Navigating the complex and costly healthcare system on a fixed income can be a daunting task for many seniors dealing with chronic health issues. The stress of finding an affordable and comprehensive plan may lead some to neglect their health needs and skip important doctor visits. However, there is a solution designed to alleviate these burdens – Medicare Savings Programs. If you are feeling overwhelmed by the enrollment process, fear not! This blog post will walk you through the purpose and advantages of Medicare Savings Programs, as well as provide guidance on how to apply.

What are Medicare Savings Programs?

Medicare Savings Programs are state-administered programs designed to assist low-income seniors in covering essential healthcare costs associated with Medicare. These programs help alleviate the financial burdens seniors face by reducing out-of-pocket expenses such as premiums, deductibles, and coinsurance for Medicare Parts A and B. [1]. 

While Medicare was established in 1965 [2], the federal government introduced Medicare Savings Programs in the late 1980s [3] to help alleviate the struggles low-income seniors tend to face when paying high healthcare costs. These programs have changed and evolved over the years, permitting states to tailor assistance based on their populations’ needs. 

Medicare Savings Programs provide benefits for low-income seniors who may otherwise not have access to much needed healthcare. These programs play a critical role in providing:

• Financial Stability: Reducing out-of-pocket costs helps lessen the financial burdens seniors living on fixed incomes often struggle with  [4]. 

• Accessibility: These programs make healthcare more accessible and ensure that seniors receive timely care for chronic conditions and preventative services, such as health screenings and immunizations[5]. 

• Improved Health Outcomes: By reducing financial burdens and creating access to healthcare, seniors are more likely to receive necessary treatments and screenings early for disorders and diseases, leading to better overall health and quality of life. [6]. 

Who Qualifies for Medicare Savings Program?

Here are the eligibility requirements needed to qualify for Medicare Savings Programs:

1. Be at least 65 years old or qualify for Medicare due to a disability.
2. Be enrolled in Medicare Part A (and, in certain cases, Part B).
3. Have income and asset limits meeting the threshold set by the program.
4. Not already eligible for Medicaid (depends on state).

What Are the Three Types of Medicare Savings Programs?

Qualified Medicare Beneficiary (QMB) Program

This program helps cover a wide range of Medicare costs, including Part A premiums, Part B premiums, deductibles, coinsurance, and copayments. 

Specified Low-Income Medicare Beneficiary (SLMB) Program

This program helps cover Part B premiums. 

Qualifying Individual (QI) Program

Finally, this program helps cover Part B premiums. There is also a fourth program called the Qualified Disabled and Working Individuals (QDWI) Program, which you may qualify for if you have a disability, are working, and are unable to continue your Social Security disability benefits because you returned to work [8]. 

How to Apply for Medicare Savings Program

After identifying that you are eligible for a Medicare Savings Program, gather all necessary information and documents, including proof of income (pay stubs, tax returns, and/or Social Security statements), documentation of resources (bank statements and/or retirement accounts), Medicare card or proof of enrollment in Medicare, and proof of identity (driver’s license or state issued ID)[9]

Choose your preferred application method and submit all required documentation – either online using your state’s website  or portal, by printing the application, filling it out, and sending it by mail, or in person by visiting your local Department of Social Services..

When applying for a Medicare Savings Program, it is important to be thorough to ensure your application is processed timely. Make sure to organize your documents early and create a checklist of steps to follow. Seek guidance from advocacy groups, social workers, or trusted friends and family if you encounter any confusion during the application process. You can also visit your local Agency on Aging or Office of Public Assistance if you need help/assistance during the process – these agencies often have team members specifically trained to help seniors complete these applications.

Does the Medicare Savings Program Assist with Primary Care?

Medicare Savings Programs provide essential support to low-income seniors, enabling them to access the quality care they deserve. By easing their financial burden and helping to cover expenses such as premiums, deductibles, and coinsurance, these programs eliminate barriers to timely medical attention and coordinated care. This vital assistance ensures helps seniors to be able to prioritize their health, easing financial hurdles that can impact their well-being [10]

Medicare Primary Care for Seniors at Greater Good Health

Greater Good Health provides dedicated support with Medicare enrollment and coverage through local licensed insurance professionals. Find a location near you and contact Greater Good Health  for an appointment to learn about tools to help with your healthcare coverage needs.

