Medicare Open Enrollment Begins October 15

Monday, October 15 begins the Open Enrollment period for 2019 Medicare. Between October 15 and December 7, you may enroll in Medicare if you became eligible in the past but did not enroll. You may also use this time to make changes to your enrollment. For example, you can switch from traditional Medicare to a Medicare Advantage Plan, change from one Medicare Advantage Plan to another, or change from one prescription drug (Part D) plan to another.

Start by reviewing your coverage. The Medicare website has a host of resources to help you learn more about plans and options so that you can evaluate your needs and select the plan that is best for you. One helpful resource is the Medicare Plan Finder tool which will help you find plans offered in your area.

There will be changes to Medicare beginning in 2019, including elimination of the so-called “donut hole” for prescription drug costs, one year ahead of schedule. Premium rates have not yet been announced, but an increase is projected. Additionally, the income threshold for the highest premium bracket has increased to $500,000 for an individual and $750,000 for a couple, up from $160,000 per individual and $320,000 per married couple.

For additional information or help navigating the complexities of Medicare, don’t be afraid to call on a professional. There are insurance brokers, healthcare advocates and others who can help you sort it all out and select the plans that are most appropriate for your individual situation. Many libraries and community based organizations can connect you with free resources. Want to learn more? Give me a call at 516-584-2007.

Alcohol Abuse in the Elderly: A Growing Problem

When you imagine an individual with a drinking problem, who do you picture? Is it a troubled teen? A college student who binge drinks on the weekend? A middle-aged man who has a few cocktails to unwind after work every evening?

Alcohol abuse can affect anyone at any age, but it is an increasing problem among the elderly. And, when older adults drink to excess, they may be opening the door to a range of other health problems.

Alcohol’s effects can be more pronounced in the body as we age, so drinking the same amount may cause a person to feel more intoxicated than they expect. Alcohol can also mask other health signs and become mistaken for symptoms of other common diseases. For example, alcohol may cause a person to become forgetful or confused, which could be mistaken for dementia or Alzheimer’s disease. Alcohol abuse can cause changes in blood vessels and the heart and could dull the pain of a heart attack leading to delayed treatment.

Alcohol abuse can worsen osteoporosis, diabetes and high blood pressure, and could contribute to strokes, ulcers and mood disorders. In addition, alcohol abuse can make it more difficult for physicians to prescribe appropriate pain relief medications should the individual require surgery or have a health issue that requires pain control.

Older adults may begin or increase their drinking to help them deal with sadness and depression. These feelings, while NOT considered a normal part of aging, are common responses to loss, loneliness and illness that many elderly people face.

If you suspect that an aging loved one may be abusing alcohol, it is important to offer support and help. Try to identify the underlying issues and find ways to address them. The causes can be complex and not easy to fix, but there are a range of community-based resources that can help. For additional information, visit the National Institute on Aging, or give me a call at 516-584-2007.

What to do when you receive a difficult diagnosis

woman listening“Everyone who is born holds dual citizenship, in the kingdom of the well and the kingdom of the sick . . . Sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.” – Susan Sontag

Receiving a diagnosis of a chronic condition or any serious medical issue can be devastating, forcing a person to move from the kingdom of the well to the kingdom of the sick in one sudden, awful moment.

If this happens to you, take a moment to breathe. Then follow these tips to help you cope:

  1. Take some time. Unless emergency medical care is required, in most instances, there is no need to react immediately. You may find yourself overwhelmed by various emotions: anger, fear, sadness and confusion are common. Give yourself a little time to process the information you have been given.
  2. Assemble your support team. Identify the friends and family members who are willing and able to help you through this time. Assign tasks if appropriate; people will appreciate knowing that there is something they can do to help.
  3. Reach out for support. Many local hospitals and community-based organizations offer support groups that focus on specific diagnoses. Call or visit the website of your local hospital, or organizations like the American Heart Association, American Cancer Society, Alzheimer’s Foundation, and others to learn if there is a support group in your area.
  4. Consider hiring a healthcare advocate. An advocate can help you navigate the healthcare system, sort through complex medical information, arrange for the most appropriate treatment and facilities, coordinate insurance coverage, and more.
  5. Take notes. Jot down your questions prior to your doctor’s appointments and write down the information you are told. Use a journal or notebook to keep track of this information and to log appointments, tests, medications and dosages, and other details surrounding your journey.
  6. Get a second opinion. Corroboration by another trusted professional will reassure you that you are making the best decisions.
  7. Educate yourself – but be wary of what you find online. The internet has given everyone a platform to share their opinions, which can lead to confusion when you are seeking reliable information about a disease or condition. Verify the source of any information you find online and stick to well-known and respected websites and organizations.
  8. Take care of you. Remember to get enough rest, focus on managing stress through yoga or meditation, spend time with friends, and try to live as normal a life as your diagnosis allows. Keeping a positive attitude and focus on the future will help you cope with the challenges ahead.

