Insurance Coverage for Fall Prevention Actions & Resources
Silver Sneakers: (a gym club membership that allows you to go to any gym in the network). Go to www.SilverSneakers.com & register the information on your Health Insurance Card. You will now be in the system.
Show your health insurance card when you go to a gym and they will look you up in the Silver Sneakers system. All the gyms offer classes and instruction for Medicare recipients at varying levels of physical fitness. Also, they have lots of online classes and activities.
Sometimes your insurance company will give you reward gift cards for participation as well. They want to promote healthy activities.
United Healthcare’s program is called Renew Active. Go to: www.UHCRenewActive.com, use your health insurance card to register and they will give you a membership number, which you provide to any Gym you wish to go to. They also have lots of activities for brain health, online video exercise classes and they have a way to track your walking/steps. They have a gift card awards program.
Free or low cost annual vision exams: You will need to go to a participating provider. Some companies will also give you money toward the cost of glasses or contacts.
Free hearing exams: You will need to go to a participating provider.
Hearing aids: Your insurance company may give you money toward hearing aids or they may limit what you will pay for hearing aids by applying a copayment. You will need to go to a participating provider.
Over-the-counter credits: The insurance company should provide you with a catalog.
You can make an order online, mailing in an order form or calling in an order.
Some companies may allow you to go directly to a drug store to get items.
Insurance companies give out monthly credits or quarterly credits, ranging from $25 to $300.
Some companies require you to use up all the credits each month/quarter or you will lose them; other companies will allow members to accumulate credits till the end of the year.
The items in the catalogs will be vary but generally are pain/cold/allergy mediation, vitamins, personal hygiene products and home safety items, and home safety items that are used to prevent falls.
Free Emergency Alert Systems and Monitoring: this is a life alert system. You are given a button that you can wear on a necklace. If you are home alone and need medical help you can push a button and help will come. The monthly monitoring cost is also included. (Available on most HMO plans).
Free Annual Checkups and House calls programs:
A visit to a primary care physician is a critical first step in Fall Prevention.
All Medicare Advantage Plans will offer you a free annual physical—including routine blood work—with your doctor.
They also cover a long list of free preventative tests and screenings.
Some companies will offer a house-calls programs where they will send out a nurse practitioner to meet with you in your home, do a evaluation of your medical history, write down all your medications and evaluate your needs within your home. They send the report to your doctor so that it can become part of your medical records. It is not meant to take the place of your primary care doctor. It is meant to support your doctor in your care.
Therapies (Speech, Physical and Occupational): A fall assessment by a physical therapist may require a medical reason, such as a fall, a near fall or a fear of falling based on a change in health and/or mobility.
Your primary care doctor or a specialist will write a prescription for the therapist.
You will then need to find a network provider with your insurance company.
Durable Medical Equipment (DME): If you and/or your PCP, Occupational Therapist or Physical Therapist determine that you need items like canes, or walkers or other durable medical equipment.
Durable medical equipment is covered by Medicare.
All the Medicare-covered DME items at: www.medicare.gov/coverage/durable-medical-equipment-dme-coverage.
Your PCP or a Specialist will need to write a prescription for durable medical equipment.
They will need to show that it is medically necessary.
Call your insurance provider to find an in-network supplier.
Preventive Care: A list of preventative services covered by Medicare can be found here: https://www.medicare.gov/coverage/preventive-screening-services.
NOTE: Many advantage plans offer enhanced preventative care services.