Medicare and Mental Health Benefits

Happy Spring everyone!

This is a very informative article on Medicare and Mental Health benefits regarding what is covered and
what will you pay out of your pocket.

As always feel free to contact me at any time if you have any questions.

Have a blessed day!

George Litchfield
Medicare Plan Specialist
Lic#OB56846
GeorgeLitchfield.com

Call me today at 888-891-5557

 

Medicare and Mental HealthMedicare has historically paid less for mental health care than for other medical care. That is changing.

The Mental Health Parity and Addiction Equity Act of 2008 required that private health plans cover both physical and mental health services equally. At the time, Original Medicare covered mental health treatment at 50 percent after the Part B deductible. The beneficiary paid the other 50 percent. But Medicare paid 80 percent for most other health care, as it still does today.

In short, Medicare was not required to abide by the same law as private plans. Beneficiaries paid a bigger share of the cost for mental health care than for other health care services.

What You Will Pay

You still will pay more for mental health care today, but it’s getting better. Congress passed legislation that reduces how much Medicare beneficiaries pay for outpatient mental health treatment. Over time, the cost will be consistent with coinsurance amounts for other medical services.

In 2013, you will pay 35% of the cost for mental health treatment after any deductibles are satisfied. (Medicare already pays 80 percent of the cost for doctor visits when the purpose is to diagnose a mental health condition rather than to treat it.) In 2014, your share will be 20%, the same as for other medical services.

What’s Covered

Mental health care includes services and programs to help diagnose and treat mental health conditions. Medicare covers outpatient and inpatient mental health care and prescription drugs you may need to treat a mental health condition. Your specific benefits will depend on the type of Medicare coverage you have.

In general, Medicare Part B covers outpatient mental health services. You usually get these services in a doctor or therapist’s office, in a clinic or in a hospital outpatient department. Part B helps pay for the following covered services (deductibles and coinsurance may apply):

  • Individual and group psychotherapy with doctors or certain other licensed professionals allowed by the state to give these services
  • Family counseling if the main purpose is to help with your treatment
  • Testing to find out if you’re getting the services you need and if your current treatment is helping you
  • Psychiatric evaluation
  • Medication management
  • Occupational therapy that’s part of your mental health treatment
  • Certain prescription drugs that aren’t usually self administered, like some injections
  • Individual patient training and education about your condition
  • Diagnostic tests
  • Partial hospitalization (day programs in a hospital setting) may be covered

Medicare Part B also covers one depression screening per year. You must get the screening in a primary care office or clinic that can provide follow-up treatment and referrals. You pay nothing for this yearly depression screening if your doctor or health care provider accepts assignment.

Medicare Part A helps pay for mental health services that require you to be admitted to a hospital. You can get these services either in a general hospital or in a psychiatric hospital.

If you’re in a psychiatric, Part A only pays for up to 190 days during your lifetime.

Medicare Part D helps pay for prescription medications needed to treat mental health conditions.

If you get your Medicare benefits through a Medicare Advantage plan or another Medicare health plan, check your membership materials for information about mental health benefits

 

–This information is provided by Medicare Made Clear

GeorgeLitchfield.com – If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call (888)891-5557 or go to our website GeorgeLitchfield.com  and we will give you a quote and help you keep money in your pocket

How to Appeal a Medicare Decision – Redlands CA, Yucaipa CA

Hello!

I hope all is well with you. Below in the article is some useful information for you or someone you know that is on Medicare.

Have you ever had these questions come up?

How do I Appeal a Medicare Decision?

When can I appeal a payment or coverage decision?

What happens if I decide to file an appeal?

What’s the first step of filing an appeal?

If so this article has the answers for you.  And if you haven’t this could be valuable information for the future.

Have a wonderful day!