Have a question or want to talk? Call me. I can help you figure out your next step. Give me a call at (516) 584-2007.

Healthcare 101: The Document All College Students Must Complete

It’s the time of year when parents everywhere are preparing to send their newly minted 18-year-olds off to college for the first time. Whether this rite of passage will include teary embraces and promises to check in regularly, or victory laps around the (at last!) empty nest, there is an important item that many parents neglect to add to their “to do” list. Along with dorm supplies and required vaccinations, make sure to have your child complete a health care proxy.

In New York State, when a child turns 18, he or she is considered an adult, regardless whether or not mom and dad are still paying the bills and carrying the health insurance. That means that medical professionals are bound by federal privacy laws, known collectively as HIPAA (for the Health Insurance Portability and Accountability Act), to keep your child’s medical information private, and to only discuss details with individuals who are authorized by the patient (your kid) to have that information.

You may not want to think about the potential for your child to require medical care while away at college, but accidents, injuries and illness do happen. And for a parent who is far away, trying to get information over the telephone from healthcare providers in another city or state, not having a health care proxy could be a major problem. Without the form, healthcare providers are unable to discuss your child’s specific conditions, you are unable to make decisions regarding your child’s care, and you can be denied information on what your child is suffering from, even for something as simple as a stomach bug or appendicitis.

Experts recommend having your young adult children complete a health care proxy form. Keep a copy of the form handy, and scan or take a picture of the form with your cell phone so that the document is always available.

If you have any further questions or would like a health care proxy form that you and your family can fill out before move-in day, reach out to us here at Care Answered. We’re happy to help you cross one more item off your college prep “to do” list.

Changes on Tap for Managed Long Term Care Providers in NYS and Your Community Medicaid

If you receive Medicaid and/or Medicare in New York State, are chronically ill or disabled and require aides or other services in order remain safely in your home, you are likely to be enrolled with one of the state’s Managed Long Term Care (MLTC) providers. MLTCs are agencies that help manage and oversee the services that patients requiring this level of care receive.

The NYS Department of Health, the agency that oversees MLTC agencies, recently announced changes to the program. Among the new rules:

  • Those who enroll in a MLTC plan after Dec. 1, 2018 will be barred from changing plans for 9 months, after the first 90 days. This makes it imperative that the family select the most appropriate agency at the start.*
  • There will be a limit on the number of home care agencies that each MLTC is able to contract with. The result could be make it more difficult for MLTCs to place aides in the homes of patients who need them. This begins October 2018.*
  • People placed in a nursing home for three months or more will no longer be able to enroll in a MLTC. In addition, patients who are MLTC members will be dis-enrolled from MLTC after three months in a nursing home. Some consumer advocates fear that when MLTC plans are no longer responsible for the cost of nursing home care, the plans will have an incentive to place members with high needs in nursing homes, rather than approve more hours of home care needed for the member to remain in the community. The start for date this change was initially July 1, 2018 but has been postponed to an unspecified date in the future.*

Navigating this process is challenging even for savvy and experienced healthcare professionals. The implications of rapidly changing rules and regulations leave many people with unanswered questions. A professional health advocate can assist families with obtaining the appropriate level of care at the right time and in the setting that makes the most sense. Care Answered is here to help. Give us a call at (516) 584-2007.

