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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 about all the things you want to know about 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: September, 2016
Sep 16, 2016

Welcome, Medicare Nation!

I’m excited about our guest and our important topic today. We’re discussing the confusion surrounding advanced directives. Have you ever thought about what would happen if you can’t speak for yourself and are in an emergency health situation? Who will express your wishes, and will the health care professionals understand? Dr. Ferdinando (Fred) Mirarchi is the ER Director of University of Pittsburgh Medical Center-Hamot. He has a solution! 

  • Tell us about health care directives and the issues that commonly arise when people come to the ER.
    • There are three types of directives: living will, DNR (Do Not Resuscitate order), and POLST (Physicians’ Order for Life Sustaining Treatment). All three of these have safety issues surrounding them, and all three bring questions. When are they to be followed? None of us know when an emergency situation may arise, so when do we carry these documents with us? Even medical professionals don’t understand these orders, but no one really wants to raise the safety concerns.
  • What happens when someone comes to the ER with no accompanying family and no papers?
    • It’s not just an ER situation, but anywhere in the hospital, for any medical procedure. “You, the patient, are asked if you have a Living Will, then you are subjected to whatever their understanding is as to what that means.” About 78% of the time, physicians assume that a Living Will equals a DNR, but in 64% of cases, a DNR is strictly an end of life order and does not apply to critical care emergencies. Medical professionals assume if you have any advanced directive that you’re an end of life care patient and don’t want care. Many don’t understand the difference between being critically ill and being in an “end of life” situation.
  • If you have advanced directive documents, should you bring them with you to any scheduled procedure, like a colonoscopy?
    • Most physicians would say YES, but I say NO. Keep your document in a safe place so that it doesn’t compromise your care and treatment. Pull it out when you need it, but then you face a retrieval issue. Will the proper medical professional have access to your papers when they need it? We have a process that can insure that those documents are retrieved when needed. Most ER doctors are forced to look at a paper and make an interpretation, based on THEIR understanding, which might not be right for you.
  • Can you explain the difference in a Living Will and a DNR?
    • A Living Will is a legal document, not a medical document. It is for use in situations when someone can’t speak for themselves, develops a terminal condition, or is in a persistent vegetative state. A DNR is specifically for when someone is found with no pulse or breathing, and no CPR is desired. There is a common misunderstanding that a DNR means no medical treatment at all, when it most often applies to end of life care. When someone has a Living Will and the medical professional assumes it’s a DNR, then it can affect care and treatment of any medical emergency. “It’s a coin toss with a 50% chance of being treated or not being treated.”
  • You’ve developed a solution to help people explain their wishes about receiving treatment. Can you explain?
    • At the Institute of Health Care Directives, we have created ID cards containing detailed information to be understood by any medical professional in any hospital. It gives patients a voice to guide their care and treatment. Your ID card has info and directives linked with a QR code that accesses a video recording of your wishes. The recorded video is in a database and can be pulled up on any smart phone for any medical situation you may encounter.
  • Will this ID card work in any medical office, hospital, or ER?
    • Yes, and it’s in clear and understandable medical language so that any professional will know what to do.
  • Can you explain how to find out more and what the service includes?
    • Visit our website: www.institutehcd.com or email us: info@institutehcd.com. You can even call us at 814-490-6584. Dr. Mirarchi is offering a 10% discount to the first 100 MN callers on either of the available packages. The Basic package is for healthy, young people, and the VIP package is for those with multiple medical problems. The VIP package gives you access to an on-call doctor 24/7/365. You can ask any question or any medical professional treating you can call for information about your condition. Our solution is a much clearer and simpler process and has received great response from physicians. The goal is to plan for when you are critically ill and (separately) for when you’re at the end of life. There is a study coming out in 3-6 months on a 15 state trial, and the preliminary results are amazing. This is truly a game-changer in the health care industry.
    • Here is the news story video of the 57y.o. man who was mistakenly noted as "DNR" in his hospital file
  •           whistle blower 9 Investigative news

 

 

 

 

 

 

Sep 9, 2016

Hello Medicare Nation listeners!

Today, I’ve put together a few questions from our audience that I’d like to read on the air. Many of you ask the same questions, so I’d like to help out as many of you as I can.

 

Wendy from King of Prussia, Pennsylvania asks???

HOW DO I GET A REPLACEMENT MEDICARE CARD?

If you are on Original Medicare, your Medicare ID card is proof of your Medicare insurance. , If your Medicare card was lost, stolen, destroyed or illegible, you can ask for a replacement card by going online and logging in to your Social Security account at www.ssa.gov

If you don’t have an online social security account, you can register one on the www.ssa.gov website.

Once you’ve logged into your account, select the “Replacement Documents” tab. Then select “Mail my replacement Medicare Card.”  Your replacement Medicare card will arrive in the mail in about 30 days, at the address on file with Social Security.

If you moved and you did not update Social Security with your new address, you must update your new address into the database, or Social Security will be sending your replacement Medicare card to your old address!

If you don’t have the internet, a computer or you just want to call Social Security, here’s the number to call:

800-772-1213

You can also go to your nearest Social Security office to get a Medicare card replacement. To find the nearest social security office, get on the home page of www.ssa.gov  “click” on the social security office location tab and type in your zip code for the nearest social security office.

