Info

Medicare Nation

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.TheMedicareNation.com Don't Forget to SUBSCRIBE to the show! Give us feedback on Facebook! www.facebook.com/MedicareNation
RSS Feed Subscribe in Apple Podcasts
Medicare Nation
2019
October
September
August
July
June
May
April
March
January


2018
November
October
August
June
May
April
February
January


2017
November
October
July
June
April
March
February
January


2016
November
September
August
July
June
May
April
March
February
January


2015
December
November
October
September
August


Categories

All Episodes
Archives
Categories
Now displaying: 2016
Apr 8, 2016

Welcome Medicare Nation! Today we wrap up our “trilogy” about Care Coordination by talking to Patient Advocate Karyn Rizzo!

 

Karyn wrote the book - Aging in America - What you need to know about Navigating our Healthcare System

 

Karyn’s book is available on Amazon. It covers everything from finding a primary care physician, choosing Medicare programs, and also some information for LGBT friendly providers, and safety tips, fall prevention etc. It just covers lots of real life issues that you face, including respite and how to take a break from care giving!

 

The book came out of the needs Karyn saw in her work everyday! She knew there was so much information she needed to cover, so she created a powerful resource in the book!

 

Fall prevention tips that Karyn provides in the book:

 

  1. Eliminate rugs in the bathroom and other rooms of the house
  2. Check the types of shoes to make sure they don’t contribute to a fall
  3. Falls happen in the middle of the night going to bathroom, so install rails
  4. Is walker or cane easily accessible from the bed?
  5. Do you have motion sensor lighting?
  6. Medications can contribute to falls

 

Another great resource on fall prevention is mayoclinic,org

 

Advocacy for Patients is important today because of the following factors:

 

  1. Healthcare providers don’t have the time to spend with you explaining things
  2. Insurance companies have complex coverage rules
  3. Healthcare treatment options are more complicated than ever

 

 

 

 

What a Patient Advocate Does:

 

  1. Individuals that directly advocate for the patient
  2. Neutral parties hired by the family - not employed by hospital or insurance company
  3. Evaluate the care plan for the patient
  4. Advocate will put together a care plan that meets the patient's needs
  5. Works through the process of appealing insurance and hospital decisions
  6. They know the system, the lingo, and the rules, so they can use them to the patient’s advantage
  7. Knows what programs the patient is eligible for and how to get you on the right program for them
  8. Advocate can also help involve other specialty Physicians to evaluate the best treatment plan for the patient
  9. Advocates can also help navigate care options for Hospice and understand when it is appropriate and when other options are better for the patient.
  10. Hospice does have a Home Health division and it can be confusing between that and end of life Hospice care, so the patient advocate can make sure you are on the appropriate service.
  11. Healthcare regulations vary from state to state, so it’s important to get accurate help navigating the system.

 

 

 

Where do you find a Patient Advocate?

 

Sometimes called a Geriatric Care Manager, Social Service Agencies - There is a national website that provides a directory of caregivers:

 

 

CareManager.org

CareGiver.org

AgingGuidebook1.com - Karyn’s website has TONS of resources

 

 

What type of Licensing does a Patient Care Advocate have?

 

Every state calls the role something different, but there are programs that certify in each state. 

Generally, they are nurses or social workers, or have equivalent experience.

Licensing or certification is required for this role.

 

 

A Geriatric Care Manager is a position that you will have to pay for. Case managers that are paid by Medicare, the hospital or the insurance company will always represent those organization’s interest first, and yours afterward.

 

It is worth every penny to have someone in the trenches that is representing your best interests!

 

 

Online Tools when you are out of state from the patient:

 

 

ecarediary.com

reunioncare.com

 

These websites create a circle of care that allows everyone in that circle to have access to all the information and take action on different aspects of the care for the patient from where ever they are in the world.

 

 

 

 

Got questions about Patient Advocacy?

 

Karyn could assist in a consultative role if you are not located in FL. She can direct you to resources in your area.

 

 

Karyn can be reached:

 

By Phone: 727-452-1300 

 

By Email: info@agingguidebook1.com

 

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

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

 

 

Apr 1, 2016

Welcome Medicare Nation! 

After last week’s show with Dr. Jeffrey Burns, I wanted to bring a guest on the show that could talk to us about her experience with the lack of care coordination with Medicare.

Melissa’s Mother fell and broke her hip before Christmas. At only 67, ended up having surgery and being in the hospital and then in a skilled nursing facility. At home she had outpatient therapy.