George Litchfield
Medicare Plan Specialist
Lic#OB56846
GeorgeLitchfield.com

Call me today at 888-891-5557

 

 

Medicare - Redlands CA - George LitchfieldAn appeal is the action you can take if you disagree with a coverage or payment decision by Medicare or your Medicare plan. That decision can be made by Medicare or by the private Medicare-approved health plan that administers your Medicare Advantage (MA/MAPD) plan, prescription drug plan (PDP) or special needs plan (SNP).

When can I appeal a payment or coverage decision?

You can file an appeal if Medicare or your plan denies one of the following:

  • Your request for a health care service, supply, item or prescription that you think you should be able to get.
  • Your request for payment for health care service, supply, item or a prescription drug you already got.
  • Your request to change the amount you must pay for a health care service, supply, item, or prescription drug.

You can also appeal if Medicare or your plan stops providing or paying for all or part of an item or service you think you still need.

What happens if I decide to file an appeal?

If you decide to appeal, first ask your doctor, health care provider or supplier for any information that may help your case. See your plan materials, or contact your plan for details about your appeal rights. Medicare and all companies that provide Medicare plans are required to help you file an appeal.

The appeals process for all types of Medicare plans has five levels. At each level, a decision about your appeal is made and communicated to you in a letter. If you disagree with the decision made at any level of the process, you can generally go to the next level. At each level, you’ll be given instructions in the decision letter on how to move to the next level of appeal.

What’s the first step of filing an appeal?

Although we won’t go through all five steps of an appeal process, we can describe the first step. How you file an appeal depends on the type of Medicare coverage you have. But no matter what type of Medicare plan you have, at any step of the appeals process, you can—and may want to—ask your doctor, health care provider or supplier for any information that may help your case, or other help.

Original Medicare

If you’re on Original Medicare, then every three months you’re mailed a Medicare Summary Notice, or “MSN.” An MSN shows all services or supplies that health care providers and suppliers billed to Medicare for your care during the three-month period. It shows what Medicare paid, and what you may owe the provider. You can also view your MSNs electronically on MyMedicare.gov.

Your first step is to find the MSN that shows the service or supply you’re appealing. You then have two options to file the appeal:

1. Fill out a Redetermination Request Form (PDF). Send it to the Medicare contractor at the address listed in the “Appeals Information” section of your MSN. Or, you can…

2. Follow the instructions on the back of your MSN, and send the request for an appeal without the Redetermination Request Form. You provide the same types of information as what’s asked for on the form, and send it to the Medicare contractor listed.

Generally, you get a decision from your Medicare contractor within 60 days after they get your request. The decision is called a “Medicare Redetermination Notice,” and it can come as a separate notice or as part of your MSN.

Medicare Advantage Plan (Part C)

You have the right to ask the company that administers your Medicare Advantage plan to pay for, or cover, health care services or items you believe should be covered. This request for services or supplies is called an “organization determination.” You can either ask for a determination yourself, or have your doctor or someone representing you ask for one.

Organization determinations typically take 14 days. If you or your doctor thinks your health could be harmed by waiting that long, you can ask for an “expedited” or fast determination. Then your health plan has 72 hours to give you a decision.

Your plan can approve your request, or partially or fully deny it. Your plan will send you a written notice explaining why, and give you information on how to file an appeal. This process may vary depending on your plan, so follow the instructions provided. However, regardless of your plan, you are allowed to ask for a copy of your file containing medical and other case information.

Medicare Prescription Drug Plan (Part D)

Appealing a decision for a Part D plan typically means working with your plan to get coverage for a prescription drug that you feel you need. As with a Medicare Advantage plan, this usually involves either you or your doctor (or representative) working directly with the company that administers your Part D plan.

Prescription drug coverage relates primarily to your plan’s formulary, or drug list. For more information, see the previous Medicare Made Clear blog post Medicare won’t cover a prescription I need—what now?.

Medicare Special Needs Plan (SNP)

Your Medicare SNP needs to tell you in writing how to file an appeal. After you file an appeal, the plan reviews its original decision. If your plan doesn’t decide in your favor, the appeal is reviewed by an independent organization that works for Medicare, not for the plan.

