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Trying to figure out the different parts of Medicare can be confusing. That’s because each part (A, B, C and D) provides different benefits. When you’re ready to enroll, it’s important to understand those differences. Here’s the skinny:

MEDICARE PART A

Provided by the federal government at no cost to most people, Medicare Part A covers care you receive in a hospital, in a skilled nursing facility or through home health care and hospice care. You are eligible to begin receiving benefits when you turn 65.

MEDICARE PART B

An optional plan that requires a premium, Medicare Part B covers several medically necessary services that are not covered by Part A. These include outpatient care, ambulance services, durable medical equipment, preventive care and part-time intermittent home health/rehabilitative care. You can enroll in Part B at the same time you enroll in Part A.

MEDICARE PART C/ MEDICARE ADVANTAGE

You can get Medicare Part A and Medicare Part B together in a plan managed by a private insurance company, like Medical Mutual. This is known as Medicare Part C or Medicare Advantage. Offered in contract with the federal government, these plans offer additional benefits, like prescription drug coverage. Medicare Advantage plans may require a monthly premium in addition to the Original Medicare Part B premium. You must live within the plan’s service area.

MEDICARE PART D

Also offered by Medical Mutual and other private insurers, Medicare Part D is an optional prescription drug plan available to anyone enrolled in Medicare Parts A and B. Premiums and out-of-pocket expenses can vary depending on the plan you choose. You must live within the plan’s service area.

I hope this gives you a glimpse of all the parts of Medicare. With a little more research, you can learn more and decide what best fits your needs.

On Aug. 1, 2016, the Ohio Department of Medicaid drastically changed eligibility rules for Medicaid serving people who are disabled and people who need long-term care.

These changes will affect people at the time they need/want Medicaid coverage and make it even more important for people to think ahead about the time that they will need long-term care.

TOO MUCH INCOME

Those are weird words to write: too much income. However, in the weird world of Medicaid for long-term care, they are real. Anyone with gross income above the Special Income Level (currently, $2,199.00 per month) triggers a new requirement in Ohio’s Medicaid rules on how the so-called “excess income” must be handled each month.

Income above $2,199 must be transferred from the person’s account(s) into a separate account in the name of a Qualified Income Trust (also known as a QIT or Miller Trust).

Money in a Miller Trust must be paid out each month as part of the person’s share in his long-term care costs. The amount of money that the person spends and the amount that the person keeps are the same under the new rules as they were under the old rules.

KEEPING OR SELLING THE HOUSE

Under Ohio Medicaid’s old rules, a single person applying for Medicaid for nursing home or assisted living costs had 13 months after the beginning of eligibility during which to decide whether he couldreturn home. If unable to return home, then the Medicaid recipient had to put his house up for sale by the end of month 13. While the house was for sale, Medicaid eligibility would continue.

Under the new rules, a single person cannot automatically wait for 13 months. The person must either make a written declaration that he intends to return home, or the house must be sold.

For you pros at Medicare open enrollment, you know that this is when you review your Medicaid Advantage Plan, Supplement and Drug plans to make sure you are set for another year.

For newbies, there are some legal issues regarding Medicare coverage that don’t get much publicity but are very important.

SKILLED NURSING AND WHAT’S COVERED

Many people incorrectly think that Medicare won’t pay much for skilled care such as rehabilitation, therapy, wound dressing and other daily health needs in a skilled facility or at home. Services and Medicare billing are stopped quickly because they think that Medicare will not pay anymore if the patient is not showing “improvement” or he “fails to progress.” This idea has become pervasive in health care, and people simply accept it as the law.

However, “improvement” is not the standard by which Medicare can stop paying for skilled nursing care; it never has been. A 2011 federal class action lawsuit against Medicare was filed to help clarify coverage for millions of seniors. The government settled the case in 2012 by agreeing that under federal law people cannot be denied coverage for skilled care just because they have reached a plateau and are not improving.

Coverage is necessary if the person needs skilled care to maintain his or her condition, prevent complications or to not backslide. This is a maintenance standard, not an improvement standard.

Medicare also was required to educate all seniors receiving Medicare and all Medicare skilled care providers about the corrected policy. The Centers for Medicare and Medicaid (CMS) agreed to do so.

In 2014, they released instructions and updated Program Manuals for Medicare billing and appeals agencies. They issued a fact sheet to inform providers and the public about the change. They were supposed to spot check nursing homes, home health care agencies and other providers to make sure they were using the correct standards.

You signed up for Medicare when you turned 65. Like most people, you probably breathed a sigh of relief, thankful that your health insurance decisions were settled.

But wait — not so fast. Didn’t any- one tell you about Medicare Open Enrollment?

Confused? So is everyone else.

Never heard about Medicare’s Open Enrollment period? If you are over age 65, you’ll soon find your mailbox jammed with official-looking envelopes from insurance companies competing for your attention. While it might be bewildering, it can also mean good news for you.

Many people find their initial enrollment in Medicare to be overwhelming. They often make mistakes. They may pick a plan that doesn’t cover the doctors or hospitals they prefer. Maybe there is a change in health or they chose a prescription drug plan that doesn’t cover their prescriptions. For whatever reason, they find they are locked into insurance coverage that simply does not fit their needs.