 Are you overwhelmed by the complexities of healthcare insurance, confusing medical terms, and high medical costs? You’re not alone. Deciphering healthcare plans can be a daunting task, leaving many in need of guidance on coverage details and access to essential care. This uncertainty can cause delays in seeking treatment, ultimately affecting long-term health outcomes. Luckily, government programs such as Medicaid and Medicare offer relief by providing coverage for low-income individuals, families, and seniors, helping alleviate financial strain. If you’ve ever hoped for a simplified explanation of these programs, you’re in the right place with our blog!

Understanding Medicare vs. Medicaid

Medicare and Medicaid are both government programs that provide health coverage to individuals in need, but how do they differ? Let’s look at each program to learn more about coverage and benefits.

Who is Eligible for Medicare?

Medicare is a government-funded program created to provide affordable healthcare access, lessen financial strains on services, and improve health outcomes for individuals aged 65 and older. Beyond seniors, Medicare also extends coverage to select groups of younger individuals with disabilities and certain medical conditions.

Generally, Medicare is for people 65 or older. You may be eligible for Medicare earlier if you have a disability, End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant), or ALS (also called Lou Gehrig’s disease). [1]

Medicare has Four Parts [2]:

• Part A (Hospital Insurance) covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. Part A typically does not require a premium if you or your spouse paid Medicare taxes while working.

• Part B (Medical Insurance) covers outpatient care, services from physicians and other healthcare providers, durable medical equipment, and some preventative screenings and services. Individuals usually pay a monthly premium for Part B that is based on their annual income.

• Part C (Medicare Advantage) includes coverage from Part A and Part B, and can also include other benefits such as vision, dental, and wellness services. Medicare Advantage plans are offered through private insurance carriers and may have different coverage options and costs based on service areas.

• Part D (Prescription Drug Coverage) covers a portion of prescription drug costs through private insurance plans. Individuals pay a monthly premium for Part D. Coverage options, copays, and co-insurance may vary depending on the plan.

What is Medicaid?

Medicaid is a joint federal and state program designed to provide health coverage to low-income individuals and families. By ensuring access to necessary care, Medicaid supports vulnerable populations, including children, those pregnant, the elderly, and people with disabilities.

You may qualify for free or low-cost health care through Medicaid based on your income and family size. Eligibility rules differ among states.

In all states, Medicaid gives health coverage to some individuals and families, including children, parents, those who are pregnant, seniors with certain incomes, and people with disabilities. Some states have expanded their Medicaid programs to cover other adults below a certain income level.[3] 

The services covered by Medicaid vary by state, but generally can include: [4]: 

• Inpatient and Outpatient Hospital Services: Medicaid covers necessary hospital stays and outpatient services. 

• Physician Services: Medicaid helps cover regular doctor visits and specialist care appointments. 

• Preventative Services: Medicaid helps cover vaccinations, screenings, and wellness checks. 

• Long-Term Care: Medicaid helps cover nursing home care and community-based services for individuals who require long-term care. 

• Mental Health Services: Medicaid helps cover mental health treatment, like therapy. 

• Prescription Drug Coverage: Medicaid helps cover prescription medications. 

• Dental and Vision Services: In certain states, Medicaid helps cover dental and vision services. 

Can You Have Medicare and Medicaid?

You may be wondering if you can have both Medicare and Medicaid? The answer is yes – you can have both. Through dual eligibility and enrollment, you can access and utilize the benefits of both programs. [5]. 

Known as “concurrent enrollment” or “dual enrollment,” this arrangement offers numerous advantages, including:

• Enhanced Coverage
• Reduced Out-of-Pocket Expenses
• Expanded Access to Services

How, exactly, do the two programs work together? Medicare and Medicaid work together as your primary and secondary healthcare coverage. Medicare serves as your primary healthcare coverage, while Medicaid acts as secondary coverage. Medicare typically pays for services first, with Medicaid stepping in to cover any additional costs that Medicare may not cover. This secondary support is especially helpful for covering copayments, coinsurance, and deductibles that Medicare may not fully cover [5]. 

Who is Eligible for Both Medicare and Medicaid?