–This information was provided by Medicare Made Clear

Georgelitchfield

 

 

GeorgeLitchfield.com – If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call (888)891-5557 or go to our website GeorgeLitchfield.com  and we will give you a quote and help you keep money in your pocket.

 

Get With the Program to Save Money on Prescription Drugs – Medicare Redlands CA

cheap-prescription-drugsSaving money on prescription drugs is top-of-mind for many people with Medicare. You may know the main ways to save money, like switching to generics. But there are also quite a few programs out there specifically designed to help cut prescription costs for you or someone you love. Check out the following to see if one of these options might work for you.

Putting Your Plan to Work for You

Do you have Medicare Part D prescription drug coverage—either in a standalone plan or as part of a Medicare Advantage plan? If so, you likely chose the plan that would help you keep your prescription drug costs as low as possible. But there are a few simple tips that may help you save even more.

  • Pharmacy Networks. If your Medicare prescription drug plan has a pharmacy network, be sure to use it. Network pharmacies could offer you extra savings and big discounts. Your plan might also have a special arrangement with certain pharmacies that could mean additional savings when you need to fill your prescriptions.
  • Mail service Pharmacies. Many Medicare plans offer a mail-order pharmacy service. Copays are generally pretty low, and you could save even more by ordering a 90-day supply of your drugs at one time. As an added bonus, you get your medicines delivered right to your mailbox—so no waiting in line at the pharmacy.
  • Prescription Drug Discount Program. Your Medicare plan might offer a prescription drug discount program. This could be a separate program from your plan benefits, or it might be included in membership. Check your plan information or call your plan’s customer service number to find out more.

Giving Your Savings a Boost

It might be worth it to take a look at other programs that can help you lower your drug costs but might be offered outside of your plan’s prescription drug coverage. If you think this might be worthwhile for you or someone you love, there are a number of programs that might meet your needs. Be sure to check with your plan before signing up for another savings program, so you can find out about any restrictions or requirements up front.

  • Pharmacy Discount Programs. Some pharmacies offer discount programs to regular customers. If you think this might be a possibility for you, a good first step is to talk to the pharmacist. He or she should be able to let you know about any discount programs—and if they’re available to Medicare recipients.
  • Prescription Discount Cards. Some private companies offer cards that help people save money on their prescription drugs. Most times, you’ll pay a small yearly fee to get the card, which is usually good at a wide range of pharmacies. If you’re interested in a prescription discount card and your plan gives you the “green light” to get one, you can generally find the most popular ones online. Your pharmacist may also be able to help you find a discount card from a trustworthy company.
  • Pharmaceutical Assistance Programs (PAPs). Brand-name drugs can be expensive. To help offset some of the cost, many drug companies have programs that offer discounts on the drugs they make. To find out if the company that makes your drugs has any such programs, call the drug company or visit the Medicare.gov PAP page.
  • State Prescription Discount Programs. The state you live in may offer additional prescription drug discount programs. To find out more, contact your state’s Department of Health and Human Services or State Pharmacy Assistance Program (SPAP). You can also call the Medicare helpline or visit Medicare.gov.

Extra Help

If you’ve tried other options and are still struggling, or if your financial situation has changed since you enrolled in a Part D prescription drug plan, it might be worth looking for Extra Help. Extra Help is a Medicare program that helps people with limited income and resources pay Medicare prescription drug costs, including premiums, deductibles and coinsurance.

 

–This information is provided by Medicare Made Clear

GeorgeLitchfield.com – If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call (888)891-5557 or go to our website GeorgeLitchfield.com  and we will give you a quote and help you keep money in your pocket.

The Eyes Have It | Free or low costs eye exams | Medicare Redlands CA

eyeglassesA well-known proverb declares that the eyes are the window to the soul. It turns out that they reveal a whole lot more than that.

