Medicare Advantage plans were created along with the Medicare drug
benefit as a result of the 2003 Medicare Modernization Act. The plans
are funded by Medicare but design and administration are carried out by
private-sector insurers.
Medicare pays a fixed amount for your care every month to the companies
offering Medicare Advantage Plans. These companies must follow rules
set by Medicare. However, each Medicare Advantage Plan can charge
different out-of-pocket costs and have rules for how you get
services (like a referral or specific doctors, facilities, or suppliers that belong to
the plan for non‑emergency or non-urgent care).
Eligible Medicare beneficiaries enroll with an MA by signing on with a agent of the insurer. Anyone under Medicare Advantage can switch back to original Medicare between January 1 and March 31. Medicare requires a release from the insuring company
before accepting back someone from an MA plan. Contact your MA plan to learn about their requirement before releasing
coverage.
It's important to review the differences between the types of plans to
see which works best for you. There are several different types of
Medicare Advantage Plans:
HMO ( Health Maintenance Organization Plan)
HMO (Health Maintenance Organization Plan) - allows you to see doctors and
other health professionals that participate in its network. If your
doctor is already in that network, it could be a good option because you
tend to pay less out of your own pocket with network doctors.
PPO ( Preferred Provider Organization Plan)
PPO (Preferred Provider Organization Plan) - gives you the freedom to
choose any doctor, which can work for you if you prefer that kind of
flexibility.
Private Fee-For-Service Plan
PFFS (Private Fee-for-Service Plan) - pays a specific amount for health care
services and the treating doctor has to accept that amount - even if it
is less than his or her usual charge. If the doctor does not agree to
those terms, then Medicare will not cover services through that doctor.
Caring About Your Back
Shopping, driving, decorating, and all the activities during the day can put a strain on your back. Physical Therapist recommend that you don't slouch - try to maintain the natural curve in your back when you stand and sit.
When you lift, bend your knees, not your back, and keep the load close to your body. Also, be mindfull of your weight. Being overweight puts an added strain on your lower back.
To avoid injury, you may need to learn some new habits. A physical therapist can perform an evaluation of your strength and flexibility and design a fitness program that fits your needs.
Assistive Devices
Assistive devices ease the strains of daily activities at home, at
work or at play. They include medical equipment, mobility aids,
information technologies, practical daily aids and gadgets to suit all
tastes and needs.
There is many devices that can considerably improve
your quality of life. Find
out how they can help you and don't hesitate to use them! Some of
those devices include: cane, walker, wheelchair, slip-resistant
flooring, grab bars, hand-held shower head, bath seat with arm rails,
non-slip floor mat, easy-to-grip utensils, side-opening oven door,
heightadjustable cupboards and counters, automatic-stop kettle, pouring
aid, and many others.
Campus Physical Therapy Center
Special Needs Plans
SNP (Special Needs Plans) - is especially for people who have - as its name
implies - special needs. That includes (but is not limited to) those
living in a nursing home, Medicaid-eligible individuals, and people with
chronic diseases or disabling conditions.
Point of Service Plan
POS (Point of Service Plan) - covers both in- and out-of-network health
services, but at different rates. You pay less out of pocket when you go
to in-network doctors, labs, hospitals and other health care providers.
Medical Savings Account Plan
MSA (Medical Savings Account Plan) - includes both a high deductible and a
bank account to help you pay that deductible. The amount deposited into
the account varies from plan to plan. The money is tax free as long as
you use it on IRS-qualified medical expenses, which includes the health
plan's deductible.
CareAdvantage - Health Plan of San Mateo
While you are a member of CareAdvantage HPSM, you must use your membership card for our plan whenever you get any services covered by CareAdvantage and for prescription drugs you get at network pharmacies. Here’s a sample membership card to show you what yours will look like:
As long as you are a member of CareAdvantage you must not use your red, white, and blue Medicare card to get covered medical services (with the exception of routine clinical research studies and hospice services). Keep your red, white, and blue Medicare card in a safe place in case you need it later.
Here’s why this is so important: If you get covered services using your red, white, and blue Medicare card instead of using your CareAdvantage membership card while you are a
CareAdvantage member, you may have to pay the full cost yourself.