*** September 2010 ***
* E-zine *

This Month's Highlights:
· New Health Bill Affect Me?
· Think-Ahead Care Giving
· Add Pharmacist to Health Team

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The simple answer is probably. But how it affects you will depend upon how you receive Medicare coverage. Those who belong to TriMark (Military Veteran Medical Coverage) or HMO's will need to wait to find out what changes their providers make in their coverage and co-pays. Expect to see those letters by October or November. Those who belong to Medicare Advantage will also have to wait to see what changes their provider makes in their coverage and co-pays. Until now such programs ran on a deficit covered by Medicare (in other words, paid for by the rest of us). In 2011 Medicare will begin to phase out their financial supplements. So if you're covered through a Medicare Advantage plan look for notifications of changes in the next several years as providers are supplemented less, and decide with each change in coverage and cost to you, if it is better for you to change to another type of "senior" coverage or stay with the program.

Medicare recipients, who are on straight Medicare, with their Plan B (hospital) coverage automatically deducted from their Social Security check, will definitely see changes in 2011 in provided services--and that is a good thing.

The one change that could make the longest term difference is eligibility for free preventive care--like an annual physical well-care check up, colorectal cancer screening and mammogram.

If you have Medicare coverage and Medicare Supplemental insurance paid privately for the 20% or so Medicare does not cover, know that Supplemental coverage is obligated to cover visits and procedures covered by Medicare. So if there is a co-pay left after Medicare pays its share for check-ups and screenings, your Medicare Supplement provider will pay the difference as it has for care visits in the past.

If you are paying for Plan D/drug coverage (by check or automatic Social Security deduction) you will see an immediate change. In lieu of the huge donut hole where you pay full price for prescription drugs after laying out $2,500 for prescription meds, you will receive a one time $250 check. These checks will roll out to those not receiving other subsistence help starting, in June 2010. At this reading, some of you may already have received them. In 2011 there will be a 50% discount on all prescription drugs once you exceed the initial $2,500 out-of-pocket outlay. The 50% discount will increase in subsequent years until in 2020 the coverage gap will be closed. (May we all be here then to be eligible!)

Other changes that could provide trickle-down benefits are opportunities for doctors providing care to Medicare recipients to see student loan forgiveness, bonus payments, and greater support for community health centers enabling an increase the number of patients they can serve. Community health teams will be encouraged so you won't have to visit multiple locations to be treated. Home and hospital care coordination will be encouraged so people can be discharged sooner.


Not yet on Medicare, but looking to retire before 65? In the past you needed to rely on your former employer to extend your coverage. For many that meant paying cash for COBRA--an extension of your last employer's program paid by you in full plus 3%. Now there will be insurance available for individuals to buy, regardless of pre-existing conditions, with no lifetime limits, with payments controlled by government regulators or supplemented by them. They are expected to be more affordable than COBRA coverage. In order for Medicare to be there for us, and perhaps our children, we also need to be responsible users of the system. When you receive a Record of Payments Statement from Medicare (or your Medicare supplemental insurance), check it over. Did they charge for a procedure you did not receive? Did you visit once, but they charged twice? Have you been told that you can get your toenails clipped at the Podiatrist and Medicare will pay, but you do not have diseased toenails? Don't be part of such fraud, and don't ignore your role as a watchdog, as well as a recipient, to preserve honest Medicare.

Report suspected fraud only after you have tried to have a problem resolved yourself. If you are unsuccessful, use one of these avenues to start a report:

Office of Inspector General (OIG) Fraud
Hotline Phone: 1-800-HHS-TIPS (1-800-447-8477)
Email: [email protected]
HHS Tips Hotline
P.O. Box 23489
Washington, DC 20026-3489

See additional insurance related information here:

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A2. THINK-AHEAD CARE GIVING by Joanne Reynolds

Care giving for an elderly loved one takes some foresight, and an ill elderly person takes even more. It's difficult to plan beyond what is happening in the immediate moment, because the stress of a pending surgery or other on-going treatment tends to keep care givers and patients alike focused on the step that's immediately in front of them.

Learning to think beyond that next step to something that may be happening in the future can help make things go more smoothly.

Here are some ideas for keeping your patient comfortable while she or he is still in the hospital, recovering from surgery, or in a care facility of any kind:

- Photos and other reminders of home in your loved one's hospital room can help reduce agitation that may arise from the disorienting surroundings.

- Provide a sports water bottle that can be literally kept on their pillow. For a post-surgery or frail patient, moving to reach for a water cup on the bedside tray is not easy. It can be a long wait for the patient who is thirsty before a visitor or hospital staff member comes along to help out.

- Dry lips are common in hospitals and care facilities. Dry lips can become cracked, and that presents an opportunity for infection. Make sure your loved one has a lip balm where she or he can reach it. Again, look to the sports world. Runners wear lip balm on cords around their necks. The neck cords with small pouches used to carry thumb drives (also known as flash drives) are the right size for lip balm, too.

- How can you keep them comfortable--warm or cool enough--and ward off the potential for pressure sores? Is there a soft undergarment that would help, such as soft ribbed men's undershirts or socks?

- Sometimes a patient's feet will swell from anesthesia and bed rest. Make sure she or he has a pair of large, comfy slippers to wear.

