Don’t Wait to Enroll in Medicare

The following is a guest post from Ross Blair, President and CEO of Plan Prescriber, Inc., a provider of comparison tools and educational materials for Medicare-related insurance products.

In 2011, a record 2.8 million Americans turned 65 and became eligible for Medicare. If you’re a newcomer to Medicare this year there is one piece of advice I recommend you take to heart: don’t wait until the last minute to start planning your Medicare enrollment.
 
Relax. You’re not locked into the same Medicare plan forever. You can change your Medicare Advantage coverage and prescription drug coverage once a year, and some Medicare supplement plans allow you to enroll at any time. If you take your time before your 65th birthday, the decision-making process should be easier.
 
Learn the basics. Trying to understand Medicare can make anyone’s head spin. Medicare is a different type of health insurance plan than you may be used to, so before you get inundated with sales pitches and unsolicited advice, try to understand the basics.
 
There are three basic ways to cover yourself: Original Medicare (Part A and Part B), with a Part D prescription drug plan; Medicare Advantage Plan, which can include vision, dental and prescription drug coverage; and a Medicare Supplement plan which fills certain gaps in Original Medicare.
 
Figure out what you can afford. It sounds simple, but if you haven’t estimated what your retirement income will be, start doing that math before you enroll in Medicare.
 
Calculate your income after Social Security benefits, pensions, IRA and 401(k) savings, etc. Then, create a list of monthly expenses including rent, utilities and food, as well as other things like your prescription drug costs. Subtract your expenses from your income to develop a good sense of what you can afford to spend on Medicare on a monthly basis.
 
Next, look at your savings and think about what kind of a Medicare deductible you can afford if you have a large medical expense.  Once you know what you can afford to pay each month for premiums and prescription drugs, as well as what type of annual deductible you could afford if you have an unexpected illness or injury, you’re ready to start comparing plans.
 
In most states there are 10 standard types of Medicare Supplement plans. For the purposes of this article, I’m using the N supplement plans as an example.
 
There are many Medicare Supplement N plans available on Plan Prescriber if you input your zip code into our tool. There may be additional supplement N plans available in the county that are not listed on the site. Plan prices don’t typically vary within a county, but be sure to use the zip code where you live when you research your options.
 
Consider your health when making decisions. Your health status will help determine the type of Medicare coverage that best suits your needs. Talk to your doctor about the types of illnesses you’re at risk for later in life, based on your current health status and family history.
 
Some Medicare Supplement plans don’t allow you to enroll later in life, and those that do may cost you more money. So, you want choose a plan that will fit your budget today, and in 15 years. And, if you take prescription drugs use a drug comparison tool, to help you pick a plan that covers your drugs at the lowest possible cost.
 
Consider your travel plans. Whether you travel internationally or to different states, it’s important to understand the circumstances under which you’ll be covered. There are Medicare supplement plans that provide travel emergency health care coverage when you’re in foreign countries. If you migrate to another state for several months each year, look for Medicare plans that will cover you outside of designated networks. However, original Medicare and most Medicare supplement plans are good in any location in the United States.
 
Question brand loyalty. Some Medicare supplement and Medicare Advantage plans come from companies you’ve heard of. If there is a brand you trust, investigate their coverage and consider it as an option. But, price is also an important factor. Don’t pay more for the exact same coverage, because you like the name of the insurer.
 
All Medicare supplement plans are required to offer the same benefits, but the costs can vary widely. So a Medicare supplement K plan from one insurer must – by law – cover the same services as a Medicare supplement K plan from another insurer in your area. Again, using a good online comparison tool helps you compare plans and prices side-by-side so you can make an informed decision.
 
Ask for help. Medicare is complex, but there are a number of resources available online, by phone and in person. In addition to online sites like PlanPrescriber, you can contact your State Health Insurance Assistance Program (SHIP) for assistance. SHIPs receive federal funding to provide free local health insurance counseling to people with Medicare. Also, the federal government has created 1-800-MEDICARE to provide information about Medicare coverage and costs, as well as health plan options.
 
Giving yourself the time to research and consider your Medicare coverage options can pay off.

The Centers for Medicare and Medicaid Services (CMS) has neither reviewed nor endorsed the information provided by PlanPrescriber.

