that takes part in the Part D Senior Savings Model, you can save on out-of-pocket expenses for insulin in 2021. This model is available to everybody who has Medicare. Plans that are part of it will offer a range of coverage options that include different types of insulin at a maximum copayment of $35 for a 30-day supply. Those who enroll in a partner plan can save as much as $446 annually. 

Medicare Supplement (Medigap) 2021

As of January 1, 2020, all Medicare Supplement plans sold to new Medicare enrollees can no longer cover the Part B deductible. In response to this, Plans C and F will not be sold to new enrollees from the said date. This remains unchanged in 2021. 

One other change to Medigap in 2021 is on the Plans F and G, which both offer high deductible versions, HDF and HDG. For the year 2021, the deductible amount will go up $30 to $2,370. Once you hit the deductible amount, your policy will cover any expenses for Medicare-approved services.

Bottom Line on Medicare in 2021

With the many changes happening to Medicare in 2021, the Medicare Annual Election Period becomes even more important as it gives you a chance to review your existing coverage and see if you need to make any changes for the next year. If you are currently on Medicare it’s imperative that you review these choices with a qualified Medicare insurance broker like those here at SecureCare65 annually. 

We Can Help with your Medicare Questions.

If you need more information and guidance related to the 2021 Medicare changes, our team of Medicare specialists can help give you a clearer picture. Don’t hesitate to get in touch with us at 800-354-1078.

People have differing opinions about Medicare supplement policies—how do you decide which one really need and if it’s even worth the investment?

Summary:

• Having Original Medicare is great, but its coverage is limited.
• You pay an extra monthly premium for this plan—on top of what you are already paying for your Original Medicare Part B coverage.
• Having a Medicare Supplement plan will help you pay for coinsurance, copayments, and deductibles. 
• Medicare Supplement policies are sold through private insurance agencies, although their standard coverage is fixed according to federal guidelines.
• Some Medicare Supplement plans also cover healthcare expenses incurred when you travel outside of the U.S.

Being enrolled in a Medicare plan does not mean that you are totally free from any medical expense. In fact, while Original Medicare does cover a large chunk of your health-related costs, being a government product, it simply cannot shoulder everything. Your total bill will be reduced but you will still need to worry about the likes of copayments, deductibles, and coinsurance. This is pretty understandable given that the government’s funding sources are limited.

That said, in order to help ease the burden on its Medicare beneficiaries, the government created a set of standardized insurance policies—only these will be sold through private companies. In comes Medicare Supplement insurance, also known as Medigap. 

Understanding Medicare Supplement Plans

A Medigap plan is an insurance product that is sold through private insurance companies. Designed as a supplement to Original Medicare, it covers certain healthcare services and supplies that the former cannot shoulder—or the so-called “gaps.” Note that you can only purchase a Medigap policy if you already are enrolled in Original Medicare Part A and Part B. It also comes with an additional monthly premium.

If you have both Original Medicare and Medigap and then a medical emergency happens, then Medicare will first pay for the items that are covered under its guidelines before Medigap steps in to pay for the rest (depending on the plan that you are enrolled in). There are several types of Medicare Supplement policies (letters A, B, C, D, F, G, K, L, M, N), with levels of coverage ranging from basic to comprehensive, and their corresponding monthly premiums rise alongside the expanded coverage. 

Another important item to note is that because Medigap policies are government-regulated, their basic coverage will be the same no matter where you are in the United States. Although some insurance agencies have add-ons to their programs, more likely than not price will be the only difference between policies of the same letter sold by various companies. Hence, if you are shopping around for the best Medigap policy for you, it’s best if you compare the offerings of different insurers first before making a decision. 

Basic Inclusions of a Medigap Plan

Regardless of the policy letter you are enrolled in, these are the minimum inclusions of a Medicare Supplement policy. The main difference between the programs is the percentage of coverage (0, 50%, 75%, 100%).

• Medicare Part A coinsurance and hospital expenses (up to an extra 365 days after the Medicare benefits are exhausted)
• Medicare Part B coinsurance/copayment
• Part A hospice care coinsurance/copayment
• Part A deductible
• Part B deductible
• First 3 pints of blood
• Skilled nursing facility care coinsurance
• Part B excess charges
• Foreign travel emergency (up to plan limits)

NOT included in any Medigap plan are: vision and dental care, long-term care (as with a nursing home), hearing eyes, eyeglasses, and private-duty nursing. If you wish to obtain coverage for these, then you will have to speak to your private insurance provider if these can be purchased as add-ons or if they have other independent policies that you can also subscribe to. 

