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How much would you pay out-of-pocket for a five day hospital stay on Medicare? The majority of people have no idea! The problem with Medicare is there is too much information. An overwhelming amount of information and not enough resources. Medicare Nation solves that problem by educating you on all things Medicare, because there are not enough resources out there! This podcast will educate you about the components of Medicare, the different categories of Medicare Plans and Medicare benefits. On other episodes I’ll interview expert guests in the health and wellness field, about diseases, Medicare issues and current changes to the Medicare program. Medicare Nation is dedicated to answering all your questions about Medicare. Expert information and insights regarding Medicare and you! Further information can be found on www.callsamm.com Give us feedback on Facebook! www.facebook.com/MedicareNation
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Now displaying: November, 2015
Nov 27, 2015

Welcome! My guest today is Dr. Jeffrey Berns, who is the president of the National Kidney Foundation. He is a professor of Medicine and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Dr. Burns is the Associate Chief of the Renal, Electrolyte, and Hypertension Division and the Director of the Nephrology Fellowship Training Program and the Associate Dean for Graduate Medical Education.

Dr. Berns addresses the following aspects of kidney disease and its risks:

  • What is the National Kidney Foundation (NKF), its mission, and your role? The central office is in NY, but there are offices around the country, each manned by a wonderful staff. Dr. Berns’ role is to talk about the NKF, kidney disease and be a spokesperson and advisor to the board. The mission of the NKF is to help those with chronic kidney disease (CKD) identify the diseases. About 80% of kidney function can actually be lost to CKD with no noticeable symptoms! The NKF also focuses on education about CKD, risk factors, and causes, and research to identify treatments and cures.
  • What are the most common risk factors for CKD? One out of three adults is at risk, and up to 10% may already have CKD but be unaware of it. The most common causes are high blood pressure and diabetes; these diseases cause over 60% of all CKD that requires dialysis or transplant. Family history is a risk factor, as well as minority ethnicity and being over age 60. The ethnicity risk is tied to some socioeconomic factors and some genetic markers that seem to predispose African-Americans to CKD. Kidney disease is an important disease and is under-recognized in the US.
  • For patients with hypertension or diabetes, what tests can be done to screen for kidney disease? The most common tests are a blood test called a Serum Creatinine Level to test kidney function and a urine test to detect protein in the urine. Simply assessing urine output is not an accurate indicator.
  • Are urinary tract infections (UTI’s) a determinant in CKD? These infections are not really a risk factor, but recurrent kidney stones and kidney infections may be precursors to CKD.
  • How would someone know if they have CKD? Blood and urine tests are the only way to detect the disease until symptoms advance to a very serious stage. Discolored urine and swelling of the feet and ankles may be symptoms. The blood and urine tests are most commonly done at the ER and doctors’ offices in conjunction with other exams and other issues.
  • What kinds of resources are available through the NKF? Visit their website at www.kidney.org. You will find information there about the prevention of kidney disease as well as information about kidney function, tests, organ donation, and transplantation. NKF Cares is the patient information Helpline, available in English and Spanish. The website also includes a Peer Support program for patients, information about insurance, and My Food Coach, which has nutritional guidelines.
  • How does Medicare coverage factor into CKD? Those over age 65 are already at higher risk for kidney disease, and Medicare is the primary payer for those patients. A co-pay of 20% is required unless you have co-insurance, and most services are covered under Medicare Part B. For people under 65, coverage is a little trickier. After 30 months, Medicare becomes the primary provider for those on dialysis, but the rules vary according to the type of dialysis that people require. Medicare coverage kicks in immediately for transplant patients, but only lasts three years. The NKF is working to change those coverage limits.
  • For kidney donors, are exact matches required? Kidneys are matched with compatible blood types. An identical sibling is an ideal match, but any living donor is preferred over a deceased donor. Family members, friends and co-workers can be donors.
  • How good is the function of only one kidney if you’ve become a donor? Potential donors are extensively screened to assure a very low risk for future kidney disease. There are small risks, as with any surgical procedure, but the remaining kidney will adapt and actually increase its function after the removal of one kidney.
  • What is the name of a kidney specialist? A kidney specialist is called a “nephrologist,” not to be confused with a urologist, who is a surgeon specializing in the urinary tract. A nephrologist has studied internal medicine and chosen to specialize in kidney diseases and treatments.
  • Visit the NKF website for more information about becoming a donor or a volunteer. You may also call 1-855-NKF-CARES.

Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here)    

 

Find out more information about Medicare on Diane Daniel’s website!

 www.CallSamm.com

 

Nov 19, 2015

Welcome! My guest today is Rosemary Gibson, who is an author and renowned speaker and presenter on the subject of healthcare. Rosemary is currently the senior advisor at the Hastings Center, and the founding editor of Less is More narratives in JAMA internal medicine. In 2014, she was the recipient of the highest honor from the American Medical Writers Association in the field of medical communication. Her books include Medicare Meltdown: How Wall Street and Washington and Ruining Medicare and How to Fix it, The Battle over Healthcare, The Treatment Trap, and Wall of Silence.

  • Tell us what the Hastings Center is and what you do there.

The Hastings Center is a healthcare think tank that looks at ethical issues from the perspective of public interest. It’s a non-partisan, non-profit organization with whom I’m proud to be affiliated. We seek to inform the public on critical healthcare issues of the day. I do this work as a public service because we have the right to know!

 

  • Where are healthcare costs headed for beneficiaries?

Costs keep going up! The reason is that hospitals, doctors, and medical device companies can keep billing for whatever they want and as often as they want. There is no one to stop it! Their motto is “Bill, Baby, Bill!” Medicare is taking a larger and larger share of social security tax. Millions are facing a 50% increase in their Medicare Part B premium. Your Medicare card is the credit card for those doctors, hospitals, and medical device companies and you can’t do anything about it! When Medicare started, there were no healthcare companies on the Fortune 100 list, but now there are 15! The system is full of corruption that is off the charts!

 

  • What is the answer? How can we stop this?

You have to take charge of your health and not trust it to anyone else! Healthcare is something they want to SELL to all of us, and we cannot assume that they want the best for us. Rosemary calls our condition “The Marinated Mind,” because we’ve been marinated to believe that any procedure recommended by a doctor is ok. Baby boomers have been brainwashed to NEVER question what the doctor says. Rosemary teaches you her “exit strategy,” where you can respectfully decline a procedure, ask for more time to think about it, and discuss it with the doctor at a later date. Listen in for details! The truth has been hidden from us, but we need to become empowered to make our own decisions!

Medicare Nation listeners, you know I’m always reminding you that we each play a part in reducing Medicare fraud. We all have to do our part. Always examine your monthly summary statement for anything that looks suspicious. One more tip: It’s Medicare enrollment time, so STAY AWAY from the high-pressure seminars! Read the material and visit www.medicare.gov or www.samm.com for more information. Do your research or find the right advisor who has your best interests in mind. Thanks for listening!

 

Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here)    

 

Find out more information about Medicare on Diane Daniel’s website!

 www.CallSamm.com

 

Nov 12, 2015

Welcome! My guests today are Catherine McMahon and Anna Howard. Catherine provides in-depth analysis for legislative and regulatory priorities for all levels of government and develops public policy principles for cancer prevention. Anna helps develop public policy principles in issues related to healthcare coverage for individuals with cancer. She is also the consumer representative for the National Association for Insurance Commissioners.

Catherine and Anna are here to help listeners understand the resources available for those diagnosed with cancer and for those whose loved ones have been diagnosed. People over 65 account for 65% of all new malignancies and about 70% of cancer deaths in the US. Listening to this podcast will help you understand how to use Medicare benefits in the best ways to prevent cancer.