 

*Source: New York Western Law Center-State Dept of Health Moves to Implement MLTC Changes Enacted in 2018-19 NYS Budget

How Healthcare Advocacy Can Benefit Your Employees

Our healthcare system is growing more and more complex. Medical breakthroughs create new treatment options to consider. Regulatory reforms are changing the way physicians practice, while economic factors impact on the way insurance companies pay for the services we receive. The outcomes of the choices and decisions we make can truly be life altering. These are important and complicated issues.

At the same time, healthcare costs continue to be a concern for companies and workers alike.

To help address these complicated issues, many employers have begun offering healthcare advocacy services as an employee benefit.

Healthcare advocates can save time and money for both employers and employees. They do this by:

  • Reducing stress and improving productivity for employees
  • Helping employees select lowest cost, highest quality providers and facilities
  • Providing healthcare navigation for employees and their family members, including aging relatives
  • Reviewing medical bills for accuracy
  • Answering questions that would otherwise require handling by internal human resources staff

 

Offering healthcare advocacy as an employee benefit is cost-effective. Advocacy services can be added to a benefits package for just a few dollars per employee per month.

According to a 2017 survey by consulting firm Mercer, nearly half of employers with 500 or more employees offer healthcare advocacy services as part of their benefits package. Among very large employers – those with 20,000 workers or more – 60% offer advocacy as a benefit.

The advantages are magnified for smaller employers. If even one key employee at a smaller company needs healthcare advocacy for themselves or a family member, providing the service so that the employee can focus fully on their work can mean the difference between continued success and financial devastation for a small company.

To learn more about how healthcare advocacy could benefit your workforce, contact Care Answered.

 

Telemedicine Lets You and Your Doctor Connect Without the Commute

If you’re in need of medical care, just getting out of the house can be a struggle some days. But just as technology is allowing us to connect with friends across the world in new and exciting ways every day, it’s also allowing us to connect with our care providers as well. Telehealth is the use of telecommunication technology to enhance health care in general, and telemedicine is the application of the technologies to improve the quality of health care given. Both are similar in scope, but telehealth is the overall subject name.

Telemedicine covers a wide variety of applications, so it can be used in many different situations. An example of telemedicine would be using video communications such as Skype to meet with your doctor instead of going to his or her office. Another would be if a patient uses a mobile device to take a picture of an injury and sends that to their doctor. Additionally, if two doctors use an application to send patient records between them that would also be considered telemedicine. Telemedicine has a number of different applications to help facilitate the best care possible.

Telemedicine when used properly allows practitioners and patients to connect without the commute. A patient can simply use their mobile device or personal computer to get in touch with their clinician if they have any questions, need reminders, or have a condition that they wish to have checked out but isn’t worth a trip to the office. This is especially helpful for seniors who may struggle to maintain their independence and ability to transport themselves to their care providers on their terms as they get older.

Many commercial insurance providers offer telemedicine as a covered benefit, and more and more doctors are offering some type of telemedicine services to their patients. If you would like to know more about the different ways that telemedicine can make your life easier and your healthcare more personalized, need help finding a doctor, or want to learn more about ensuring that your care is the best it can be for you, contact us at CareAnswered. We’re here to help.

Do you Need a Medicare Supplemental Insurance Policy?

Medicare supplemental insurance coverage medical charges

If you are near or past the magical age of 65, chances are you have already given a good deal of thought to Medicare, the health insurance program that covers Americans over 65 and the disabled. In addition to Medicare Part A, which covers in-hospital care, Part B, which covers doctor’s and outpatient office visits, and Part D, which covers prescription drugs, you may have heard about Supplemental Policies. These products are sold by commercial insurance companies to help you pay for additional expenses, like co-pays and deductibles, not covered by traditional Medicare. But are these policies worth buying? The answer is…it depends.

Medicare supplemental insurance – sometimes referred to as Medigap – claims to cover anything that Medicare does not. But if you read the fine print, it turns out that there isn’t much that Medicare doesn’t cover. Medicare pays for the majority of the medical procedures. The adjustors at Medicare will calculate a fair value for the services rendered, pay the provider for around 80% of the calculated cost, and the remaining 20% or so is left to you as a patient. This means that under Medicare you will be left with a considerably low out-of-pocket cost for your health care.