Medicare’s open enrollment is a chance for a do-over. It is an annual opportunity to take a close look at all the other Medicare health insurance options. It’s your chance to make changes that benefit you. Medicare’s open enrollment period begins every year on Oct. 15 and closes Dec. 7. During this period, people who have previously signed up for Medicare can:

• change from Original Medicare to a Medicare Advantage plan

• change from a Medicare Advantage plan back to Original Medicare

• switch from one Medicare Advantage plan to a different Medicare Advantage plan

• join a Medicare prescription drug plan

• switch from one Medicare prescription drug plan to a different Medicare prescription drug plan

• drop Medicare prescription drug coverage completely

Any changes made during this open enrollment take effect Jan. 1 of the following year.

WHERE TO BEGIN

Those covered by a Medicare Advantage plan or Prescription Drug plan will receive an Annual Notice of Change from their insurer outlining changes to their plan for the following year.

Does the registration process require that your pet be vaccinated? If yes, you can trust the organizers know that some diseases might be spread if your dog or other dogs are not vaccinated. This is a great safety consideration. If not, do not enter this charity dog walk. You never know if other dogs are vaccinated. You might risk your dog’s health.

Is your pet current on all vaccinations and parasite control? If yes, then your dog is probably prepared to be around other dogs. If not, make sure you make an appointment with your veterinarian well in advance.

Is your dog comfortable around strange people and strange dogs? If yes, then you reduce the risk that your dog may become scared and bite another dog or a person out of fear. If not, this might not be the right opportunity for an outing.

Can your dog walk for as long as you plan to walk? If yes, then you’re doing a great job keeping your dog exercised well. If not, consider working up to that distance so your dog can enjoy the experience.

Will your dog be walking on pavement? Pavement can be very hot for dog paws, and they might get burned. If the day is sunny, and your dog is walking on pavement, feel the ground with your own hands and make sure it feels comfortable to you. If it’s too hot for your hands, it’s  probably too hot for your dog’s paws.

What do you need to bring? Bring a water bowl and some water for you and your dog. Walking is great exercise, and both of you need to be well hydrated. Snacks are optional. Have a well-fitted collar and strong leash. Retractable leashes are not advis- able because they can cause injury o your hand.

As people age and face the challenges of growing older, many turn to fitness programs to stay healthy and active.

When people enter their fourth, fifth or sixth decade, their bodies lose some resiliency. A well-rounded exercise routine can help reduce injuries and the onset or frequency of conditions associated with aging, such as heart disease, Type II diabetes, osteoporosis and some neurological conditions.

A RECIPE FOR SUCCESS

A fitness regime should include exercises that work on the cardiovascular system, muscular strength and endurance, flexibility, balance or neuromuscular control, and proper nutrition.

It’s important to begin slowly and progress steadily. Exercise two to three times weekly at a minimum.

Strength training exercises should focus on the whole body. Lifting weights, pulling on resistance bands or using exercise machines, for example, can develop strength with proper use. Lift weights very slowly with proper form for best results.

FLEX IT

Over the decades, joint flexibility usually begins decreasing due to the natural aging of soft tissue and posture position. While it’s important to spend a lot of time stretching, it does not have to be intensely painful. Hold stretches for 20 to 30 seconds or longer in a position that causes slight discomfort.

A GOOD BALANCE

Weakness from muscle loss can lead to balance problems, especially when changing positions too quickly or walking on uneven or unstable ground.

Balance problems lead to falls and injuries. Simple drills such as balancing on one leg with the eyes open and then closed can help the nervous system stay “in tune” with the musculoskeletal system.

Lifelong learning is one of the keys to active aging, defined as “the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age.” That’s according to the World Health Organization, which encourages older adults to stay active by participating in social, cultural, economic, spiritual and civic affairs in order to extend healthy life expectancies. In short: learn more to live better (and longer).

KEEP LEARNING

Health refers to physical, mental and social well-being. Activity is not just physical; it’s also cognitive. According to Psychology Today, gerontological research shows that enriched learning environments (formal academics or self-directed learning) help to reduce cognitive and emotional decline (including depression and poor self-image) due to aging. Conversely, reduced mental stimulation might lead to a decrease in cognitive functioning as people age.

There’s no need to leave learning behind once you graduate high school or college. When you stop learning, studies show you’re inviting mental stagnation and reduce the potential for exploration and growth. The good news? In Northeast Ohio, lifelong learning is an accessible alternative. Regardless of age, you don’t need to travel far to keep your mind and body engaged by pursuing knowledge and experience.

At Cuyahoga Community College’s Encore Senior Adult Program, manager Suzanne Ortiz says classes double as social gatherings. “It’s a great opportunity for friends to get together on a Friday afternoon on our eastern or western campus and learn about any topic they can think of: history, art, the sciences, exercise. …It’s an opportunity for them to get together and do what they’ve always wanted to do.”

CLASS WITH BENEFITS

Whether it’s learning to dance, speak a foreign language, gain computer skills, improve your golf swing or master a craft, encore education delivers real benefits for older adults by:

• keeping the mind sharp

• improving memory

• increasing self-confidence

• offering an inexpensive (or free) way to try something new

• gaining independence by learning to “do it yourself”

• offering a sense of accomplishment

• meeting like-minded people

• building upon existing skills

• learning a marketable skill or trade

Adult students are the nation’s fastest growing educational demographic, according to the U.S.