Ageism, Medicare, and the 5Ms

What is Successful Aging?

The absence of disease and disability

High cognitive and physical functioning

Active engagement with life

What is Optimal Aging?

The capacity to function across many domains—physical, functional, cognitive, emotional, social and spiritual—to one's satisfaction and in spite of one's medical conditions

What is Healthy Aging?

The process of developing and maintaining the functional ability that enables wellbeing in older age - creating the environments and opportunities that enable people to be and do what they value throughout their lives

DOES NOT MEAN FREE FROM DISEASE

Insurance options for older adults in the US

commercial

medicare

medicaid

tricare

Requirements for signing up for Medicare

1. 10 of more years of paying Uncle Sam taxes

2. turning 65

What does Medicare Part A cover?

acute care in hospitals

IPRs

skilled nursing stays

hospice care

home health

What does Medicare Part B cover?

outpatient rehabilitation services

ambulance services

durable medical equipment

mental health

What IS NOT covered under Medicare?

LTC

most dental

eye exams related to prescribing glasses

dentures

cosmetic surgery

acupuncture

hearing aids and exams for fitting them

routine foot care

What is Medicare Part C?

Combines the benefits of Medicare Part A, Part B, and sometimes Part D - "Medicare Advantage Plans"

it is Medicare administered by commercial insurance just like commercial insurance

What is the bare minimum Medicare Advantage Plans must offer?

at least the benefits Medicare fee-for-service offers

What does Medicare Part D cover?

prescription drugs

Why might Medicare recipients need Medicaid?

Limited income/resources may make sudden healthcare costs unaffordable

What is a "spend down" for Medicaid?

Using personal resources until meeting Medicaid financial eligibility limits.

What does "dual-eligible" mean?

A person who qualifies for both Medicare and Medicaid.

What does "insurer of last resort" mean?

Medicaid generally pays after other available insurance or payers

What type of care can create major costs for Medicare recipients?

Long-term care, such as nursing facility care

Why can fixed income make healthcare costs difficult?

There is limited financial flexibility to handle unexpected expenses.

What do age-friendly health systems care about?

providing older adults best care possible

reducing some of the specific harms older adults face more often than others

ensuring older adults, our fam, and caregivers are satisfied with care

improving value of care for us all, including professionals

What are the 5Ms to a age-friendly health system?

multicomplexity

mind

mobility

medication

what matters most to the pt

What does mutlicomplexity mean in terms of age-friendly health systems?

describes whole person, typically of older age, living w/ multiple chronic conditions, advanced illness, and/or w/ complicated biopsychosocial needs