Medicare Supplement Insurance Pricing

As mentioned earlier, price is the primary difference between the Medigap plans offered by different agencies. However, while you cannot control how private companies set their monthly premium rates, you can find out HOW they price their Medicare Supplement policies so you aren’t met with surprise bills in the future. Insurance agencies determine their prices based on any of these three methods. 

1. Community-rated (no-age-rated)

Monthly premiums are not based on your age and everyone who applies will be charged the same regardless of age or gender. Premiums can go up in the future due to inflation issues, but never because of age.

2. Attained-age-rated

Prices are based on your current age, so younger buyers will have an advantage of lower rates. However, the fees can go up as you get older and it could more expensive in the long run. This is a good option, however, for those who do not have enough money now to pay for a plan. 

3. Issue-age-rated (entry-age-rated)

This pricing structure is based on the age you are when you purchase your Medigap plan—and this won’t change as you get older. 

Other factors that can affect the pricing of Medigap premiums include your location, smoking history, health history, and if your provider thinks that you should be subjected to a medical underwriting and screening process. As of 2020, rates for Medicare Supplement plans range from $50 to $1,130. 

Is Medigap Worth Your Money?

Because Medigap policies come with an additional cost, it’s only fair that you ask whether it’s truly worth the investment. In making this decision, you can start by considering your current typical out-of-pocket health-related expenses. 

If you are relatively healthy, have a good prognosis, and are not subject to any maintenance meds or procedures, then you might want to start with the lowest-cost Medigap plan or maybe delay purchasing it. However, if you need recurring care for a chronic illness or are concerned that an emergency might happen in the near future, then it’s wise to enroll in a comprehensive plan. Otherwise, all the money you had saved up for retirement will only go towards your medical expenses. 

That said, shouldn’t you be using your retirement funds to actually relax and enjoy? Such considered, having a Medigap plan can definitely be a worthy investment. 

Medicare Advantage vs Medigap

A Medicare Advantage Plan (also popularly known as a PPO or HMO) is different from Medigap policy. If you currently have a Medicare Advantage plan but want to return to Original Medicare, then you may apply for Medigap insurance shortly before your HMO coverage ends. As long as you have the intention of leaving your Advantage plan, you can start applying for Medicare Supplement coverage. [Note: it is illegal for an insurance provider to sell you a Medigap plan unless you are definitely switching back to Medicare.]

That said, to ensure that enjoy continuous coverage and there are no empty gaps during the transition, you can ask your insurance provider to have your Medigap policy begin when your Medicare Advantage ends.

Note that most Medicare Advantage policies cover prescription drugs, which Original Medicare does not. Some also even shoulder the cost of eyeglasses and hearing aids. If these are important to you and you’re not leaving your HMO provider (employer) anytime soon, then it would be wise to stay. 

Conversely, if you are in a Medigap plan and want to switch to Advantage, then you will need to cancel your policy first before you can proceed. Further, if you find that you don’t like Medicare Advantage after enrolling, federal law gives you the right to return to Original Medicare within 12 months from purchasing.

When to Buy a Medicare Supplement Plan

The best time to buy any of the Medigap plans is during your six-month Open Enrollment Period. This is the half-year window when you turn 65 years old wherein you can purchase any Medicare Supplement plan available in your location and not be rejected for any reason (even if you have a pre-existing health condition). This period begins on the first day of the month that you turn 65. 

If you do nothing during this time and forego enrollment, you run the risk of getting rejected for a plan or being asked to pay a higher monthly fee than the standard rate. You might also be required to undergo medical underwriting. Check the guidelines governing OEP in your state, as some locations may have additional conditions and privileges. 

To know more about which Medicare Supplement plan is the best option for you and how you can find the right insurance provider that will cater to your needs (and budget), you may get in touch with our team of Medicare experts who will gladly guide you through the entire evaluation and selection process. 