 

Kenny from Rio Rancho, New Mexico asks??????

WHAT INTERNET BROWSER CAN I USE TO VIEW THE MEDICARE.GOV WEBSITE?

The official Medicare.gov website states –

For optimal results, use Internet Explorer 8.0 or 9.0. You can also view in Firefox, Chrome and Opera.

 

June from San Diego – California asks????

WHAT DOES MEDICALLY NECESSARY MEAN?

Medicare will only pay for services that are considered to be medically necessary. According to Medicare.gov,  services or supplies are considered medically necessary if they:

  • Are needed for the diagnosis, or treatment of your medical condition.
  • Are provided for the diagnosis, direct care, and treatment of your medical condition.
  • Meet the standards of good medical practice in the medical community of your local area.
  • Are not mainly for the convenience of you or your doctor.                       AN EXAMPLE of NOT “Medically Necessary,” is cosmetic surgery. Maybe you don’t like your nose because it’s too big for your face. Medicare will not pay for cosmetic surgery to make you look pretty. It must be “Medically Necessary.”  A better example would be if your face was disfigured due to a car accident, a fire or a severe dog bite. You will need treatment to stop the bleeding and to prevent infection, so Medicare will pay for the treatment of those types of injuries.

 Thanks for listening!

 Send your questions to Support@TheMedicareNation.com

Sep 2, 2016

How to Find a New Prescription Drug Plan

Welcome Medicare Nation!

Many clients have been contacting me the last several weeks to tell me their Medicare plan has dropped one or several of their prescription drugs from the plan’s formulary.

MAPD plans and Stand Alone Prescription Drug Plans (PDP) may change their formularies during the calendar year. Two examples of when they can do this, is if a prescription drug is found to be unsafe by the FDA. If a prescription drug may cause serious injury or death, they will remove the drug from the market. All Medicare plans would be forced to remove that drug from their formulary.

Another reason a drug may be removed or added is when a generic of the brand drug comes out. This year Crestor, a brand drug for high cholesterol, became generic. With generic drugs available, the cost of the drug to the Medicare plan goes down. The plan adds the generic to their formulary and either keeps Crestor in addition to the generic, or removes Crestor from the formulary and keeps the generic versions.

If you are on a Medicare Advantage Prescription Drug Plan (MAPD), you are locked in the plan, until the open enrollment period which begins on October 15th this year, or you have a special enrollment period.

You can go to www.Medicare.gov to look up special election periods, or you can listen to episode #36 published on April 15, 2016.

Stand Alone Prescription Drug Plans and MAPD plans, which have prescription drugs included, will be announcing their 2017 plans and formularies by October 1, 2016.

Several Medicare Advantage Plans or Stand Alone Prescription Drug Plans may be available in your area.

How do you compare plans to find the right one for you or your loved one?

Use the official Medicare Website Plan Finder’s database.

Go to www.Medicare.gov

  1. You’ll see a Dark Blue Bar under Medicare.gov
  2. Hover your cursor over the tab that reads “Drug Coverage.”
  3. Click on the last item in the column labeled “Find Health & Drug Plans.”
  4. Add your zip code & click on “Find Plans.”
  5. Check the box that pertains to you.

Original Medicare?

Health Plan (MAPD)?

  1. Check the box that pertains to you in regards to assistance.

Do you receive extra help?

I Don’t Know?

  1. Click “Continue.”
  2. Now enter your drugs. All of them.

When you enter a brand drug, a box will come up asking you if you’d prefer to check the “generic.”

If you take the brand, keep the brand drug. If you use the generic – choose the generic. If you don’t know…..choose the generic for now. You can ask your pharmacist or doctor later.

  1. Select “My Drug List is Complete.”
  2. You’ll see on the right side a grayish box that has a Prescription ID#

Copy that number and the Password Date. You will be able to come back and edit the drug list in the future, without having to add all the previous drugs again. What a timesaver!

  1. Now select a pharmacy you use.
  2. Then select “Continue to plan results”
  3. On this page, you’ll see a summary of your search.
  4. Select the box that pertains to your plan.

   Either Prescription Drug Plan with Original Medicare or

   Health Plan with Prescription Drug Plan (MAPD).

      All the drug plans in your geographical area available to you will be displayed.

      Now you can look at each plan to determine which plans have all your prescription drugs and which ones do not.

      You can enroll directly from the Medicare.gov portal, call Medicare directly or call your insurance agent or better yet – your Medicare Advisor.

      You have several options.

      With your Prescription ID# and the Password Date,  you will be able to come back at a later date and edit your list.

      Start getting your list together, so it will be easier for you to check out 2017 plans!

 Here's the link to read the guidelines your Primary Doctor uses in prescribing you scheduled drugs.

www.cdc.gov/drugoverdose/prescribing/guideline

Do you have questions or feedback? I’d love to hear it!

I may answer one of your questions on the air!

email me:

support@themedicarenation.com       

Go to the Contact page and send me an email or “click” on the “Speak” button and talk to me!

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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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