(November 5, 2015)- Carol Tomey had her left hip replaced a year ago. Rehabilitation has been slow but steady.
“When I came in, the staff here assured me that I would, Medicare would cover all the charges,” said Tomey.
Tomey hasn’t had to worry because she signed up with traditional Medicare.
“In Mrs. Tomey’s case,” said Angela Norris, RN, “she had original Medicare; she had three consecutive nights in the hospital and with Medicare that allows you for admission for skilled nursing facility up to 100 days.”
That’s more than three months for rehab, which is pretty generous, it turns out. Had Carol signed up with Medicare Advantage, which is administered by insurance companies, she’d probably not get that 100 days.
“What folks don’t often understand when they sign up for one of these plans, they have to get approval through their insurance companies," said Norris.
Insurance companies tightly control programs like rehab in a skilled facility like Allisonville Meadows. The insurance companies have to make a profit. They do that when they cut costs. So for those picking a program, it’s buyer beware.
“My recommendation would be, one of two things: contact somebody who has an unbiased opinion, that can review the facts, compare and contrast between Medicare and Medicare Advantage,” said Norris.
Medicare Advantage plans are administered by Anthem, United Health and Humana. They can compare favorably with traditional Medicare in the areas of drug coverage and out of pocket limits.
For a more detailed comparison click here. A senior and family health fair is being held Saturday Nov. 7 from 9 a.m. to 12 p.m., where a question-and-answer session is planned regarding the difference between Medicare and Medicare Advantage.
Seniors have until Dec. 7 to make their choice.
4 Your Health is presented by American Senior Communities.