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This summer, my 78-year-old dad decided to do some pullups on my son’s pullup bar. Unfortunately, it’s one of those pullup bars that is wedged between a door frame and when my dad put his weight into it, the bar dropped and he hit the floor hard.
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He said he was fine, but the lingering concussion and occasional dizzy spells said differently. After weeks of CT scans and hospital stays, my dad was diagnosed with bleeding in the brain. The neurologist recommended removing two large sections of his skull so they could stop the bleeding.
Because my dad felt fine otherwise, my parents started searching for more options and found that Medicare will pay for a second medical opinion. They immediately sent his records to the regional neurological center who found that he had been misdiagnosed – instead of major surgery on his skull, he had a minor spinal fluid leak that could be corrected in a simple office visit!
As you can imagine, our palpable relief and gratitude for the second medical opinion made me wonder: are there more benefits that Medicare or Medicare Advantage offer that could be vital to a senior’s health and well-being?
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Yes! Medicare modernization is working to advance its approvals of innovative therapies and technologies, recognizing that Medicare needs to move more quickly to keep up with the speed of innovation. And while Medicare continues to work toward that goal, it does have a few surprises up its sleeve – they have worked to provide a more robust program that addresses the real needs of Medicare beneficiaries, while also maintaining a modern view as to what benefits consumers are seeking.
Here are five benefits you should know about:
1. Opioid Use Disorder
The opioid crisis is reaching all across our country. In 2017, 1.7 million people experienced substance abuse related to prescription opioid pain relievers. Because opioids are prescribed, it can be difficult to determine whether or not to take them for pain.
Fortunately, Medicare offers alternative treatment for those who need it. Treatment can be office-based through management, care coordination, psychotherapy and counseling services. Or treatment can be provided through enrolled Opioid Treatment Programs that provide medication, counseling, drug testing, and therapy sessions.
2. The Give Back Benefit
A lesser-known benefit of Medicare Advantage plans is the Give Back Benefit, or the Part B Premium Reduction Benefit. Many Medicare Advantage plans now offer to “refund” a portion, or all, of your Medicare Part B premium back to you through your monthly Social Security Check.
To find out if Medicare Advantage plans in your area participate in this premium reduction benefit, check the plan’s Summary of Benefits page and look for: “Part B Premium Reduction: Yes.” Or speak with your health insurance agent, who can help you find plans in your area that participate in the Give Back Benefit.
3. Weight Loss Counseling & Nutrition Therapy
Your Medicare Part B plan may cover weight loss counseling for those who have a body mass index of 30 or higher. To receive the benefit, you must receive the counseling in a primary care setting, like a doctor’s office. After the diagnosis, Medicare Part B will usually cover one in-person visit per week for the first month and one in-person visit every other week for the next five months.
In addition to weight loss counseling, Medicare Part B covers some medical nutrition services for those who have diabetes, kidney disease and have had a kidney transplant in the last 36 months and have a referral from their primary care physician. Medical nutrition services can include an initial evaluation of nutrition and lifestyle, individual and group nutrition therapy sessions, and follow up visits to check in on how you are managing your diet.
4. Second Medical Opinion
Medicare offers you the opportunity to have a second medical opinion for medically necessary surgery through its Part B coverage. A second medical opinion may help you make the right decision for your health care.
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If you’d like to understand your treatment choices or have another doctor review your condition for a second opinion, Part B helps by paying for 80% of the Medicare-approved cost.
5. Acupuncture
In an unexpectedly modern twist, Medicare Part B plans now cover acupuncture to help reduce pain and combat the opioid crisis by providing alternatives to prescription medications. Medicare Part B covers acupuncture to relieve low back pain that lasts 12 weeks or longer, has no known cause and is unrelated to any prior surgery or pregnancy. Yearly, Medicare will cover 12 sessions within 90 days and an additional 8 sessions may be granted if you show improvement from the treatment.
Medicare is working to meet the needs of our seniors and offers many innovative and surprising benefits. Next time you have an unusual medical need, go ahead and ask if it’s covered – you may be surprised!
Jan Dubauskas is a health care expert, enthusiastic insurance pro, attorney and mom serving as Vice President of healthinsurance.com. Follow her on Twitter @DubauskasJan.
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January 16, 2021 at 07:00PM
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