Tag Archives: medicare

Is assisted living covered by Medicare?

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Courtesy Vista Springs Assisted Living

By Vista Springs Assisted Living


When it comes to the costs associated with senior living options like an assisted living community, there are a lot of questions that family members ask themselves when finding a home for a loved one. Things may be on your mind like what are the costs associated with increased care needs, how much is the monthly room and board, and if luxuries are an additional charge. 


Finding senior loved ones the best senior living community depends on knowing the answers to all of these questions and more. When thinking about ways to help finance assisted living, another common question is if Medicare, or senior health insurance available to everyone over 65, will help pay for the costs of assisted living.

What is assisted living?

So what is assisted living? How is it different from other types of residential senior living communities, like a nursing home or a senior retirement community? The biggest difference between assisted living and other senior living options is that assisted living, as the name suggests, assists seniors who need help with activities of daily living, or ADLs, while still offering them plenty of independence. 


Nursing homes, which are also an example of a senior living community that offers care services for seniors, have very limited independence due to the high level of care that residents typically need. On the other hand, senior retirement communities are for retirees who do not yet need any help with ADLs. 


Assisted living is a perfect medium between the two. Assisted living offers residents plenty of independence in their lives and the ability to make their own decisions, while still providing care services and ADLs assistance for things like:

  • Medication management
  • Housekeeping and cleaning
  • Laundry
  • Meal preparation
  • Money management
  • Bathing and personal care
  • Appointment and schedule keeping
  • Standing up and other mobility needs

What Medicare covers

To make a long answer short, Medicare does not cover assisted living costs. Medicare, for the most part, does not pay for any type of long-term residential care, including nursing homes and assisted living communities, so if one of these is the best option for your loved one, you will need to find a different way to pay than through their Medicare plan. 


Medicare will sometimes pay for a short-term stay in a skilled nursing facility or for some home health care options, but senior living communities like assisted living are not included in Medicare plans. This can pose a problem for many elders, especially as the senior population often needs some sort of residential care community as they continue to age. 

Other payment options

While Medicare doesn’t help pay for assisted living, there are some other payment options that can give your loved one assistance in covering the costs of a senior living community.

Long-term care insurance

Most long-term care insurance policies will cover the expenses associated with senior living, including assisted living costs. While the popularity of the traditional version of these plans has decreased over time, there are new “hybrid” plans that might be a good investment for your loved one. 

Life insurance policies

Some life insurance policies will cover assisted living costs, but it varies from plan to plan. While most of us might think that life insurance is only paid out after a death, they can offer payouts to seniors still living if they meet the plan’s qualifications. 

Veterans benefits

Often times there are VA benefits that will help pay for assisted living or other residential care options if your loved one served the country. Check with your loved one’s local VA chapter for more information. 

Medicaid

If your loved one doesn’t have any savings, or had a low income while they were working, they might qualify for Medicaid, a government program made to help cover the costs of healthcare for those in dire financial circumstances. Medicaid coverage is determined state by state, so it may or may not help depending on where your loved one lives. 

Out-of-pocket

If your loved one has saved enough money throughout their life, they may be able to afford assisted living costs from their savings. Planning ahead is key for this payment method, and things like waiting lists, community “shopping”, and retirement income plans are important for your loved one. 


Reprinted with permission from Vista Springs Assisted Living.



Music therapy for senior holistic care

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Courtesy Vista Springs Assisted Living

By Vista Springs Assisted Living


Holistic care seeks to address some of the aspects of your health that traditional care options can sometimes overlook. The holistic approach works to heal more than the body by taking the mental and spiritual needs of a patient into consideration. Things like aromatherapy using essential oils and color therapy help promote wellness that, when used with the direction of a healthcare professional in conjunction with regular care options, can lead to a happier and healthier you.


Music therapy is a type of holistic care that involves listening to, creating, or moving to music. A certified music therapist can assess the needs of an individual and create a plan that can improve physical, emotional, cognitive, and social needs. Seniors in particular, whether in assisted living communities or other senior living communities, can greatly benefit from music therapy as it is low-effort and provides a number of holistic benefits.