5 Things to Do to Hold Your Physician Accountable (VIDEO)

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5 Things to Do to Hold Your Physician Accountable

Truth or Consequences
@Ron Levine, Getty Images

In a recent Health Affairs article:

• Two-thirds of doctors responding to a survey agreed that they should disclose serious medical errors to patients.
   
• One-third did not completely agree that they should.
   
• Nearly two-fifths said they did not completely agree that they should disclose their financial relationships with drug and device companies to patients.
   
• Just over one-tenth said that, in the previous year, they had told patients something that was not true.

Lisa Iezzoni, lead author of the article incorporating the survey results and, a physician and professor of medicine at the Harvard Medical School and director of the Mongan Institute for Health Policy at Massachusetts General Hospital in Boston said that “Patients who do not get the full story might not be able to make an informed choice about the best course of action for their care. Until all physicians take a frank and open approach to communication, it will be very difficult to enact patient- centered care more broadly."

Iezzoni and colleagues surveyed 1,891 physicians nationwide in 2009 to find out if they followed the standards on communication laid out by the ABIM Foundation’s Charter on Medical Professionalism. That landmark document, published in 2002, urges doctors to be open and honest with patients and to disclose medical errors promptly.

Although the vast majority of physicians completely agreed that physicians should fully inform patients about the risks and benefits of treatment, many admitted not always following the Charter’s standards on honest communication or maintaining trust with patients.

• Nearly 20 percent of physicians said they had not fully disclosed an error to a patient in the previous year because they feared the admission would trigger a malpractice case.

• More than 55 percent of physicians said they often or sometimes described a patient’s prognosis in a more positive manner than the facts might support.
  
• Women and under-represented minority physicians were significantly more likely to follow the Charter’s provisions on honest communication compared to white male doctors.
  
  
• More than a third of physicians did not completely agree that they should disclose all financial ties with drug and device companies to patients, even though such ties can influence treatment.  

So what to do.

1. Consider the services of a patient advocate.
   
   Advocates are there on your behalf and will ask the tough questions and assure your care is coordinated. My friend Trisha Torrey has developed a number of tools to help patients get the support they need, and to help advocates and those who hope to become advocates develop the additional skills they need to do so.
    
2. Visit Physician Compare to find baseline information about your physician.
   
   
3. If your physician is prescribing a certain medication or suggesting a certain procedure, ask him/her to disclose relationships with drug or device companies.
   
   
4. For family caregivers, consider the services of a geriatric care manager that can coordinate care for you if your loved one is a far distance away.
    
5. Know what the most prevalent medical errors / causes are. They include:  

• Medication Errors
  
  
• Bad Communication
  
  Click for the ten questions every patient should ask their doctor. 
  
  
• Infection
  
  Hospitals are one of the most likely places to receive an infection. This article reports on the incidence of high IV infection rates.
   
• Falls
  
  Ten percent of falls for the elderly occur in hospitals. Patients who have other mobility issues like a broken leg, walker, or cane, can also find the clean hospital floors more slippery than those at home.
   
• Surgical Errors
  
  Wrong site, wrong procedure, and even wrong patient surgeries are some medical errors. Speak to your surgeon about the procedure you are having, why you are having it, and what the surgeon will be doing during the surgery.
   
• Pharmacy Errors
  
  Pharmacies can also make errors on your medication. In fact, according to this article from CNN, 30 million Americans are the victim of outpatient medication errors each year.
  
  
• Lab Errors
  
  Types of common errors can include MRI or CT taken incorrectly, samples taken incorrectly, or results misinterpreted. If you feel your lab results are misleading, you are within your rights to ask for another lab test to confirm.
   
• Treatment Errors
  
  Be sure to ask why you are having the treatment, how long the doctor has been doing them, and if there are any alternatives. This website is full of guidelines for treating many common illnesses.
   
• Follow Up Care
  
  When discharged from the hospital or clinic, be sure and know what your follow up care is and what to expect from it.
   
• Birth Injuries
  
  It may be the most joyous time in your life, but birthing a child can also lead to medical errors. The most common can result in serious injuries such as cerebral palsy and paralysis. Check several hospitals in and outside of your area. See the incidence of birth injury and, if possible, read reviews by other mothers who gave birth there.

Cirillo Named Channel Partner - Bringing New Solutions to Address Patient Experience

I typically do not write about my personal career here but this post I believe is important.

I have been selected Healthcare Channel Partner for CEO² .

My passion is to improve healthcare. My platform of educated aging is what you read about everyday. This is the other side of my life.

