In case you were wondering…or possibly hesitating to seek treatment…yes, Medicare does have a mental health component.
This government program covers inpatient and outpatient mental health care which includes services to help find, diagnose and treat mental health problems. Part A will help cover care given in a hospital and Part B will help pay for doctors’ services, outpatient therapy, laboratory tests and partial hospitalization.
These services can be given in a clinic, doctor or therapist offices or outpatient hospital department. They can include individual and group therapy, family counseling, testing, occupational therapy, prescription medicine that cannot be self-administered and individual patient training and education.
Medicare, however, only pays for services provided by a health care professional who is part of the program. Always ask if your health professional accepts Medicare payment before scheduling treatment.
Some outpatient mental health care may require more intensive treatment than can be delivered through simple office visits. Your doctor or therapist may recommend what’s called a partial hospitalization program, a more intensely structured program. But, for partial hospitalization program to qualify for Medicare payment, your doctor must testify that the only alternative would be admission for inpatient treatment.
These partial programs are given through hospital outpatient departments and local community mental health centers.
Medicare does limit its coverage in an inpatient psychiatric hospital to a total of 190 days lifetime. After that, it will only pay for more inpatient psychiatric care in a general hospital where there is no lifetime limit for covered care. Because of this, most people receive treatment in the psychiatric ward of a general hospital.
Generally, you will have to pay 50 percent of the doctor and professional charges for mental health benefits after your yearly Medicare Part B deductible. If one has a supplemental Medigap or secondary insurance, it may cover the Part B deductible and the co-insurance. It’s always best to review your policy before you begin treatment so you are clear on what you may have to pay out of your own pocket. Don’t hesitate to discuss these issues with your provider.
Finally, individuals must understand the difference between traditional Medicare and a Medicare Advantage plan (HMO/ PPO) in order to decide which type of Medicare delivery system best meets their needs. All Medicare Advantage plans must provide the same benefits and services that are offered under traditional Medicare, but may not offer the same selection of doctors. Co-payments and deductibles also may differ.
For more information on Medicare or the Medicare Advantage plans you are encouraged to call SHINE (Serving the Health Information Needs of Elders) at 1-800-334-9999.
(Ms. Curtis is Regional Director of SHINE, a division of the Massachusetts Executive Office of Elder Affairs.)
Whether this is the first marriage for one or both, or if you have been down this road before, it’s likely that each party is entering this new partnership with more assets than toasters and vacuum cleaners.
Many couples create pre-nuptial agreements (PNA) to legally sort things out. A pre-nup is not romantic, but if one party has significantly more assets than the other, if you have children, or if you own or expect to inherit a business, it makes sense. It’s the best way to ensure that what you bring to the marriage is passed on according to your wishes in the event of your death or a divorce.
The first rule: Before heading down the aisle, be forthcoming:
Credit histories and ongoing debt: Marriage sometimes can make you a co-debtor.
Extent of total assets: This means everything, particularly if you live in a community property state.
Financial support of the marriage: Will both keep separate bank accounts or create joint accounts…or a combination of the two?
Obligations from previous unions: Discuss amount, and term, of alimony or child support, pre-existing business debts incurred with a former spouse, obligation to provide insurance coverage for an ex-spouse and does you ex have legal claim to your employer-sponsored retirement plan savings? Or, if you receive assets from a former spouse, will remarrying stop the receipt of a particular inheritance or discontinue financial considerations?
Property issues: What becomes of the house you don’t live in? What if the marriage ends through divorce or death and there also are children? This can be tricky and may require legal advice. But beware that this is not a sure thing. Judges have a lot of discretion and your ex may have employed a more skillful divorce attorney.
Supporting children: Second marriages often blend families. Jointly establish how much financial support each child will receive. Federal financial aid forms require that a stepparent’s income be considered in determining how much financial aid the child receives.
Informing your children of provisions to protect their inheritance may make them more supportive of your new union, especially if it has created a stepfamily or half-siblings. Similarly, naming your stepchildren in your will as beneficiaries—if you wish to leave them assets—is essential.
In general, the importance of clear communication with your spouse and all of the children in all matters cannot be overstated.
(DISCLAIMER: This material has been provided for general informational purposes only and does not constitute either tax or legal advice. Investors may wish to consult a professional tax advisor or a lawyer IRS CIRCULAR 230 DISCLOSURE: To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. tax advice contained in this communication is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed herein.)
(Mr. King is a Certified Financial Planner™ in Hyannis. 1-800-325-1099 or robert@capitalportfolios.net.)
The thought of “networking” sometimes makes one cringe. It conjures visions of people with name tags holding plastic glasses of white wine racing the clock in their search for jobs, potential customers or, possibly, that certain someone.
Here on the Cape, however, a new type of networking has developed in the social services field. Oh, there is a business element involved (to a greater or lesser degree), but the basic goal of these business-people is to connect with others in this often specialized field to provide their clients w\access to a full continuum of services.
One of the more successful of these is the Community Care Resource Group.
Founded almost 18 years ago when some of the marketing and admissions people from the Cape’s skilled nursing and assisted living communities started to meet informally “just to talk,” this small group now numbers more than 100 professionals representing a variety of fields such as home care, medical alarms and legal and financial services.
As in the beginning, their mission focuses on the Cape’s growing senior population, collaborating on ideas and providing information and referrals for elders in the community.
CCRG members meet mornings at rotating sites on the second Wednesday of the month and the program often includes a speaker. (The original group of admissions and marketing people still meets every other month.)
New members are welcome. Check out www.communitycareresource.org.
In a sign of the growing popularity of this activity, CCRG members and a similar organization across the bridge, the Bristol County Networking Group, will be holding a joint meeting September 6 at the Sippican Healthcare Center in Marion.
The Bristol mission statement echoes that of their Cape neighbors, dedication “to the support of individuals or groups serving the needs of elders…”
They also meet monthly (with a summer hiatus) and information can be obtained from the website of the Morton Hospital and Medical Center in Taunton, www.mortonhospital.org, clicking Services, Elder Behavioral Health Services and then the Bristol Networking icon.
Another relatively new organization on the Cape with a more commercial emphasis is Senior Life Services, which meets monthly at Mayflower Place in Yarmouth.
This group specializes on “professional planning for seniors,” with the emphasis on “professional.” This includes assistance in matters legal, financial and residential, both institutional and for those who choose to remain at home.
At last count that had 11 members representing a wide variety of fields and they’re seeking more. Contact John Butler at 509-790-7100.