Benefits of music therapy

Stress reduction

Music therapy can help seniors relax and focus not on their surroundings—which can often be stressful or frightening—but rather to what they are listening to. The right music and lyrics can slow an anxious heart rate and help seniors relax.

Pain alleviation

As with stress reduction, using music therapy can help seniors by focus their attention on the music rather than any physical pain that they may be suffering from. The treatment can help seniors by creating a sensory stimulation that relaxes muscles and calms the mind.

Bringing seniors together

Music therapy is often a social activity. Seniors can listen and do activities in groups while connecting to each other through the music. Being in a group during therapy helps seniors feel less isolated and alone. And an improved social life is important to your loved one’s overall well-being.

Physical movement and exercise

We all know songs that immediately get our feet tapping, and music therapists know how to take advantage of this. Music encourages movement. Swaying, tapping, dancing, and clapping are all forms of physical movement that can improve a senior’s well being without being straining and taxing on the body.

Improved mental health

Listening to music changes our moods. We notice this as we listen to our favorite songs and playlists. Some music can brighten us up, while other music can have a sobering effect. Music is incredibly powerful when it comes to affecting our moods, and a trained music therapist can harness that to improve the mental health of seniors.

Cognitive benefits

One of the most unique benefits of music therapy compared to other holistic care options is the improvement it has been shown to have on cognitive functions in seniors. The rhythmic sounds and vibrations in music increases blood flow to the brain, which can help with a senior’s ability to speak and think clearly.

Music therapy, dementia, and Alzheimer’s

A major reason behind the use of music therapy as a holistic care treatment for seniors is the relation between music and memory—namely, memory loss diseases like Alzheimer’s and other forms of dementia. Music therapy has been shown to help seniors who are suffering from these ailments.


Music can trigger intense memories, even in patients who struggle with memory loss. There have been cases of unresponsive seniors in late stage dementia moving and interacting with music, and cases of nonverbal seniors humming or making noises during music therapy appointments.


Music therapy can also help pacify some of the aggressive and agitated behaviors associated with memory loss disease. As with stress and pain management through music therapy, the relaxing sounds and rhythms can help soothe seniors and encourage calmness.

Paying for music therapy

A big question that you may have is whether music therapy is a reimbursable service through a healthcare plan. Under Medicare, music therapy is a fully reimbursable service so long as they are included in part of a treatment plan rather than as a recreational activity. With Medicaid, music therapy can sometimes qualify under existing treatment categories. Each state is different, so make sure you know beforehand.


Private insurance usually goes through a case-by-case study, but nearly all major health care plans have reimbursed for music therapy at some point. Make sure that you have the backing of a health professional and a treatment plan to show how music therapy will help to reach treatment goals.

Final thoughts

Music therapy provides great benefits for seniors, but as with other holistic care options it shouldn’t be taken as a magic cure for all ailments, or as a replacement for traditional medical care. Music therapy works best when combined with other care therapies.


Another thing to keep in mind is the lack of verified scientific research and scientific studies done on music therapy. While it is an established health profession there are some claims of what music therapy can do that ought to be carefully considered before they are believed.


You can find a music therapist near your loved one, or a sometimes a nearby open class specifically tailored for seniors. The benefits of music therapy when administered by a certified music therapist are incredible, and your senior family member can enjoy all the benefits of this holistic care treatment.


Reprinted with permission from Vista Springs Assisted Living.

Getting help with Medicare

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File photo

By Regina Salmi, Area Agency on Aging of Western Michigan

 

When it comes to figuring out Medicare, it can feel as though we’ve taken on an encore career trying to sort through it all. There’s Medicare, Medicare Advantage, Medicare supplemental insurance, part D coverage and then the retirement insurance you may already have. It can feel overwhelming. With the Open Enrollment period right around the corner, it might be time to get some help with deciding what plans work best for meeting all of your healthcare needs. The Michigan Medicare/Medicaid Assistance Program, or MMAP for short, is available to do just that.

 

MMAP is part of a federal program that provides free local healthcare coverage counseling to people with Medicare. MMAP is non-profit and run by highly skilled volunteers.

 

Bob Callery, MMAP Regional Coordinator, states, “MMAP does not have any affiliations with insurance companies and our volunteers are not licensed to sell insurance.”