Changes in the eye can signal a range of health problems, from high cholesterol to liver disease to diabetes. Some changes are visible, such as a yellowing of the white area around the iris (jaundice) that might indicate liver problems. Other changes are felt, such as itching that may be a sign of allergies. Still other changes are in vision itself, such as a blind spot or blurriness that can have many causes.

Some changes in the eye are undetectable except by looking inside. The eye is unique. It’s the only place in the body where doctors can see arteries, veins and nerves without using surgery. This requires a dilated eye exam.

Regular dilated eye exams can help detect many age-related eye diseases in the early stages. Examples include macular degeneration, cataract, diabetic retinopathy and glaucoma.

January is National Glaucoma Awareness Month

Medicare Part B (medical insurance) covers a dilated eye exam to test for glaucoma once every 12 months for people at high risk. The exam must be done or supervised by a doctor who is legally allowed to do the test in your state.

You have a higher than normal risk of developing glaucoma if you:

  • Have diabetes
  • Have a family history of glaucoma
  • Are African American and age 50 or older
  • Are Hispanic American and age 65 or older

With Original Medicare, you pay 20% of the Medicare-approved amount for the test. You may need to pay more if you haven’t yet met your Part B deductible for the year. If you receive the test in a hospital outpatient setting, then you may pay a copayment to the hospital. Your costs with a Medicare Advantage plan will depend on the specific plan.

Keep Your Eyes Healthy

It’s important to have a complete eye exam every year or two after age 65 to check for age-related eye diseases and other eye conditions. Original Medicare doesn’t cover routine eye exams. However, many Medicare Advantage and Medicare supplement insurance plans offer this coverage. Read your specific plan benefits to learn what may be covered and the costs.

People who may need assistance with eye care costs can contact EyeCare America, which provides free or low-cost eye exams to eligible seniors. EyeCare America is a program of the Foundation of the American Academy of Ophthalmology.

–This information was provided by Medicare Made Clear

GeorgeLitchfield.com– If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call (888)891-5557 or go to our website GeorgeLitchfield.com and we will give you a quote and help you keep money in your pocket.

I’m Covered for 2013—What Now? | Redlands CA | Medicare

2013Now that OEP is over, you might be wondering what’s next. Where can you find information about your 2013 coverage? Do you have all the plan materials you need? What happens if you haven’t received new membership cards or other important documents? Here’s a list of things to look for as you head into the 2013 Medicare plan year.

It’s in the Cards

Whether or not you changed your Medicare coverage during OEP, you’ll need to make sure you have current membership cards. Remember: you might need more than one card. For example, if you have Original Medicare and a standalone Part D prescription drug plan, you will usually have two cards, one for Medicare services and one for your prescription drug coverage. And even if you didn’t change your current Medicare coverage and it was automatically renewed, you might still get or need new cards for the new plan year. If you haven’t gotten your new cards yet, call your plan or Medicare (see “For More Information” below).

Stay “In the Know”

The plan materials you should have—or should expect to get—depends on the kind of Medicare coverage you have for 2013. Here are some of the most common types of plan information:

Original Medicare (Medicare Part A and Part B)

  • Medicare & You – this is a publication from the Centers for Medicare & Medicaid Services (CMS). It’s a complete description of your coverage and benefits. You might already have gotten the 2013 version in the mail this Fall. You can also download it at Medicare.gov (see “Resources” section below).
  • Medicare Summary Notice (MSN) – this is a statement of medical services you should get in the mail every three months if you have Original Medicare.

Medicare Advantage and/or Medicare Prescription Drug plan (Medicare Part C and/or Part D)

  • Annual Notice of Changes (ANOC) mailing – this document explains year-over-year plan changes. For example, changes for 2013 vs. 2012. If you were a plan member in 2012, you may have seen your plan’s ANOC in October, either online or in a mailing. If you switched plans during OEP, you might have received your new plan’s ANOC with other plan materials or in a new member welcome kit.
  • Evidence of Coverage – this is usually included in the ANOC and includes a full description of all benefits included in your plan for 2013.
  • Formulary – A formulary is a list of the drugs your plan will cover if you have a standalone Part D plan or a Medicare Advantage plan with prescription drug coverage. It also gives you information about costs, drug tiers and any special requirements certain drugs might have.