CEO² will help take my thought leadership around patient-resident experience and my real-world experience in hospitals, long-term care organizations and with boomers/seniors to another level. By partnering with CEO² we can deliver systemic solutions to help healthcare providers change patient-resident experiences and sustain those changes. And it starts with individual passion and purpose.

I have been searching for several years to find a partner that could help bring the ideas I have written about to life. More than a patient experience solution, this is truly an organizational transformation process.

 

By transferring skills in both business acumen and people know-how, CEO² makes people successful as individuals and as team members and the results are repeatable and sustainable for the organization.

My company Fast Forward Consulting will continue to do the work clients rely on. Only now that work will be inspired and fueled by a team of people who will bring fresh ideas into healthcare.

The attached release and backgrounder can provide more information.

Make A Wish Programs For Seniors (VIDEO)

Preventing Medication Injury (VIDEO)

Make A Wish Programs For Seniors

@Joe McBride, Getty Images

USA Today published an article a few months ago that looked at organizations that grant wishes to seniors. I couch them as "Make A Wish Programs for Elders" for lack of a better term. They mentioned three but frankly left out my good friend P.K. Beville's organization, Second Wind Dreams, in the process.

Let's take a look at these programs because they can be a good adjunct to your activities program and in the process garner great publicity for your organization.

1. Second Wind Dreams
   
   Founded in 1997, Second Wind Dreams® was the first organization focusing on granting dreams for elders in the United States. Through the fulfillment of dreams and educational programs, Second Wind Dreams® enhances the quality of life for those living in elder care communities (nursing homes, assisted living, hospice, etc) and changes the perception of aging.
2. Forever Young Senior Wish Organization
   
   Forever Young works to change the image of aging and redefine it with self-confidence, respect, and a hopeful life for seniors. In October 2009, Forever Young found a huge need in the senior adult community. Many World War II veterans had not seen that National WWII Memorial in Washington D.C. It has become one of the main missions of the organization, taking multiple trips a year.
3. Twilight Wish Foundation
   
   Twilight Wish Foundation was founded in Doylestown, Pennsylvania in 2003 by Cass Forkin, after her chance encounter with several elderly women in a diner. After noticing them counting their change to pay their diner bill, Forkin anonymously paid it for them. Their gratitude for her simple gesture inspired Forkin to found Twilight Wish Foundation. Twilight Wish has granted over 1,660 individual wishes to deserving seniors across the U.S.
4. Jeremy Bloom's Wish of a Lifetime
   
   Jeremy Bloom's Wish of a Lifetime (JBWOL) enriches the lives of seniors. JBWOL was established by two-time Olympic Skier, former NFL football player and Colorado native Jeremy Bloom. Bloom launched the Foundation with a vision to initiate a cultural change by granting the wish of a lifetime to deserving seniors throughout the United States. The Colorado-based 501(c)3 nonprofit organization was launched in Spring 2008 as The Donna Wheeler Foundation. Later, the Foundation was officially named Jeremy Bloom's Wish of a Lifetime.

If nothing else these grant wishing organizations can use financial support. But more than that, senior living facilities should embrace these organizations. When I talk to my friend P.K. she laments that more organizations do not take advantage of these programs. I am not sure if long term care organizations are not interested, are unaware, think there is some type of liability....whatever. I would encourage you to check these organizations out and support them on behalf of all of our seniors. and then tell your local assisted living and nursing homes to incorporate these programs into their community life.

Reprinted from my about.com upcoming blog.

Preventing Medication Injury

Check those meds!
@Richard Newstead, Getty Images

A recent article in the Injury Board Magazine looked at medication injury and how to prevent medication disasters. Here are some tips:

• Keep a list of all your medications including prescription, over the counter medications and supplements. And make copies for your healthcare providers.
  
• Starting a new prescription? Talk to your pharmacist and your physician about the risks and side effects and how the medication will interact with your other medications.
  
• Follow the instructions for taking your medications.
  
• Check the insert in your medication to make sure that you are receiving the appropriate one.
   
• Research the medication online and take a look at what the pill looks like. Compare that to what you actually receive.

And as always, check with your physician.

Track This Bill - Extending the Dependent Care Credit

A bill introduced in the House of Representatives would extend the dependent care credit to include expenses related to caring for parents and grandparents who do not live with the taxpayer.
 