 

This is important, because it means the MMAP counselor is looking at what is in your best interest. MMAP counselors will explain Medicare benefits and how they work, review prescription plans, Medicare Advantage Plans and Medigap policies. They are also able to help individuals apply for benefits. Having the right coverage can make a big difference in a person’s life (and their finances).

 

Sharon, a MMAP counselor, met with a woman who was living on about $900 per month. She was a widow and paying for the health coverage her husband had before he died. She was paying approximately $400 a month for this coverage.

 

“That didn’t leave her much to take care of her house and utilities,” Sharon relates, “We talked about getting her on supplemental insurance through Medicare. She was really reluctant at first, but in the end we were able to save her about $300 more a month.”

 

File photo

Another MMAP counselor shared a similar story. Karen received a call from a person living on a little over $700 per month who exclaimed, “I can either eat or take my medications.” Karen was able to get help her do both by reviewing her coverage and helping her get the benefits that worked best for her.

 

Open Enrollment for Medicare begins Oct. 15 and runs until Dec. 7.  MMAP recommends Medicare beneficiaries review their plans every year to check for policy changes. The plan you’re currently on can change the medications they cover, their network of pharmacies, even premiums, deductibles and co-pays. At the same time your own needs might be changing as well, requiring a different kind of coverage than you had this year. Reviewing your benefits and insuring your coverage is right for you might help you avoid costly payments.

 

The Social Security Administration has also begun releasing the new Medicare cards. In an effort to reduce identity theft and fraud, the cards were redesigned to remove your social security number and to replace it with a unique identifier. Michigan residents will see them arriving this fall with all new cards being mailed before March 31, 2019.

 

Callery advises, “These cards will be mailed to the current mailing address on file with Social Security. Make sure you contact them if your address needs to be updated.” Mr. Callery also warns, “Social Security and Medicare do not call beneficiaries to update their records. If you receive a call like this, it is a scam. Do not give any of your personal information to the caller and hang up the phone!”

 

MMAP counselors are available to meet with people in person, over the phone and are available for home visits for those who are home-bound. If you’re interested in working with MMAP to review your Medicare benefits you can reach a MMAP counselor by calling your local Commission on Aging, dialing (800) 803-7174 or contacting Area Agency on Aging of Western Michigan at (888) 456-5664 or aaainfo@aaawm.org. You can learn more about MMAP by visiting their website, www.MMAPInc.org.

 

 

 

 

Snapshots: Wyoming, Kentwood and other news you need to know

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We Have Teeth and We Vote!

Led by Oral Health America, Demand Medicare Dental is a national campaign to improve oral health (and overall health) for older adults by adding a dental care benefit to Medicare. 

 

 

Online taxes, election security, county mental health on agenda at Chamber’s Government Matters

The Government Matters meeting brings together representatives from the cities of Wyoming and Kentwood, Kent County commissioners, local Michigan state senators and representatives, as well as often representatives of Michigan’s U.S. senators and U.S. congressman who represent the Wyoming and Kentwood area.

 

 

Pet-friendly vacations for all West Michigan dog-lovers

Any pet-lover knows it’s tough to walk out the door for vacation when you have to leave your furry friends behind. Luckily, there are plenty of places throughout West Michigan ready to welcome both you and your four-legged friends! We’ve gathered some of our favorite pet-friendly locations to help you plan your next trip for the entire family.

Senior Living: Open Enrollment Season for Medicare Starts Oct. 15

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By Amanda Haberlein,

Public Relations/Communications Coordinator for the Area Agency on Aging of Western Michigan

 

Each year Medicare offers an Open Enrollment period for those who have a Medicare Part D prescription drug program. Open Enrollment begins Oct. 15 and lasts through Dec. 7 and is the time when Medicare beneficiaries are encouraged to review their current plan and determine if it is still the best option to fit their current needs. This is the only time during the year that beneficiaries can make changes to their prescription coverage so it’s important that they review all the factors when making their decision.

 

areaonagingIn fact, the Michigan Medicare/Medicaid Assistance Program (MMAP) which utilizes volunteers to help people make informed health care decisions, including choosing a prescription coverage plan, recommends people follow the five steps below during Open Enrollment.