However, Medicare does not cover everything nor everyone, and that is where supplemental plans come into play. Deductibles and co-pays – the amount for which you are responsible if you are on Medicare – are covered by Medigap insurance. If you anticipate a high volume of hospitalizations or doctor’s visits, supplemental insurance may be a wise investment for you. If, however, you only visit the doctor a few times a year, the cost of supplemental insurance may not be offset by the amount of coverage offered.

In short, the answer really does depend on your individual needs. You can get more information by visiting the Medicare website. If you would like to know more or would like assistance with choosing a plan, reach out to us at Care Answered.

How to Find a Home Care Provider

Illness, injury or advancing age can result in the need for assistance in our day-to-day lives. When this happens, it is important to make sure that you have the appropriate provider to care for you or your loved one. The question then becomes, how do you know if your loved one is in good hands? The answer is through preparation and asking questions

The first thing you need to do is start a conversation. Include your loved ones and primary care physician in the discussion about the need for home care and the type of care needed. This will ensure that everyone can bring their concerns to the table. Step two is to start compiling lists. Make a list of daily activities with which you/your loved one need assistance. Every person is different and no two home care providers will need to perform the same exact tasks.

Building off of this, you should determine what hours of the day and how many days a week you/your loved one needs care. It is also important to create a medication list (include supplements) that contains information on why the medication is taken, what dosage, and when it is taken. Keep in mind many home care agencies can’t have their aides “administer” medications. This means the aides cannot take the medicines out of the bottle to give you, but they can give reminders. (Always ask any care provider what they are able to do based on your list of daily activities.)

After you’ve described the specific needs of you/your loved one, it is recommended that you make a list of personality traits you/your loved one would find ideal, because remember, this person will be in your home. For example, would you have a preference for someone chatty or quiet/reserved? Is there a language in which you are more comfortable communicating? Would you be more comfortable with a man or a woman? Is there a culture that you feel most at ease around? These are all important questions that should be answered before choosing an aide.

It is also helpful to establish a communication plan with the home care provider if you are a loved one. Perhaps you want to be contacted immediately if any change of behavior is noticed, or establish a protocol for any emergency situations. In addition, whether you decide to find a home care agency or choose a home care provider privately, make sure a background check is done. While it would be ideal to interview all of your prospective home care providers, sometimes it is not possible to conduct in-person or phone interviews with all of them. The lists and schedules that were made earlier can help prevent any unforeseen issues.

Of course, even after preparing as best as possible, it’s important to follow through. Try to have a loved one or advocate stop by unannounced to make sure that the home care provider is meeting all expectations.

Still have questions? Contact Care Answered for personalized help with selecting the right in-home caregiver for you.

Just What Does a Patient Advocate Do?

As healthcare evolves, doctor’s visits have only gotten more complicated. When was the last time you managed to finish an appointment without receiving a litany of things to remember: don’t eat this food; do eat this food; exercise more; take this medication at morning, noon, but not night: take this unpronounceable medication as needed, but this similarly spelled medicine can only be administered once per day. To make matters worse, you’re already under a lot of stress due to the health concern that brought you there today. At a certain point it becomes impossible to remember everything you are supposed to do to take care of your own health.

But what if you didn’t have to? What if you had someone who was there with you every step of the way to take notes, or bring up concerns you may have forgotten or just don’t feel comfortable voicing on your own? What if you had a patient advocate?

A patient advocate can be anyone you can trust. You can ask a family member or loved one to be your advocate or you can hire a professional patient advocate to stand by your side. Either way, your patient advocate will be with you for every step of treatment, making sure that you get the best care available. With a patient advocate by your side, you no longer need to divide your attention between your recovery and your care.

Your patient advocate will accompany you to all your appointments and take notes on what the doctor says. They’ll help you understand just what your doctor is talking about, and what you need to do to recover. Additionally, your patient advocate will speak up about any concerns you may have. Your patient advocate is your best ally and confidant in the doctor’s office.

A patient advocate can do all of this and more: help you select the best treatment option or facility for your care; help you untangle and understand your health insurance benefits and coverage; help create a safe discharge from the hospital, help you with decisions for yourself or a loved one.

If you do not have someone in mind to be your patient advocate, or simply have more questions, contact Care Answered and we will gladly help you through the process, at every step of the way.