Medicare Supplement Insurance

Since Medicare Supplement Insurance plans vary by state, and each plan is different, you should contact your plan directly with questions.

–This information was provided by Medicare Made Clear

 

GeorgeLitchfield.com– If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call (888)891-5557 or go to our website GeorgeLitchfield.com and we will give you a quote and help you keep money in your pocket.

Can You Hear Me Now?

Not hearing so well lately?  Here is some great information on the signs and the causes of hearing loss.

Have a great day!
George Litchfield
CA Lic#OB56846
GeorgeLitchfield.com

 

Nearly one in five Americans has some level of hearing loss.1, 2 It is the third most common chronic condition among older Americans.1, 2

Hearing loss can contribute to social isolation, higher risk of falls, depression and dementia. Seniors with severe hearing loss can have five times the risk of getting dementia as those with normal hearing.3 In addition, the brain loses its ability to hear when deprived of sound. Preserving hearing can help the brain perform at its best.4

It’s important to understand the signs and causes of hearing loss. That way, you can take charge of your hearing health.

Signs of Hearing Loss

You may suspect that you or someone you know is suffering from hearing loss. Watch for these signs:

  • People complain that you turn the TV volume up too high
  • You have trouble following conversations when more than one person is talking
  • People seem to mumble or not speak clearly
  • You have trouble hearing in noisy backgrounds

Causes of Hearing Loss

Aging is the most common cause of hearing loss. The inner ear can change over time and affect hearing. Other factors include:

  • Exposure to loud noise
  • Ear wax
  • Auditory nerve damage from head injuries or tumors
  • Infections
  • Changes in blood supply to the ear due to heart disease, high blood pressure or diabetes

You can take steps to help prevent hearing loss. Here are some things you can do:

  • Turn down the volume on your television, radio, phone, etc.
  • Wear ear protection when you’re in noisy places or using loud equipment, like a lawn mower
  • Get enough vitamins A, C and E, and N-acetylcysteine. This can help protect ear cells against free radicals generated by loud noise

Get Your Hearing Tested

The effects of untreated hearing loss are serious. You may have problems in your relationships with friends and family. Your overall health and quality of life can suffer.

It’s best to get help as soon as you notice signs of hearing loss. You can get a simple hearing test. It can help you decide whether you might need more help. Medicare Part B may cover hearing exams that your doctor orders.

1. Archives of Internal Medicine, Nov 14, 2011

2. National Institute on Deafness & Other Communication Disorders, 2011.

3. Archives of Neurology, Feb 2011

4. The Journal of Neuroscience, Aug 31, 2011
–This information was provided by Medicare Made Clear

For more help with your Medicare question call us at (888) 891-5557 or visit GeorgeLitchfield.com and fill out our no obligation consultation form and we will call you.

Medicare = Freedom and Flexibility of Choice

If you’ve already signed up for a Medicare plan, are you locked into your choice? The simple answer is no. Medicare offers you the freedom to add, switch or drop coverage every year. This gives you the flexibility to change your coverage as your needs change.

Am I getting what I want from my plan?

The things you want and need from your Medicare coverage can change from year to year. The things you don’t need can change, too. So which type of coverage is right for you?

Original Medicare might be right for you if:

  • You need basic health care coverage for doctor visits and hospital stays.
  • You want to see any doctor who is accepting new Medicare patients—even if you travel out of state.
  • You already have prescription drug coverage or don’t mind buying a standalone Medicare Part D prescription drug plan.
  • If you have other insurance—like from an employer—that you want to keep, but you also want to take advantage of your Initial Enrollment Period.
  • Your current insurance provider doesn’t offer Medicare-approved plans.
  • You like the convenience of having one type of coverage for each health care need—medical, hospital, prescription drug coverage, etc.