Still unsure if Medigap is worth your money? Give us a call at 800-354-1078 so we can provide the information you need to make a sound decision. Understanding the ins and out of the Medicare and Medigap world can be quite confusing, especially if this is your first time hearing about this or feel overwhelmed with information. We are here to help you with your next steps.

Medicare is a godsend for all Americans as it not only helps senior citizens cope with the expenses that come with aging, it also reduces the amount of financial stress on their families. Access to affordable healthcare products and services is a privilege that U.S. citizens are lucky to have because not all countries provide this level of care and assistance.

However, if you’re not careful and do not read the guidelines that govern this system of healthcare, you could also find yourself stressing over surcharges, penalties and other otherwise avoidable fees. This is why the government is extra vigilant in offering information via print resources and online about the rules that surround enrollment and availing of Medicare and related services. It is also our duty as citizens to keep ourselves informed of the rules and yearly updates and changes to make sure that we or those close to us get the most out of Medicare.

Why Medicare Is Important and Necessary

Simply put, Medicare is a guarantee that members will be able to afford health insurance. Before it was introduced, more than 50% of Americans had zero access to health services and had no choice but live with distress (and imminent death) when all illness struck. In the past, retirees either had to clean out their bank accounts, seek welfare, ask for financial help from children or relatives, or just make do without any care at all. Now, those who are enrolled even in basic Medicare coverage know that they can access a much wider range of products and services, not just for illnesses but also for general wellness.

Medicare is not free, except for Part A coverage. Part B ($135.50/month for 2019), Medicare Advantage (custom priced), Part D prescription drug coverage (minimum $33.19/month for 2019), and Medicare Supplements (Medigap, custom priced) all come with a monthly premium. However, these fees are significantly lower than what seniors would have had to pay in case an emergency happens or if they just want to consult with a doctor for whatever reason. The scope of benefits far outweighs the monthly cost.

In short, Medicare paves the way for everyone to have access to sound health care services for treatment, prevention and overall wellness purposes. Additionally, because it is regulated by the federal government, members can rest assured that they get the same quality services regardless where they get it anywhere in the country, with others even extending as far as enjoying emergency care coverage while traveling to another country (Medigap).

At this point, it is important to note that Medicare is not just for the senior members of society. It also covers disabled persons who are usually unable to get approved for regular insurance from private providers. Other conditions that qualify a person for Medicare coverage are end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS).

Costly Medicare Mistakes That You Should Watch Out For and Avoid

1. Delaying Part-B enrollment

When people hit the age of 65 but are still enjoying HMO coverage from their employment, they usually opt to skip enrolling to Medicare Part B and just sign up for Part A. This is to avoid having to pay a monthly premium for something that they won’t technically be using yet because the previous employer-provided insurance coverage still exists. While this sounds like a smart move, it might not be practical in the long-term.

There is practical wisdom in being doubly insured. Medicare will shoulder expenses first and let the private insurer cover the remainder in certain cases, or the it goes the other way. After all, it’s not like you will be staying in employment for a longer period, so it’s best to get Medicare bit done as scheduled to avoid any penalties later.

2. Not taking advantage of your initial enrollment period

Your Initial Enrollment Period is the best window to apply for Medicare Part B. This is the time when you are first eligible for coverage, during which you are given plenty of leeway. Would-be seniors have seven months to sign up for Part B. These include the three months before your 65th birthday, your birth month, and the three months after it.

By delaying your Part B enrollment, you will be subjected to a late-enrollment penalty, which is equivalent to 10%+ for every 12 months that you were eligible but did not enrol. You will be required to pay this higher monthly premium until you opt out of Medicare entirely, which means that you will be paying for it for the rest of your lifetime. The savings at the start is attractive, but surely you don’t want to pay higher fees in the long run.

3. Failing to plan in advance

Choosing the right Medicare plan means exercising foresight—as in “where do you see your health going in the next 5 to 10 years?” Remember that health insurance is preparation for something that still does not exist, so if your current health status predisposes you to certain types of illnesses, you might want to consider expanding beyond Part B and then signing up for Part D prescription drug coverage.

If you are healthy now but suspect you might not be in five years, signing up for a Medicare Supplement plan also helps you prepare. If you are not pre-armed with an illness does happen, you will have to pay for expenses out-of-pocket—and they will expensive.