To be eligible for dual enrollment, you must meet the criteria for both Medicare and Medicaid. This includes being either 65 years old or older, or under 65 with a qualifying disability (and receiving Social Security Disability Insurance for at least 24 months).  [6]

Additionally, applicants must meet their state’s income limits for Medicaid, have limited assets as defined by the state, be a resident of the state in which they are applying, be a U.S. citizen or qualified legal resident, and be enrolled in Medicare Parts A and/or B.

How to Apply for Medicare and Medicaid

After understanding the eligibility criteria and benefits of Medicare and Medicaid, it is important to know how to apply for these programs.

To apply to Medicare [7], first, determine the enrollment period suitable for you. The initial enrollment period begins three months before your 65th birthday and extends three months after it. Special enrollment periods might be available through your or your spouse’s Employee Health Plan as well.

After identifying the appropriate enrollment period, gather all necessary information and documents, such as your social security number, birth certificate (or proof of age), and employment details if relevant. Choose your preferred application method – online through the Social Security Administration website, over the phone, or in person at your local Social Security office. Once your application is complete, you will receive confirmation of enrollment.

To apply for Medicaid [8], ensure you have gathered the required documentation including proof of income, bank statements, social security numbers, and identification.Then, visit your state’s Medicaid program website to submit your application. Depending on your state, you may be able to apply online, by phone, or in person. Eligibility results are typically received within two weeks of applying.

As we grow older, our ability to process stimuli changes, which often impacts our capacity to remember important information, learn how to do new things and the speed at which we take in and process information. This cognitive decline can feel discouraging, especially when you compare your cognitive abilities as a senior to how it was when you were younger. However, understanding how to recognize the early signs and symptoms of cognitive decline is essential for improving it, preventing it, and maintaining quality mental health and well-being. In this blog, we’ll talk about how!

What is Age-Related Cognitive Decline?

Before jumping into how to treat cognitive decline, let’s first run through what this is. Age-related cognitive decline can be described as the gradual changes in cognitive abilities that happen as part of the aging process. Other cognitive issues, like dementia and Alzheimer’s disease, count as more severe and progressive impairments. And, although these disorders are also fairly common, they aren’t a part of “natural aging.” 

Common cognitive changes, or cognitive decline, include:

• Slower information recall, which happens when seniors take longer to remember names or facts. It’s like when you have a fact or thought at the “tip of your tongue,” but just can’t seem to grasp it quickly. 
• Mild forgetfulness occurs when seniors forget where they placed certain items or miss appointments. 

What Age Does Cognitive Decline Start?

The age at which cognitive decline starts may be different for each individual, but it typically begins during one’s 60s [5]. Multiple factors may influence how slow or fast one develops cognitive decline, including lifestyle and genetics. For example, a healthy and active lifestyle, in which one reads often, engages in engaging conversations, and regularly participates in physical activities can delay cognitive decline [6]. Additionally, a family history of cognitive issues may increase risk and onset [7]. 

Age-Related Cognitive Decline vs. Dementia

Many people are confused about age-related cognitive decline and dementia, and this is understandable. Both dementia and cognitive decline involve memory issues, which is why they are confused. However, it is important to understand how they differ. 

Dementia is more severe than cognitive decline. Age-related cognitive decline tends to be mild and does not impair the individual greatly in their everyday life [8]. Sure, they may forget where they placed their watch or have trouble multitasking, but they can remember how to dress and feed themselves, how to get back to their home, and important identifying information about themselves, which often sets them apart from those suffering from dementia. Age-related cognitive changes are also gradual, whereas dementia usually progresses at a faster and more alarming pace. 

Causes of Cognitive Decline in Aging

Age-related cognitive decline can be caused by a variety of biological and environmental factors:

• Changes in Brain Structure [8]: As we get older, certain areas in our brains may naturally reduce in size. This often affects memory and processing speed. 

• Cardiovascular Health [9]: Poor heart health is a common issue that seniors face. This can reduce blood flow to the brain, which impacts cognitive function. 

• Mental Health Issues [10]: Numerous studies show that mental health issues, like depression and anxiety, have a large impact on cognitive health and its decline. 