Medicare Advantage (Part C) might be right for you if:

  • You want the same coverage as Original Medicare plus extra benefits, like dental coverage, wellness services or a fitness benefit.
  • You are comfortable choosing a doctor from within a plan’s network.
  • You like having the option to choose a plan with prescription drug coverage built in.
  • You have a chronic illness, like diabetes, and want a Special Needs Plan designed for your unique needs.
  • Your current insurance provider offers Medicare-approved plans and you’d be more comfortable sticking with a plan you know.
  • You like the convenience of having all your coverage and benefits in a single plan.

How much do I want to pay?

It’s important to make sure your Medicare coverage fits into your budget every year, especially if your situation has changed. Original Medicare generally offers set costs. In other words, most people will pay the same cost for the same services. Medicare Advantage plans offer you flexibility to choose the cost sharing that best fits your needs and budget.

Plan premiums are one part of your overall costs. But there are a few other things to consider, as well. Deductibles, copays and coinsurance are all pieces of the cost puzzle. Original Medicare also doesn’t have an annual out-of-pocket expense cap, but Medicare Advantage plans do. Is this important to you when comparing costs?

Timing – When can I make a change?

The best time to make a change to your Medicare coverage is during the Medicare Annual Enrollment Period (AEP), October 15 to December 7 each year. During this time, you can add, switch or drop most types of Medicare coverage. There are also General Enrollment periods (GEPs) for specific types of plan changes. Visit Medicare.gov to find out more. If you need to change plans because of a change in your life—like moving to another state—you could also qualify for a Special Enrollment period (SEP). Learn about general rules for SEPs here.

Use your freedom of choice.

Change is a constant. Personal, medical and financial changes can mean your Medicare coverage no longer meets your needs. It’s good to know Medicare gives you the freedom and flexibility to get the coverage you need no matter how those needs change.

–This information was provided by Medicare Made Clear

http://www.turning65-newtomedicare.com – Turning 65 ? Looking for reliable Medicare Insurance? or Looking to get better rates. The Litchfield Insurance Agency assists the Beaver Medical Group in Redlands. Whether it be Medicare, Health, Life. We will find the right plan for you. Serving Redlands, Banning, Yucaipa and the Inland Empire. Call us today 888-891-5557

How Can I Find Out What My Medicare Plan Choices Are?

When you first enroll in Medicare, and every year after that, you have choices to make. Is Original Medicare or a Medicare Advantage plan the best choice for you? Do you want to add a prescription drug plan or a supplement insurance plan to Original Medicare? Which Medicare Advantage plan will best meet your needs?

Before you can make choices, you need information. You need to know what your plan choices are. And you need to know what coverage each plan offers as well as its costs.

Go to the Official Medicare Web Site

Perhaps the most obvious place to start looking for Medicare plans is Medicare.gov. The site is a great source of information about Original Medicare Parts A and B, including coverage and costs, which can change every year. It also has an online tool that you can use to find Medicare Advantage, supplement insurance and prescription drug plans in your area. You will get a list of plan names with summaries of the plan coverage and costs. You can even enroll right from the site or link to the plan sites for more information.

Use Community Resources

Keep an eye out for local community Medicare educational events. These are sometimes sponsored by local or national organizations, like AARP, or insurance companies. You might see notices for these events posted in your local newspaper or on bulletin boards in pharmacies, libraries, etc. Community events can be a convenient and personal way to get the information you’re looking for. And don’t forget your pharmacist. He or she is often well informed about which Medicare plans are offered locally.

Other community resources include local insurance agents, your local Social Security Office and your State Health Insurance Assistance Program.