4. Not signing up when you are first eligible

Because not everybody retires at 65, it’s easy to skip the period when you are first eligible and decide to worry about it later. There is truth to this: you don’t really need Medicare if you are still working at 65. However, related to 1 and 2 above, not only will you risk having to pay penalties and higher premiums, you could also get turned down (if you apply for Medicare Advantage or Medigap plans) if you do not meet medical underwriting requirements. In the end, you either pay more or pay for healthcare services and products out of pocket.

5. Signing up for a plan without studying their cost and benefits

Just going on ahead and signing up for a Medicare or Medigap plan just so it’s over and done with is a huge and potentially costly mistake. If you’re unsure about the benefits or do not understand the resources provided to you, it’s best to consult with a qualified Medicare or Medicare Supplement advisor so all your cards are laid out and everything is transparent. You might still opt for the priceyer plans, but at least you know what’s coming (and are prepared) when the bill arrives.

6. You have a Medicare Advantage plan but you went out of your network

If you opt for a Medicare Advantage plan, which is provided through a private insurance agency, you will need to limit your consultations and access services with the provider’s given network of doctors, clinics and hospitals. If you are in an area where there the network is thin, you might be forced to go outside the network for convenience—and that will mean out of pocket expenses and higher charges. That said, if Medicare Advantage is your preferred route, be sure that the private insurer you sign up with has a wide network that you take advantage of from anywhere.

7. Assuming that you are covered because your spouse is

If you had enjoyed healthcare coverage from your spouse who was previously employed, it is not the same with Medicare. Spouses will have to enroll as separate entities and pay their own premiums. Assuming that you are covered because your husband or wife already has Medicare means out of pocket expenses should a medical emergency happen or even if you just want to have a wellness exam from a local clinic.

8. Failing to enroll within eight months after leaving regular employment

This is a careless but very common mistake among those who did not sign up for Medicare at 65 because they are still employed. Note that you need to enroll within eight months after you resign from your job to avoid any headaches. Otherwise, you are left with no choice but to wait until the next enrollment window (January to March, with actual coverage not starting until July 1 of the same year). This means you are not covered at all during the gap—and this could translate to out of pocket expenses should a medical emergency arise.

9. Not monitoring your Part D plan yearly

Signing up for a Part D prescription drug coverage and then keeping it on autopilot year after year can spell additional costs on your part. First, Part D plans get updated and see changes annually, so the costs will vary. Some plans will have more expensive premiums as the years go by. Also, if you initially signed up for Part D for branded medications but then decided to go for generic products later, then you might want to switch to another type of plan.

10. Buying the same Part D plan as your spouse

Medicare Part D prescription drug coverage plans charge couples separately and will not give discounts for dual purchases. That said, it doesn’t make sense to have the same coverage as your significant other, especially as you don’t really need the same medicines. Otherwise, you end up paying for something you don’t get to use and don’t really require. Part D coverage should be according to your specific needs. Who knows, yours might be significantly cheaper than your spouse’s.

11. Not choosing the right and most appropriate Medicare Supplement plan

Purchasing a Medigap plan within six months after enrolling in Medicare Part B enables you to get any plan that’s available in your area without being subjected to any medical underwriting procedure. You are guaranteed the plan of your choice. However, if you find later on that the plan you selected is not for you and decide to switch, it could be costly. Insurance providers might charge you a higher premium, or reject your application altogether.

Some insurers allow you to switch plans without undergoing a new medical exam, while some states let you change regardless of your current health status—but this can’t be assumed for all states and companies. This is why it is very important to carefully study the benefits, coverage, and cost of the Medigap plan you choose from the beginning to avoid these expensive changes.

12. Assuming that Medicare covers all healthcare products and services

Note that Medicare does not coverage vision, hearing and dental needs, unless they are medically necessary for another procedure that it covers. That said, if you have such specific needs, you will want to sign up for a separate plan from private insurers to minimize your expenses as much as possible. Otherwise, you will be forced to pay for regular fees, most of which are not retiree-friendly.

13. Not signing up for Part B coverage if you have COBRA or retiree coverage

Medicare is 65 and up’s primary source of healthcare coverage, unless you haven’t retired yet and are still enjoying insurance provided by your current employer. However, there are other types of work-related insurance that will not provide the same level of coverage: severance packages, retiree and COBRA coverages are examples. If you have these and do not sign up for Medicare Part B when you turn 65, it can mean huge haps in your healthcare access PLUS late enrollment penalties that run for your entire lifetime.