Age-Related Cognitive Decline Symptoms

If you are a senior and think you may be experiencing cognitive decline, ask yourself if you have any of the following symptoms: 

• Forgetfulness, or having trouble remembering recent events, names, and/or information. 
• Difficulty concentrating, like having trouble focusing during conversations, while reading, or multitasking. 
• Trouble making decisions, like weighing options or making plans. 

When to Seek Cognitive Decline Help

If you have any or all of the symptoms above, talking to a healthcare provider is a great next step. Consult with your doctor if your memory issues are beginning to interfere with your daily tasks, relationships, or well-being. Additionally, feelings of confusion, disorientation, or personality changes are warning signs that warrant a talk with a professional. 

Your healthcare provider may recommend some screenings and assessments that can help determine if what you are experiencing is age-related cognitive decline, or possibly something else. If they see fit, they will likely perform a cognitive test and evaluation, which can help to find appropriate treatment. 

Primary Care Benefits for Aging Cognitive Decline

Primary care providers work hand-in-hand with you to help manage your cognitive decline. They will perform routine check-ups and assessments to help monitor your changes in cognition over time and ensure your personalized care plan is working effectively to get you where you need to be. Likewise, primary care providers can offer preventative measures and lifestyle recommendations for supporting overall cognitive health, such as particular exercises, diets, and lifestyle changes. 

Schedule an Appointment With Greater Good Health

We value preventative and holistic care for age-related cognitive decline at Greater Good Health. Click here to contact us today!

Do you ever feel nervous, embarrassed, or unsure about communicating your health concerns with your doctor? To ensure that seniors receive the best possible healthcare, they must be willing to communicate openly and honestly with their healthcare providers. Effective communication helps healthcare providers understand and support their patients’ unique health journeys, which leads to personalized and effective treatment plans. Although effective communication is ideal, many seniors find conversations with their healthcare providers difficult. They may experience hearing or cognitive impairments that make communication difficult or feel intimidated by medical terminology that healthcare providers often use. This blog post will go into the significance of communication with healthcare professionals, tackle the common concerns seniors face, and examine how to overcome them. 

Common Elderly Health Concerns

• Chronic Conditions: Seniors often face a variety of chronic conditions that can negatively impact their quality of life. It is important to discuss how to treat these conditions and reduce their effects. Some of these common chronic conditions include Arthritis, which leads to joint pain and mobility issues [1], heart disease, which requires careful management of diet, exercise, and medication [2], and diabetes, which requires regular monitoring of blood sugar levels and lifestyle changes [3]. For more detailed information on managing these chronic conditions, please explore Greater Good Health’s website. 
• Cognitive Decline: This includes issues such as memory loss, dementia, and Alzheimer’s disease, and is a common concern among seniors [4]. Cognitive decline can tremendously affect one’s ability to function and complete daily tasks independently. This makes it necessary for seniors and their caregivers to recognize early signs and markers of cognitive decline, and seek appropriate support. The best place to start when learning how to recognize the signs and symptoms is by speaking to a healthcare professional. 
• Mobility and Balance Issues: A large group of seniors experience mobility and balance issues, which increases their risk of falling and hurting themselves [5]. These falls can lead to serious injuries and further limit their mobility. Asking your doctor about what strength and balance exercises would help you the most, as well as discussing any concerns or worries you may have, is essential for fall prevention. 
• Mental Health: Many seniors deal with mental health concerns, such as depression, anxiety, and social isolation [6]. These concerns can greatly affect seniors’ well-being and outlook on life. Seniors need to talk about their mental health and check in on how they are feeling with their healthcare providers. Mental health is often interconnected with physical health; negative effects can be alleviated with the right interventions. 
• Sensory Impairments: These include hearing loss and vision problems, which are common among seniors, but can significantly impact their quality of life [7]. These concerns often hinder communication and your ability to partake in social activities, exacerbating feelings of isolation and loneliness. Regular screenings and conversations with healthcare professionals can likely help seniors maintain their independence and interactions with others [8]. 