Ask the Plan Sponsors

Once you identify plans in your area, or if you already know which insurance company you want to use, you may want to call customer service representatives or go to each plan web site to further investigate the plans that interest you. Many company web sites have online tools that allow you to search and compare specific plans that have the features you’re looking for.

When considering a plan, it’s important to read the Evidence of Coverage (EOC). Plan sponsors are required to provide this document, which gives a thorough description of what services the plan covers. You can ask for a copy to be sent to you or, often, view or download it from the company web site.

Keep Your Needs in Mind

Medicare coverage isn’t the sort of thing that you can just decide on once and then forget about. Things change—benefits, costs, your health, your finances—even where you live. Any of these can affect your Medicare plan choices. You need to pay attention to your needs and to what plans are available to you, so you can make the best choice for you—every year.

–This information was provided by Medicare Made Clear

http://www.turning65-newtomedicare.com – Turning 65 ? Looking for reliable Medicare Insurance? or Looking to get better rates. The Litchfield Insurance Agency assists the Beaver Medical Group in Redlands. Whether it be Medicare, Health, Life. We will find the right plan for you. ServingRedlands, Banning, Yucaipa and the Inland Empire. Call 909-790-7748.

Medicare Covers Medical Nutrition Therapy

Did you know that March is National Nutrition Month®?

Every year, the Academy of Nutrition and Dietetics (formerly the American Dietetic Association) sponsors a nutrition education and information campaign focused on helping people make informed food choices and developing sound eating and physical activity habits. This year’s theme is “Get Your Plate in Shape.”

What better time to learn about Medical Nutrition Therapy and whether it may be helpful for you?

What is Medical Nutrition Therapy?

Medical Nutrition Therapy is a preventive service that may be covered under Medicare Part B. It is provided by a registered dietitian or other qualified health professional. You must have a referral from your doctor to receive the service, which includes:

  • A nutrition and lifestyle assessment, based on information you provide about your eating patterns, activity level, etc.
  • Nutrition counseling and goals, based on the nutrition and lifestyle assessment and on medical information, such as blood pressure or blood glucose numbers, provided by you and your doctor.
  • Information regarding managing lifestyle factors that affect diet and health.
  • Follow-up visits to monitor your progress.

Who is it for?

Medical Nutrition Therapy can be helpful for many people with certain medical conditions, injuries or weight problems. However, it is a key component of treatment for people with diabetes or kidney disease, including people who have had a kidney transplant.

According to the American Diabetes Association, there is a direct link between diet and diabetes management. That makes sense, since blood glucose levels are affected by what you eat—specifically the carbohydrate foods you eat. Medical Nutrition Therapy can help you manage your carbohydrate intake so that the insulin in your body or that you inject can use it efficiently for energy.

It’s important to note that Medical Nutrition Therapy is not the same as diabetes self-management education. But it plays a big role in helping you manage your blood glucose levels.

When can I get it?

If you qualify and you have a referral from your doctor, then Medicare will cover Medical Nutrition Therapy every year. It covers three hours of one-to-one counseling the first year and one hour every year after that. Your doctor must prescribe the service and renew the referral every year. If your condition, treatment or diagnosis changes, then you may be able to get more hours of treatment covered.

How much does it cost?

Medical Nutrition Therapy is covered under Medicare Part B. You pay no copay and no deductible for the service, as long as you are qualified and your doctor prescribes it and refers you. The service must be provided by a registered dietitian or a Medicare-approved nutrition professional. You may want to confirm with your doctor or the service provider that Medicare will cover the cost.

–This information was provided by Medicare Made Clear

http://www.turning65-newtomedicare.com – Turning 65 ? Looking for reliable Medicare Insurance? or Looking to get better rates. The Litchfield Insurance Agency assists the Beaver Medical Group in Redlands. Whether it be Medicare, Health, Life. We will find the right plan for you. Serving Redlands, Banning, Yucaipa and the Inland Empire. Call 909-790-7748 today!