 

Melissa shares the following about her Mother’s experience:

 

  • She went to stay with her Mother during this time - she lived 4 hours away
  • She felt like she would just provide companionship and help her Mom get back on her feet
  • She quickly realized she would have to be a patient advocate for her Mother
  • She found out that the care for her Mom was good, but communication was terrible
  • She tried to follow up on her Mom's care on a daily basis, but it was overwhelming
  • Melissa wasn’t exactly sure of the medicine her Mother took on a daily basis
  • Melissa didn’t have all the information available about the Doctors that her Mom sees
  • Mom had an app on her cellphone that had all her medical info and also allowed her to call 911
  • Mom lived alone and fell late at night when she was in her garage
  • 1 in 3 people 65 and over will fall and a hip fracture is the #1 injury from that fall
  • She and her Mom text every night and every morning since her Mom lives alone
  • Surgery on the hip was successful, but there were some blood clots to deal with
  • Mom has a high tolerance for pain, but yet still seemed to be in a great deal of pain
  • Melissa found out that there was some miscommunication between the nurses and her Mom regarding pain meds
  • The hospital staff thought that Melissa's Mom had refused one of her pain medications
  • Actually Mom only questioned it because she thought she couldn’t have the 2 meds together
  • It wasn’t a refusal of medication, but her Mom just didn’t understand the issues and was confused
  • Constantly ask questions. Write them down as you remember them. Ask the questions to every staff member at every shift. 
  • Her Mom spent a week in the hospital before she went to rehab. It felt like they wanted to release her too soon.
  • The clinical coordinator for the hospital didn’t have a lot of information on placement options in a city 45 minutes away
  • They used the online site ratings through Medicare to find a skilled nursing facility
  • Minimum requirement is 3 overnight stays in the hospital to qualify to go to skilled nursing facility
  • medicare.gov has the resources to check ratings of skilled nursing facilities.
  • Private Institution ratings are not available on www.medicare.gov
  • Transportation to the skilled nursing facility, 45 minutes away, wasn’t handled by the hospital because the facility she was moving to was out of their "network."
  • The family had to arrange transportation through a private medical transportation service, where Mom could transported in her wheelchair.
  • In the skilled nursing facility, her Mom was there for 5 days before she even saw the nurse practitioner.
  • The physical therapist never actually showed up due to scheduling conflicts.
  • It’s important to find out the schedule that the Doctors will be keeping and seeing your family member and make sure you are there when they make the rounds.
  • Melissa found out that her Mom got confused about what meds she was taking for what ailments, so she wasn’t a help to sort things out.
  • Medicare allows Physicians to write prescriptions for home care therapy and it is provided at no cost to you. As long as a Dr. writes a prescription and the Physical Therapist is an approved Medicare provider and the patient can’t make it out to traditional therapy, it will be provided on most Medicare plans  free of charge.
  • Melissa was shocked at how important it was for her to be involved in her Mother’s care and recovery.
  • The outcome for Melissa’s Mom was good, but there were so many times along the way that could have gone terribly wrong, if Melissa wasn’t there to advocate for her Mom.
  • If you are not physically able to be with a family member during a crisis, you may need to inquire about hiring a Patient Advocate.

 

The Official Medicare website is a starting place for finding skilled nursing facility ratings.

Getting a patient advocate is a good idea if you aren’t prepared or able to assist your loved ones during a medical crisis.

 

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

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

 

 

Mar 25, 2016

Welcome, Medicare Nation!

March is National Kidney Disease Awareness Month, so I’ve invited Dr. Jeffrey Berns on Medicare Nation. Dr. Berns is the president of the National Kidney Foundation and a professor of medicine and pediatrics at the Perelman School of Medicine at the University of Pennsylvania and the Associate Chief of the Renal Electrolyte and Hypertension Division. He is also the director of the Nephrology Fellowship Training Program and the Associate Dean for Graduate Medical Education. Dr. Berns is a busy and dedicated physician, and I’m grateful he is taking the time to inform us about kidney disease today!

  • Give the listeners an idea of the prevalence of kidney disease in the US.

One in three people are at risk for kidney disease, while one in nine already has some level of kidney disease. Chronic kidney disease is measured in stage 3, 4, and 5. Stage 5 is the level at which dialysis or a transplant is required. Throughout your lifetime, it’s important to avoid exposure to things that can damage the kidneys, and that includes many prescription medications.

  • Is it correct to say that kidney disease if most often a “silent” disease?

It is similar to high blood pressure, which is also an important risk factor for kidney disease. Kidney disease is asymptomatic until permanent damage is done. Some tests can reveal the disease to a doctor, but patients don’t often have symptoms until it’s late in the game.

  • What is the difference between a nephrologist and an urologist?

A nephrologist is a physician with specialized training in medical diseases of the kidney, while a urologist is trained in surgical diseases of the kidney and urinary tract.

  • What are signs and symptoms that would indicate late stage kidney disease?

 

  • Protein in the urine in large amounts
  • Swelling of the feet, hands, legs, and face
  • High blood pressure
  • Fatigue
  • Difficulty concentrating
  • Sexual dysfunction
  • Loss of appetite
  • Metallic taste in the mouth

 

  • When should people see their doctor about kidney disease?