How to Talk to Your Doctor About Health Concerns for Seniors

Proactive and effective communication with healthcare professionals is extremely important for seniors to address their health concerns and prevent issues from arising. Open dialogue can help healthcare professionals and seniors get on the same page of understanding, improve care, and enhance quality of life. Here are some steps to help seniors champion themselves in conversations with their healthcare providers, even when it may feel daunting: 

Prepare Before the Appointment

• List Your Concerns: Write down your symptoms, concerns, changes in health, and questions you may have. Share this list with your healthcare provider once you get to your appointment. Making a list beforehand ensures that you won’t forget anything at your appointments. 
• Review Medications: In addition to listing your concerns, also list all of the current medications and supplements you are taking. This includes herbal supplements and vitamins. Having an updated list of your medications and supplements will help your healthcare provider assess potential interactions and adjust treatments where needed. 
• Ask for Help: Even with the proper preparation, it can sometimes still feel difficult to have to talk to your healthcare provider alone. In this case, feel inclined to involve a caregiver or family member. They can provide support in communicating your concerns effectively. 

Focus on Symptoms and Changes in Daily Life

• Talk About Pain: When speaking to your healthcare provider, it is important that you describe the pain levels you are in, how long you have been feeling this way, and what triggers this pain. For example, do you experience back pain all the time, or is it only when you are standing for long periods of time? Rate your level of pain on a scale of 1-10 if possible, and be sure to talk about how it affects your daily responsibilities. 
• Discuss Mobility and Independence: Mention any difficulties you may be experiencing with necessary activities, like walking, balancing, or other daily activities. Be as specific as possible so that your healthcare provider can understand how much your symptoms impact your life. 
• Address Mental Health Concerns: Make sure to bring up any mental health concerns you may have, such as trouble remembering things, or anxiety and depression. These are important to talk about, as they can lead to physical symptoms and drastically affect your quality of life.  

Ask Questions and Clarify

• Don’t Hesitate to Ask: Remember, your healthcare provider is there to answer any and all questions you may have. Do not be afraid to probe them on diagnoses, treatment options, or prognosis. Your health is crucial and deserves proper answers. 
• Ask for Clarification: Although unintentional, some healthcare providers may answer your question in a way that doesn’t make sense to you, especially if they are prone to using medical terminology that is not as accessible as they may think. Do not shy away from asking your healthcare professional to explain the medical terminology in simpler language, or ask them to repeat their answer. 
• Bring Up Preventative Care: Remember to ask your healthcare provider about preventative screenings, vaccinations, and other age-related check-ups that may be due. You want to be as proactive as possible about preventing future illnesses and conditions. 

Overcome Communication Barriers

• Be Honest: Although you may feel embarrassed or weary about mentioning certain health issues, make an effort to share your thoughts and questions regardless. Honesty is necessary for receiving effective and accurate treatment. 
• Work with Hearing or Vision Impairments: If you experience hearing or vision impairments, bring assistive devices to your appointment to support you. If you do not have assistive devices, make your doctor aware of your impairments and ask them to accommodate you. 
• Use Written Information: It may be easier to remember and grasp your healthcare provider’s medical advice when they write it down for you, rather than just telling you. Request written summaries or notes from your doctor, so you can review them later. This can help promote understanding of your treatment plan. 

Follow Up After the Appointment

• Next Steps: At the end of your appointment, remember to schedule your next appointment for regular visits or a follow-up appointment for a persistent issue. 
• Medication Adjustments: If you are prescribed a new medication or treatment, add this to your list and review any changes with your doctor or pharmacist to ensure safety and effectiveness. 
• Stay Organized: Use an agenda or calendar to keep track of all your upcoming appointments, treatments, and any new health developments. Stay organized to avoid any confusion or missed appointments. 

The Benefits of Specialized Senior Healthcare

• Tailored Care: Specialized senior care is utilized to manage the specific aging-related issues that you may be facing. For example, geriatric care management focuses on the assessment and treatment of older adults, making sure that their health concerns are prioritized and that seniors have the resources they need to make quality health decisions [9]. This is a tailored approach that allows healthcare providers to develop personal relationships with their senior patients and provide individual care plans that consider both the medical needs and lifestyle preferences of their patients. 
• Comprehensive Approach: Specialized senior healthcare uses a holistic approach to view well-being. This means that instead of just working towards greater physical health, healthcare providers are emphasizing physical health and social, emotional, and mental health. This will likely involve creating personalized exercise programs, nutritional guidance, support for mental health concerns, and recommendations for social and community activities. Focusing on all aspects of life makes specialized care helpful for seniors to not only manage their existing conditions but to enhance their overall well-being. 
• Coordination of Care: A significant aspect of specialized healthcare is coordination of care, which is when all your healthcare providers work together as central points of contact to ensure that care is synchronized across different services. For example, your primary care physician will likely work together with your therapist, endocrinologist, nutritionist, etc, to make sure you are getting the comprehensive care you need. This coordination helps reduce the risk of medication errors, duplicate tests, and conflicting treatment plans. 

