Plan J "extras"

[agentjhc]

Someone asked me what type of home coverage is provided by Plan J. I've read that it says "home recovery" but what does that entail with a plan J? Does it cover "sitter" services for terminally ill?

 

[goillini52]

Someone asked me what type of home coverage is provided by Plan J. I've read that it says "home recovery" but what does that entail with a plan J? Does it cover "sitter" services for terminally ill?

Without looking it up(my memory isn't what it used to be...lol)...it will cover up to 40 Medicare approved home visits at $40 each for a maximum $1,600 per year. It covers the same # of visits you had covered by Medicare. If you had 20 visits approved by Medicare, that's what Plan J covered.

It also has a $120 per year preventative care benefit that would pay on routine physicals.

Other than those 2 benefits, it's the same as Plan F(at one time it included prescription coverage).

 

[yogooglethis]

Without looking it up(my memory isn't what it used to be...lol)...it will cover up to 40 Medicare approved home visits at $40 each for a maximum $1,600 per year. It covers the same # of visits you had covered by Medicare. If you had 20 visits approved by Medicare, that's what Plan J covered.

It also has a $120 per year preventative care benefit that would pay on routine physicals.

Other than those 2 benefits, it's the same as Plan F(at one time it included prescription coverage).

The routine physical is a moot benefit now since medicare now covers annual wellness but IMO the at home recovery is a good benefit however it's rarely used because the insured has to be proactive about making a claim since it is not automatically triggered by an initial claim to medicare like the other covered benefits.

 

[goillini52]

The routine physical is a moot benefit now since medicare now covers annual wellness but IMO the at home recovery is a good benefit however it's rarely used because the insured has to be proactive about making a claim since it is not automatically triggered by an initial claim to medicare like the other covered benefits.

Technically, it's not quite the same thing.

"Medicare does not cover an annual physical exam, as such. This may be confusing, so let’s look at what Medicare does cover."

https://blog.medicaremadeclear.com/Physical-Exam-Wellness-Visit-What-Medicare-Covers-2/

 

[yogooglethis]

Technically, it's not quite the same thing.

"Medicare does not cover an annual physical exam, as such. This may be confusing, so let’s look at what Medicare does cover."

https://blog.medicaremadeclear.com/Physical-Exam-Wellness-Visit-What-Medicare-Covers-2/

Technically you are right but whatever they call it it is basically a pat down .the biggest difference is now the provider can get paid by coding it under preventitive whereas before medicare covered it at all many providers use to code it under office consultation to get paid.

 

[goillini52]

Technically you are right but whatever they call it it is basically a pat down .the biggest difference is now the provider can get paid by coding it under preventitive whereas before medicare covered it at all many providers use to code it under office consultation to get paid.

Yep, it all depends on how they code it.

 

[agentjhc]

But the "home visits" aren't for sitting with a terminal patient at there home?

 

[goillini52]

But the "home visits" aren't for sitting with a terminal patient at there home?

No, they aren't.

 

[Newby]

But the "home visits" aren't for sitting with a terminal patient at there home?

Sounds like you might be thinking of Hospice care. Medicare A & B already cover that. And all Med Sups cover the RX co-pay for the drugs administered by hospice.

 

[agentjhc]

I was thinking same about hospice. Someone messaged me a specific question about what extra they could get from a Plan J. I'm not sure of the other details.