 

Five Steps to Choosing the Best Medicare Part D Prescription Coverage:

 

Review your current plan. Experts recommend that everyone reviews their current plan, even if you are happy with the coverage you have received. Plan information can change each year resulting in changes to medications that are covered, premium prices and even the co-pay amounts. Just because your current plan has met your needs, doesn’t mean it will continue to for the next year. Make note of any changes you see in your current plan and if they don’t work for you be sure to look at the other options available. If you are still happy with your current plan after you’ve reviewed any updates, simply do nothing and you will remain enrolled in the same plan.

 

Consider ALL your medications. It’s not uncommon to be prescribed a medication that you weren’t taking at this same time last year. Be sure to have a current list of all the medications you are taking and check each one against the plan you are considering to see if it’s covered and what the cost will be. Don’t assume that just because it is a low cost medication or well known drug that it will be covered in all plans. A simple way to start is to visit www.medicare.gov and input all your medications. They will then generate a list of plans that will cover those prescriptions. Again, you need to review those plans for things such as premiums, co-pays and coverage amounts before making a final decision.

 

See if you qualify for help. Experts encourage those on a fixed income to see if they qualify for help through the Extra Help, Medicare Savings or the Medigap Subsidy Program. Extra Help is a Social Security program that helps to reduce or eliminate prescription plan premiums, deductibles and copays for covered medications. The income limit for the Extra Help program is $1,505 for a single and $2,023 for a couple (asset limits of $13,640 for single and $27,250 for a couple). The Medicare Savings Program is a Medicaid program that will pay the Medicare Part B premium, with income limits of $1,010 for single and $1,355 for a couple (assets must be below $7,280 for single and $10,930 for a couple). The Medigap Subsidy Program through the Michigan Health Endowment Fund will provide assistance with Medigap premiums if the beneficiary has a participating policy. The income limits for this program are $1,485 for a single and $2,003 for a couple, with no asset limit. The financial assistance plans can make prescription costs more affordable for those on fixed incomes. Experts say often people are unaware that these programs are available to help and can often make a big difference for those who qualify.

 

Don’t procrastinate!  Even though Open Enrollment seems like a long time, experts encourage people not to procrastinate and to start researching early. “We encourage people to start right away, this way if they run into questions they have time to get their questions answered and they aren’t left scrambling,” said Bob Callery, Program Coordinator at MMAP. “During Open Enrollment, our volunteers across the state as well as those that work at Medicare receive a lot of phone calls and it may take a day or two to return calls and sometimes longer, depending on the call volume. Any technical glitches with the medicare.gov website can make people anxious, so we always encourage starting early.”

 

Ask questions! Changes to your Medicare Prescription coverage can only be made during open enrollment, which means if you make a mistake you will be stuck for the rest of the year. Mistakes can translate into increased costs and confusion about coverage.  Experts encourage asking questions to make sure you understand your coverage. “Medicare and the Prescription Drug Plans can be confusing for a lot of people, which is why we have volunteers to help,” said Callery. “If you have questions, you can look at the Medicare.gov website, call Medicare directly or call MMAP. We just ask that you understand we may not be able to return your phone call the same day, depending on call volume, but we do everything we can to answer all the questions that come to us.”

 

Experts also encourage those with the Blue Cross Blue Shield Legacy Medigap plans to contact MMAP today as Blue Cross Blue Shield announced this summer that they are raising the monthly premium for these plans starting January 2017.  For many people, these premium prices can be a significant increase to their monthly budget.  MMAP volunteers can help individuals review their options if they are enrolled in one of the BCBSM Legacy plans and wish to find a better option.

 

The Michigan Medicare/Medicaid Assistance Program (MMAP) is a free and unbiased statewide program made up of volunteers who can help you sort through Part D information. Volunteer counselors have gone through extensive training and can help navigate the maze of Medicare and Medicaid. To speak with a counselor, contact 1-800-803-7174.

 

Have questions on services for older adults and caregivers? Contact the Area Agency on Aging of Western Michigan at 616-456-5664 or 888-456-5664 or visit  www.aaawm.org for more information and resources.