14. You forgot to stop contributions to your Health Savings Account (HSA)

If you sign up for Medicare, you can no longer contribute to an HSA. Be careful about your contributions in the period you resigned from your current job and enrolled in Medicare, as your HSA payments should be prorated according to the number of months prior to Medicare coverage.

15. Not monitoring or spreading out your gross income, making you subject to higher surcharges

Getting old doesn’t stop you from still making investments and boosting your gross income, but if you forget to spread out your totals, you could end up paying more in surcharges for Medicare. For example, if your gross income changes midway, your Part D plan could switch from a monthly premium of $13 to a whopping $74.80 just like that. Financial experts recommend spreading Roth conversions over a few years or withdrawing your cash from these accounts, instead of from the tax-deferred ones.

Still Have Questions?

Still unsure about your Medicare and Medicare Supplement choices? You may get in touch with our qualified insurance advisors to determine the best and most cost-effective options that are applicable to your health status, lifestyle and budget. If you already are enrolled in a Medicare Supplement plan and would like further guidance on how to make things more affordable, we can also help. Contact us at (800) 354-1078.

The legalization of marijuana for medical and treatment purposes across several U.S. states has increased the discussion on its viability and safety. The issue remains controversial up to this day, especially as cannabis is listed by the Drug Enforcement Agency as a Schedule 1 drug, which means that it has a high potential for abuse and is seen to have no presently acceptable medical purpose for healing.

Studies on the effectiveness of consuming or inhaling cannabis are few and proof of their sustained positive effects are limited. Still, a growing number of senior citizens are turning to this alternative form of medicine to address a wide number of ageing related conditions and illnesses.

Medical Marijuana and Senior Citizens

According to the National Council for Aging Care, the number of senior citizens using medical marijuana has increased by a whopping 250 percent from 2006 to 2013. In a 2018 study conducted by physicians from the geriatric and palliative medicine at Northwell Health in New York, it was also revealed nine out of 10 seniors like using this product for addressing chronic pain and said they will recommend that their friends and loved ones take it as well.

Those who have used medical cannabis for treatment purposes present reasonable proof that it works, although because it is an herbal product, doctors caution that its effects may differ from person to person. Still, it has not stopped advocates of this treatment to promote it as reliable in terms of treating a wide number of child, adult, and senior health problems such as general pain, Alzheimer’s disease, mental health disorders and anxiety, eating disorders, sleep problems, neurological deficits, glaucoma, and more.

The Legalities of Medical Cannabis

Before moving forward to whether medical marijuana is qualified under Medicare coverage, we have to first understand the legal and state implications related to its use. First, it is classified as a Schedule 1 Drug, which means it is not generally accepted as safe for use. It is also not approved by the U.S. Food and Drug Administration, which is a primary prerequisite for qualifying for Medicare assistance. Although in some states, medical marijuana is considered acceptable and fully legal, it will first need the approval of the FDA for it to be classified as a true medical program.

Do note that for a drug or a treatment to obtain an FDA seal of approval, it will have to undergo clinical trials involving thousands of human subjects to determine the measurable benefits and true risks from its use. To date, there are no large-scale studies that will show the effectiveness of medical cannabis and prove that its benefits outweigh its risks and potential addictive issues.

Medical Marijuana and Medicare Assistance

So, does Medicare cover medical marijuana and its components? For now, it’s a big NO. If your doctor prescribes medical marijuana as part of your treatment program, even if you are in a state that declares it as legal, Medicare reserves the right to refuse shouldering its related expenses. Take note that you will first need a Medicare Part D policy to be able to seek subsidy or full coverage for prescription drugs, otherwise you will have to sign up for a Medicare Supplement (Medigap) to obtain assistance for medications.