The bill was introduced in response to the rising number of people providing financial assistance to a parent or grandparent. According to the bill, “the proportion of adult children providing personal care or financial assistance to a parent has more than tripled during the past 15 years.”

In order to be listed as a dependent, the adult must be physically or mentally incapable of caring for himself and be the taxpayer’s mother or father, or an ancestor of the taxpayer’s mother or father.  If passed, the tax credit would apply to all taxable years beginning January 1, 2011.
 

Read the full bill: Elder Care Tax Credit Act of 2012.

Musical Training Can Overcome Hearing Loss (VIDEO)

Musical Training Can Overcome Hearing Loss

Eline de Ruite, Getty Images

A study published in the journal Neurobiology of Aging shows that lifelong musical training — particularly when continued late in life — can help overcome age-related hearing loss.

Researchers at Northwestern University's Auditory Neuroscience Laboratory measured how the brains of young musicians, older musicians and non-musicians responded to auditory stimuli. They found that older musicians had a distinct neural advantage over young musicians and non-musicians.

Independent researchers say that these findings, in conjunction with earlier animal studies, support the idea that the brain can be trained to overcome, in part, some age-related hearing loss.

The results suggest that “intensive training even late in life could improve speech processing in older adults and, as a result, improve their ability to communicate in complex, noisy acoustic environments,” Don Caspary, Ph.D., a researcher in the field of age-related hearing loss at Southern Illinois University School of Medicine said.

Source: McKnights

Bone Density Tests - Too Many Not a Good Thing

Frequent bone density tests for senior women may not be needed, according to a study in The New England Journal of Medicine.

Medicare pays for a bone density test every two years. But the study followed nearly 5,000 women ages 67 and older for more than a decade. None had osteoporosis when they enrolled in the study, and only 10% of those with substantially low bone density developed osteoporosis within a year.

Investigators suggest that the bone-loss disease develops slowly enough that women who have normal tests at age 65 can wait up to 15 years before being tested again. Women with moderate osteopenia, a risk factor for osteoporosis, should be rescreened in five years, and women with advanced osteopenia should be rescreened in a year, the authors wrote. 

Fee for service hospital providers will not like this one.

Check with your physician.

Boomers Skipping Meds (VIDEO)

Curious About Boomers - Here is an Interesting Infographic

++ Click to Enlarge Image ++

Image Source: Senior Homes

Boomers Skipping Meds

Investment News Daily reports that the Employee Benefit Research Institute (EBRI) found that people over nearly a quarter of individuals above age 50 were trimming costs by:

• making changes to their prescription medication
• switching to generic drugs
• obtaining free samples 
• stop taking their medication entirely. 

About one in five of those surveyed also said they either skipped or postponed doctor's appointments.

The analysis was based on a survey of 4,433 individuals.

The economic conditions, coupled with reduced income and the need to lighten debt were cited as factors. Declining stock values were also citied. 

EBRI's study found that individuals who said their heath was “poor” are most likely to avoid health care services or reduce their meds to cut expenses. About 30% adjusted their medications. More than 

By comparison, only 15.3% of those in excellent health tinkered with their medication.

First, no one should fool with their health.

Second, there are a myriad of safety net programs out there to help people with less means obtain the health care they need. 

Check Out National Council on Aging Offerings for Caregivers (VIDEO)

Nicotine Patch May Help Improve Mild Memory Loss in Older Adults (VIDEO)

Check Out NCOA's Offerings for Caregivers/Seniors/Boomers

Do you help older adults find benefits?
 

If so, be sure to check out the new website for NCOA’s National Center for Benefits Outreach & Enrollment. Now part of NCOA.org, the site includes a host of new features. Download fact sheets with detailed info about core benefits programs and find promising practices in the clearinghouse. Or look through the library for sample benefits outreach materials, webinar slides, and publications—all searchable by topic, state, and keyword.

Learn to live better with a chronic condition
 

Do you or an older adult you know have an ongoing health problem such as diabetes, heart disease, stroke, or arthritis? A new website from NCOA could help you find a workshop that can lead to a healthier life. Visitors can learn more about the Chronic Disease Self-Management Program, see if it’s right for them, learn how it works, find an in-person or online workshop, and watch success stories of participants.

1. See if a workshop is right for you.
   
   Answer five simple questions, and the site will help you decide if a self-management workshop is right for you. It takes just three minutes to see if you're ready.
   