  • What is the Cancer Action Network, and what does it do? The CAN is the nonprofit, advocacy affiliate of the American Cancer Society that supports legislative solutions to defeat cancer. One purpose is to give patients and their families a voice in government. There is a federal lobbying team in Washington, DC and staff in every state working on the local level. The CAN works to prevent cancer and to help patients find access to care. (The complete abbreviation is ACSCAN.)
  • Why are preventive services so important? Screening tests, counseling, and preventive medications work together to prevent illness before symptoms occur. 50% of cancers can be prevented with these services, including tobacco cessation screening, obesity screenings, and cancer screenings to detect early stage cancer. The ACS has made cancer prevention a top priority.
  • What is the function of the US Preventive Services Task Force? The USPSTF is an independent, voluntary panel of national experts in preventive medicine. Their clinical recommendations will become the appropriate insurance coverage for preventive services.
  • What preventive services does Medicare cover for cancer screenings? The USPSTF updates their recommendations periodically, but currently, an initial physical exam and annual physical exams are covered.  Some of the screenings are a colorectal exam, lung cancer screening, breast and cervical cancer screening. To be eligible for the lung cancer screening, a patient must by 55-77 years old and be either currently smoking or have quit smoking in the last 15 years.  They must have a “smoking history” such as a pack a day and have a written order from their doctor for the screening. A colonoscopy is another screening that is covered, but the problem occurs if the doctor removes polyps during the exam because that qualifies as surgery and will make the patient subject to out of pocket costs.
  • What legislation is currently being introduced to Congress? The ACSCAN is pushing for new laws to include removal of polyps in screening exams instead of calling it “surgery.”  The bill is called “Removing Barriers to Colorectal Cancer Screening Act and is HR 1220 in the House and S624 in the Senate. Listeners are encouraged to call their members of Congress and urge them to co-sponsor and pass this legislation ASAP!
  • What choices are available to Medicare beneficiaries? Patients can choose Traditional Medicare, Parts A, B, or D, or they can choose a Private Plan Option called Medicare Advantage. Over 30% of Medicare users choose an Advantage plan.
  • What should you ask your doctor about screenings? First of all, take advantage of the annual wellness exam, but talk to your doctor about what’s going on with your heath and your medications.
  • Visit www.acscan.org for information, tips, and fact sheets. You can find volunteer opportunities at www.cancer.org or call 1-800-227-2345 to ask questions of the ACs 24/7. Check out these resources for the maximum use of your Medicare benefits!

 

Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here)    

 

Find out more information about Medicare on Diane Daniel’s website!

 www.CallSamm.com

 

Nov 5, 2015

 

Welcome!  My guest today is Dr. Steven Loomis, who is an optometrist in Colorado.  He has been a member of the American Optometric Association Board of Trustees since 2007 and is the newly elected president of the AOA since 2015.  He has served on numerous other professional boards and received many awards.  

During this Medicare enrollment season, there are many questions about eyeglasses, hearing aids, and dental care, which are not part of regular Medicare benefits.  You may be wondering what to do.  Dr. Loomis is here to answer some relevant questions:

  • How did you decide to become an optometrist?  “I had decided to be a pediatrician when I realized I might not want to be with children ALL DAY LONG.  A friend suggested optometry, so I considered it.”  Dr. Loomis has found the perfect niche over the past 30 years, and he is confident that he made the right decision.

 

  • Can you clarify the difference between optometrist and ophthalmologist?  An optometrist treats most eye diseases and injuries to the eye, along with providing exams for glasses and contacts. Optometrists provide 70% of primary eye care to patients. An ophthalmologist is an eye surgeon who works closely with an optometrist to treat patients.  They even sub-specialize in specific eye care fields.

 

  • Are most optometrists Medicare providers?  Yes, all that I know of are.  We have been full Medicare participants since 1986.

 

  • What will Medicare cover for vision care?  Medicare will cover any eye disease or injury, inflammation, glaucoma, but does not cover routine well vision exams.  Those diagnosed eye diseases have their regular exams covered to monitor their problems.  Medicare Advantage Plans DO cover preventative eye care services, but you MUST know and understand your plan.

 

  • Can you explain diabetic retinopathy?  The retina is sensory tissue in the back of your eye that transmits pictures to the brain.  Diabetes attacks the tiny blood vessels in the eye, but a special photo must be taken to view the vessels.  Diabetics and pre-diabetics must have yearly exams to monitor the condition.

 

  • Why should a Medicare Nation listener get an annual eye exam if they aren’t having a problem?  The two leading causes of blindness are diabetic retinopathy and glaucoma.  Glaucoma is a condition in which pressure inside the eye damages nerve fibers. Macular degeneration is another eye disease. These eye diseases are asymptomatic, which means that they can exist without initial symptoms until vision is severely affected.

 

  • How would a senior make the most of their Medicare dollars?  They must understand their plan; participants in Parts A & B are eligible, but the amounts vary from state to state.  Usually, patients have to pay about 20% of approved amounts.  If they have met their deductibles, then now is a good time to get it done.  For example, the Part B deductible is only $147, so must people have already met that by the time the 4th quarter rolls around.

 

  • How else can uncorrected eye problems or undiagnosed eye problems affect seniors’ quality of life?  Most seniors want to maintain their vision for reading, watching TV, and other daily activities.  Also, falls are a big problem that can devastate a senior, and a significant number of falls occur because of poor vision.

 

Links and Resources:  

www.aoa.org

 

Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here)    

 

Find out more information about Medicare on Diane Daniel’s website!

 www.CallSamm.com

 

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