Despite this snag, seniors who are supporters of medical marijuana shouldn’t lose hope just yet. This is because there are certain prescription drugs that may mimic the effects of cannabis, which then may be acceptable in Medicare or Medigap’s list of medications for coverage. It’s best that you speak with your healthcare provider to find the best options for care that will still be covered by your policy. Otherwise, be prepared to shoulder the out-of-pocket costs of incorporating medical cannabis to your maintenance or treatment program. If you have questions about the role of Medicare in the use of medical marijuana, talk to a qualified advisor who can help lay out all your choices before you make a decision. Medical cannabis is increasingly being accepted as a solid form of treatment for various types of illnesses. As its proponents launch more campaigns and conduct more research and studies about its effectiveness, it’s not really entirely impossible that Medicare and Medigap would also take it under their wings in the future.

A huge part of ageing and entering the senior years is the increasing need for chiropractic care. While not everybody will likely need any major spine alignment procedures, there are certain chiropractic procedures that will help senior citizens enhance flexibility, balance, coordination, and mobility. These procedures are also often necessary when a person starts to feel some discomfort and pain. Thus, the question of whether Medicare includes chiropractic care to its coverage is often asked.

Why Is Chiropractic Care Needed for Older Adults?

It is a fact of nature that bones do start to exhibit signs of wear as we get older and this amount can vary from person to person. Those who already are feeling the strain on their bones and joints are more likely to see the problem escalate to bigger mobility and posture issues, which when experienced with intense pain can indicate a pinched nerve. While this part of ageing is expected, it shouldn’t be a hindrance to enjoying one’s golden years. This is where chiropractic care steps in.

The common misconception is that chiropractic care is physically stressful because the manipulation techniques could place the elderly’s frail bones at risk. However, as chiropractors are also medical practitioners, it should be known that there are varying degrees of manipulation, depending on the patient’s needs and condition. This can be in the form of gentle massages and mobilization techniques, as well acupuncture or dry needling. All that said, chiropractic care is an essential part of the ageing process — so everyone can transition gracefully and as pain-free as possible.

What Medicare Pays for Chiropractic Care

The only chiropractic procedure that is covered under Medicare, Part B (medical insurance) specifically, is manipulation of the spine to correct a subluxation, which happens when one or more bones on the spine are out of their normal position. No X-ray is needed to prove this condition. It is also covered under Part B when it is medically necessary and if it is performed by a qualified chiropractic care provider or a licensed chiropractor. This includes both inpatient and outpatient care, such as lab testing, doctor visits, equipment, necessary surgical procedures, home health care and other directly related situations.

Medicare Part B covers 80% of this type of chiropractic care while the patient takes care of a small annual deductible. You may purchase supplement insurance or Medicare Supplement plans to help pay for such expenses. Take note that X-rays are not covered unless it was specifically ordered by the doctor to determine whether a subluxation does exist. The initial exam by the chiropractor to find out is a misalignment is present is also not part this. The coverage refers only to the adjustments that need to be made.

Chiropractic Care and Medicare Advantage

A popular way to obtain additional coverage for chiropractic services is to get a Medicare Advantage plan. Note that they may cover such services, though what they include and how much of a copayment the patient must pay are not standardized. Providers of Medicare Advantage plans have the liberty to set their own packages of benefits, and pricing so it’s best to shop around and compare offerings before signing up for anything.

Medicare Advantage plans typically offer the same services as Medicare Part A and Part B, but the difference is that they are limited by their network of healthcare professionals. This means that you should seek medical consultations and assistance only from the providers on their list if you want to gain full advantage of this plan. In addition, unlike Medicare that lets patients pay a deductible and then they cover 20%, MA charges via a copay system — and, again, this can vary depending on the time of treatment and the services rendered.

Chiropractic Care and Medicare Supplements (Medigap)

Having a Medicare Supplement plan will also help in reducing the expenses or getting some of the procedures related to chiropractic care for free. For example, some Medigap plans can cover all of the Part B coinsurance and copayments, which may include chiropractic office visits for a subluxation. Medicare Supplement Plans F and G can take care of Part B excess charges, while Plans C and F can shoulder the Part B deductible. Plan will require you to shoulder a copay of $20 for doctor visits, while Plans K and L will have you making 50% and 75% in out-of-pocket costs, respectively.

To further understand how a Medicare Supplement figures into your specific needs for chiropractic care, it is best to talk with a qualified SecureCare65 advisor so you can see all the choices available for your situation and budget. You can give us a call at 1-800-354-1078 so our team can answer your questions immediately.