- The medical team has numerous members, and when they visit, they will be giving your loved one a variety of post-surgery or other care instructions. Make sure your loved one has a file folder or large manila envelope, and a spiral-bound notebook with him or her in the hospital. If the medical team is handing out already-photocopied instructions, that will be the place to keep the instructions. The folder or envelope will make it much easier to find those instructions when you need to access them. If the doctor is writing instructions out, those notes can go in the notebook.

-Anyone who's undergone surgery--and is on pain medications--or who is elderly and frail is not mentally sharp. As care giver, you need to advocate as strongly as possible to be notified when the lead physician, surgeon, or hospitalist will be visiting your loved one, so that you can be on hand to participate in the discussion. Some hospitals now issue pagers to family members so that they can be summoned when the doctor is on the way to consult with the patient.

-A contact phone number is going to be crucial in the first few days after your patient leaves the hospital. You need to know who to call when questions or problems arise.

© Copyright 2010 by Joanne Reynolds Contact: 949-422-9893, [email protected]

Learn more about care giving at

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1. Get an Assist From Your Pharmacist
Having a good working relationship with your pharmacist may make a significant positive impact on your health. It certainly can help you to have a better health outcome for chronic health conditions. There have been cases where getting blood pressure under control was aided by having both a pharmacist and doctor assisting patients. Here are a few steps to bring your pharmacist up to speed on your situation, thus enabling him/her to provide specific advice to you

- Let the pharmacist know what medicines you are using. Include prescription, nonprescription, herbs, vitamins and any other supplements
- Fill all prescriptions at the same location.
- Review contents and labels on all refilled prescriptions.
- Discuss any drug allergies or other medicine issues.
- Check for compatibility of any new medicines with your existing regime.
- Check for side effects of any new medicines, and how it should be taken
(i.e., with food, or with a liquid, or melted under the tongue).

Find more medical information at:

2. Even More Planning Will Be Required
According to the National Institutes of Health and the U.S. Census the 65+ population of the U.S. is expected to double in size in the next 25 years. That means one in five Americans will be 65 or older in 2030 for a total of 72 million of them (us?).

This amazing increase will be due to the post-WWII baby boom, as well as a marked increase in average life span. In the second half of the 20th century, preventive and diagnostic health advances are largely responsible for this longevity increase. This will put a burden on medical and social services, and will result in increased costs for long-term care.

Learn more about retirement planning and insurance at:

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We present here some words from those with a birthday this month.

Adam Sandler - "I never had a speech from my father 'this is what you must do or shouldn't do' but I just learned to be led by example. My father wasn't perfect."

Angela Cartwright - "I didn't have to bury myself in drugs and alcohol and all of that, and I think a lot of that had to do with my strong upbringing."

Hugh Grant - "For any new technology there is always controversy and there always some fear associated with it. I think that's just the price of being first sometimes."

Peter Sellers - "The nightmare of all art, as well as of all politics, is generalities."

Sid Caesar - "In between goals is a thing called life, that has to be lived and enjoyed."

More "Thoughts" at: get some books at

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1. Keeping a Delicate Balance
With normal aging we might expect to become more inactive and grow weaker with age. Lack of activity and weak muscles can lead to fragile bones and a propensity to fall, which often results in hip fractures, hospitalizations, and the need for long-term care However, research shows that this doesn't have to be the case. Those who regularly walked, performed balance or muscle-strengthening exercises, or did a combination of these exercises, improved on a number of different measures of balance. Learn more about this topic in a Johns Hopkins Health Alert at:

2. Preparing for Hurricane Season
Hurricane preparedness kits can ease heightened fears if a storm is approaching. Each kit should include important documents, clothing, medication, tools, food and water, hygiene items, first aid supplies, kitchen items, comfort items and pet supplies. Some items to pack for pets include the veterinarian's contact name, vaccination records, medications, food, water bowls and extra collars

With storm season in full swing you and your family, including your senior citizen, should be prepared to survive on your own after an emergency. This means having your own food, water, and other supplies in sufficient quantity to last for at least three days. Local officials and relief workers will be on the scene after a disaster, but they cannot reach everyone immediately; you could get help in hours, or it might take days. In addition, basic services such as electricity, gas, water, sewage treatment, and telephones may be cut off for days, or even a week or longer.

See a Disaster Supply Checklist

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1. More Reasons I Like Retirement:

Question: What's the biggest gripe of retirees?
Answer: There is not enough time to get everything done.

Question: Why don't retirees mind being called "seniors"?
Answer: The term comes with a 10% discount.

Question: Among retirees what is considered formal attire?
Answer: Tied shoes.

2. Things My Grandpappy Told Me

- Your fences need to be horse-high, pig-tight and bull-strong.
- Keep skunks and bankers at a distance.
- Life is simpler when you plow around the stumps.
- A bumblebee is considerably faster than any tractor.
- The words that soak into your ears are whispered...not yelled.

"Oh My Aging Funny Bone" is at:

This issue has been edited by Betsy Day ([email protected]).

Copyright 2010, ALL RIGHTS RESERVED. Information in this document is subject to change without notice. Other products, service and companies named herein are trademarks or registered trademarks of their respective companies or mark holders and are solely responsible for the content of their articles. Articles are included for informational purposes and are not an endorsement.

This Copyright E-zine may be forwarded to others only if sent in its entirety. Other uses are subject to written permission of the publisher.

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