Trying to understand Medicare coverage is like trying to understand how a furnace works. It’s boring and complex and there are a lot of parts to consider. And then the heat goes out and suddenly you are trying to figure out something that is boring and complex with a lot of parts and you are cold and it’s a crisis. It’s one of those things that you don’t really want to understand but you need to use. And if you ARE someone who likes to understand what Medicare covers then please come help the rest of us, you little unicorn.
Getting older isn’t cheap and like all insurance companies Medicare is stingy. There are a few little tips I have collected and want to share with you bc we wanna take little victories where we can. Never mind that long term care can cost over 100K per year. We will take the bones they throw us when we can. To help lighten your load by an ounce or two, here are some surprising things Medicare covers:
Assistive Devices
Canes, walkers, wheelchairs and commode chairs are called assistive devices in the medical world. In Medicare language they are also called durable medical equipment or DME. If your senior is likely to need one of these items for 3 years or more and their doctor orders it, Medicare will cover it. Ask for this. Sometimes healthcare providers forget or don’t know about this coverage.
Therapeutic Shoes/Orthopedic Shoes
Most people don’t like to spend money on unnecessary and expensive items. Lots of seniors will insist on wearing a “perfectly fine” pair of shoes that have lasted them several years. If your senior is one of the 30% of older adults with diabetes then it is important that they wear supportive and solid footwear. Diabetes often causes decreased sensation in the feet and toes scrunched into older shoes are prone to pressure sores that your senior might not be able to feel. Medicare pays for podiatry visits so long as there is a problem or a chronic condition like diabetes or bunions that could cause (costly) problems. Podiatrists can order therapeutic shoes and will refer to a place that will bill Medicare for them. These miracle shoes are spendy and can cost up to $200.
Chronic Disease Management Help
My dad didn’t realize what diabetes was all about or how important it was to manage well until he lost a toe. Nothing quite like a toe amputation to really drive the point home. Type 2 diabetes is more common in the elderly and it’s pretty hard to figure out especially if you don’t feel sick from it and you aren’t really that interested in figuring it out. Education about the condition is key to managing it. Medications to treat it can cause diarrhea so lots of seniors don’t like to take these meds. Ask your senior’s doctor for an order for this valuable education service. Included is 1 hour of individual training, 9 hours of group training and if needed 2 hours of follow up training yearly. Education is provided by some combination of dietician, RN or pharmacist. Medicare Part B covers this service.
Home Safety Assessments
Each year more than a third of adults over the age of 65 report at least one fall and half of them occur in the home. In 2021 almost 3 million older adults were treated in the emergency department for a fall. Ask your senior’s doctor about a home fall assessment. They can order one if there has been a recent fall or hospitalization and Medicare Part B will cover it. You can find a lot of information about fall prevention online but one nice thing about someone else providing a home assessment is that it takes you as the caregiver out of the role of the bad guy. Many seniors are understandably saddened by the need for home modifications (and sometimes this comes out as anger or yelling). When someone else comes and explains this to your senior it can provide validation, backup and most importantly someone else to blame if your senior is upset.
There are a lot of things Medicare does cover and a lot of things Medicare doesn’t cover. If you are wondering if something you are thinking about for your senior is on that list then check out this handy search tool on the Medicare website. It’s not perfect but it is a good place to start.
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