2. Learn how it works.
   
   Watch two short videos to see what the workshops are all about. One video focuses on the in-person workshops, and the other explains the online workshops.
   
3. Find a workshop.
   
   The site makes it easy for you to find an in-person workshop near you. Just click on your state to see what's available. Or, you can sign up for an online workshop and take the class from the convenience of your own home.
   
4. See success stories.
   
   Read stories of real people who have taken the workshop and are now living healthier lives. Says Laura of Oregon: "The six-week course exposed me to new ways of thinking about myself and the medical problems that affected my life. [It] gave me new strategies for keeping depression and pain at bay, ways to relax my mind and body, and eye-opening ideas about exercise that I could do."

Nicotine Patch May Help Improve Mild Memory Loss in Older Adults

Using a nicotine patch may help improve mild memory loss in older adults, according to a recent study published in Neurology.

The study involved 74 people with an average age of 76 who had mild cognitive impairment and were not smokers. Half of the participants received a nicotine patch for six months and half received a placebo. The participants took several tests of memory and thinking skills at the start of the study and again after three and six months.

After six months of treatment, the nicotine-treated group regained 46 percent of normal performance for age on long-term memory, whereas the placebo group worsened by 26 percent.

Study authors cautioned against unsupervised use of the substance.

“People with mild memory loss should not start smoking or using nicotine patches by themselves, because there are harmful effects of smoking and a medication such as nicotine should only be used with a doctor's supervision,” said study author Paul Newhouse, MD, of Vanderbilt University School of Medicine. Really he said that! Kind of interesting statement.

The study was supported by the National Institute on Aging and the National Institute of General Medical Sciences. Pfizer Inc., provided the transdermal nicotine patches.

Good information but don't be rushing to your doctor just yet.

Statins May Lead to Diabetes in Older Women (VIDEO)

Statins May Lead to Diabetes in Older Women

Just on the heels of our beloved aspirin being linked to macular degeneration, now a new study suggests that statins, you know Crestor, Lipitor and the like, could lead to diabetes in older women.

In a study of more than 150,000 diabetes-free women in their 50s, 60s and 70s, about 10,200 developed diabetes six or seven years after the investigation began. Forty-eight percent of the women taking statins were more likely to be diagnosed with diabetes than those not taking statins.

Researchers are not sure why this is so. Statins' effects on the muscles and liver could cause the body to make slightly more sugar than it normally would, or the drugs could cause users to exercise less, they suggested.

Still researchers agree that the benefits of these drugs to lower cholesterol and reduce heart attack risk outweighs their potential side effects.

Aspirin Use Can Possibly Worsen or Cause Wet Macular Degeneration (VIDEO)

Aspirin Use Can Possibly Worsen or Cause Wet Macular Degeneration

Peter Dazeley

A European Eye Study has found that the beloved daily aspirin could have a down side when it comes to your site.

Researchers found that frequent aspirin use was associated with wet macular degeneration and the odds rose with increasing frequency of consumption.

The wet form of the eye disease is the more advanced version of the disorder, which is a leading cause of blindness in the elderly. Aspirin was not found to increase the risk for the less-severe “dry” form of the disease.

Researchers from the Netherlands Institute for Neuroscience of the Royal Academy of Arts and Sciences, as well as the Academic Medical Center, analyzed data from 4,700 men and women across Europe.

They advise patients with the disease not to use aspirin as a painkiller as it could worsen the disease.

Vitamins B, C, D and E and Omega-3 Support Better Cognitive Function (VIDEO)

Vitamins B, C, D and E and Omega-3 Support Better Cognitive Function

Researchers have linked specific vitamins and nutrients in the diet with cognitive performance and the risk of Alzheimer’s disease.

The research, published in the journal Neurology, showed that people with healthier diets — rich in omega-3 fatty acids and a variety of vitamins — had bigger brains and better cognitive function than those whose diets were unhealthier on the whole.

Many previous surveys of people have found that those who report diets high in vitamin E and omega-3 fatty acids have slower rates of cognitive decline, compared with people whose diets are lower in these nutrients.

The team found that people who had higher blood levels of vitamins B, C, D and E and omega-3 fatty acids scored higher on the mental-function tests, including attention tasks and visual and spatial skills, than those with lower levels of these nutrients. People who had higher levels of trans fats in their blood, by contrast, scored lower on these tests.