Primary Care for Senior Health Concerns at Greater Good Health

At Greater Good Health, we believe in championing our patients to make quality and well-informed decisions about their health. This is why we encourage patients to have effective communication with their healthcare providers and advocate for their needs. Reach out to Greater Good Health to learn more about our services and how we can help you on your senior healthcare journey! 

Finding the most fitting senior care option is extremely important so older adults can get the health support they need while enjoying their best quality of life. Because there are so many choices out there, it may feel overwhelming trying to find the option that best fits your needs. Every senior health option offers different levels of care and amenities, which can get confusing, especially when considering them all at once. The end goal, however, is to find an option that acts as a solution to a personal health need—no matter what that health need may be. This blog will provide an overview of the most common senior care options and some tips on how to navigate making this choice.  

Understanding Senior Care Options

Senior care options cover a wide range of services for older adults, designed to include both in-home and facility-based care, depending on preference and need. In-home care involves professionals coming directly to your home to help with daily tasks, medical procedures, and/or companionship. For example, in-home care may have a professional help you wash your dishes and do your laundry, administer your insulin for diabetes, and/or keep you company while you eat dinner. Facility-based care, on the other hand, involves living in a community or center where professional support is available at all times. This can range from basic assistance to full-time nursing care. 

Seniors and/or their caregivers should research the different care options available and assess their current needs and preferences to make a smart choice. By exploring many options, families can find the right fit, keeping their loved ones comfortable, safe, and happy, all while meeting their health needs.

Home Care Options for Seniors

There are a few common types of home care options that seniors can choose from depending on their needs, including: 

• In-Home Care [1]: Professional caregivers will come to your home to help you with basic tasks, medical needs, and/or companionship. Whether you need help with your chores, require someone to help you organize and administer your medication, or just feel lonely and want someone to keep you company, in-home care professionals have you covered. 

• Assisted Living [2]: Though commonly confused with nursing homes, assisted living communities allow seniors to feel independent while still getting the support they need. Assisted living communities are typically apartment or townhouse-style living spaces, where residents have private or shared spaces but have access to on-site assistance with tasks, medication management, and emergency needs. Assisted living communities often provide opportunities and shared spaces for social activities, like group meals and game nights. 

• Nursing Homes [3]: This is the highest level of care for seniors who may require extra medical attention and support. This type of facility is staffed 24 hours a day with doctors and nurses, in case of emergency health issues or conditions that require continuous care. 

Making the Right Choice

To find the senior care option that works best for you, make sure to assess your health needs/goals and lifestyle preferences. Do you prefer lots of social engagement, or do you prefer to stay more independent? Do you struggle with completing your daily tasks? Do you find the security of living in a community with healthcare professionals comforting? Knowing the answers to these questions on personal preference and health needs is important before you commit to a care option. Additionally, it is recommended that you compare the costs of the options you are considering with your current financial situation and budget. It may be helpful to make a chart of all your options and their costs, so you can see it mapped out in front of you. 

Healthcare professionals are here to help you, so use their vast insight to your advantage! Consulting with healthcare providers, care managers, and financial advisors is important for making the right decision about your health care. Your doctor can provide insight on the level of medical attention you require, which may help you choose between in-home care vs assisted living or nursing home facility. Care managers can help you weigh your preferences and figure out which living situation would make you the happiest, while still caring for your physical health. Finally, financial advisors help you understand the costs of care, and how this may fit into your budget. 

Senior Care Options at Greater Good Health

At Greater Good Health, we focus on providing care that is senior-focused, proactive, empathetic, accessible, and holistic. We are committed to offering you quality care in a variety of ways, including primary care, preventative care, chronic care management, and care coordination. Contact us today, and together, we can work towards meeting your health needs and goals!