We all have to be aware of the risk. Most older people are at increased risk, and minorities are at a higher risk. If kidney disease is in the family history, then the risk is higher. Diabetes increases the risk, but many cases of mild kidney disease can be managed quite well by a primary care physician.

  • Wouldn’t it be a good idea to check blood levels for patients at yearly checkups?

That would be the perfect time and opportunity for routinely-done tests. Your doctor can monitor you for any change over time, and you can ask your doctor if you have signs of chronic kidney disease.

  • The National Kidney Foundation has partnered with MACC (Medicare Advantage Care Coordination) Task Force, aligned with 35 leading patient-care providers for patients with multiple disorders. Tell us more about MACC.

Many patients with kidney disease also have other issues. MACC allows for their care to be more cohesive and patient-centered instead of fragmented care coordination.

  • What can listeners do to improve care coordination?

Make sure each of your doctors are communicating with each other. Most providers have electronic patient records that every doctor can see. Patients should remind each of their physicians to send their medical records to their primary physician. Your Primary physician is in charge of coordinating your care. Provide your Primary physician with a list of your other providers names and phone numbers. Carry a list of up-to-date medications to every doctor.

  • How is Care Coordination utilized with different types of Medicare Plans ?

Original Medicare provides the most freedom in seeking physicians with no referrals. Lack of communication between physicians causes fragmented care, with no care coordination. Medicare Advantage Plans include networks of physicians, with required referrals to see specialists. This allows continuity and greater communication in care coordination. Medicare Advantage Plans are continually trying to improve payment models and care coordination. Here are several steps individuals should follow to improve care coordination:

  • Know your risk factors.
  • Talk to your primary care doctor and have screening tests.
  • Carry a list of medications with you.
  • Keep a list of numbers and names of care providers.
  • Make sure your plan has care coordination tools.

 

Learn more about Kidney Disease, find helpful resources and support on the National Kidney Foundation's website

Visit www.kidney.org for more information.

To learn more about the Medicare Advantage Care Coordination Task Force :

Visit www.medicarechoices.org

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

email me:

support@themedicarenation.com

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

Mar 18, 2016

Welcome, Medicare Nation! It’s March, which is a huge month for awareness. Last week’s show highlighted colon cancer awareness, this week we are discussing MS awareness, and next week’s topic is chronic kidney disease. 

What is MS?

  • MS is multiple sclerosis, which is a disabling disease of the central nervous system. It occurs when there is a disruption of the electrical circuit between the brain and the rest of the body. Nerves have a myelin sheath that covers and protects them; when the sheath is damaged and the electrical impulses are disrupted, then multiple sclerosis is the diagnosis.

What are signs and symptoms of MS?

  • Fatigue that interferes with your ability to function
  • Numbness/tingling in face and extremities
  • Muscle weakness
  • Dizziness/vertigo
  • Pain, significant and chronic
  • Vision problems

How is MS diagnosed?

  • It’s a difficult disorder to diagnose, and can be found using blood tests and MRI’s. Doctors can test the electrical impulses in the brain, and they also pay attention to family history. Medicare covers these diagnostic tests to some degree, so CHECK YOUR PLAN! See your doctor if you experience any symptoms. Over 400,000 people in the US have been diagnosed, with more than 200 newly diagnosed cases each week! Most patients are between 20-50 years old. There is no cure for MS; all doctors can do is to try to slow the progression of the disease.

For more information, visit www.nationalmssociety.org or call 1-800-344-4867 to contact the National MS Society.

 

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

 

email me:

support@themedicarenation.com

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

 

 

Mar 12, 2016

The Center for Medicare and Medicaid Services has suspended another Insurance Medicare provider's plan.

CMS has suspended and sanctioned Ultimate Health Plan (UHP) Medicare Advantage Plan. Suspended Feb 26 and effective immediately. They are not allowed to market and sign up new enrollments for the UHP. They have determined that the conduct of UHP failed to provide services in compliance with CMS standards. According to the CMS document, "the failures were determined to be widespread and systemic."

If you are on a UHP plan, you still have your benefits at this time. A Special Enrollment Period has not been granted by CMS at this time.You will need to contact Medicare at 800-633-4227 to request permission to select another plan due to the suspension. Document your conversation with the representative - their name, the date and time that you got the approval, etc.

If you used a "captive" insurance agent, they only offer Medicare plans from the company they are contracted with.  I do not recommended that you contact a "captive" agent, because they will not advise you about other options with insurance carriers that may provide you with better options.

If your family member is on Ultimate Health Plan and has a serious, chronic disease then you may want to look into other Medicare plans in the area in which they reside, to see if a better plan option is available. If you or a family member has Chronic Kidney Disease which requires dialysis or a kidney transplant, they may not be able to switch plans at this time.

Medicare will look at each individual's situation on a case-by-case basis.

If you have questions regarding the sanctions against Ultimate Health Plan, send me an email at:

support@themedicarenation.com

To speak with a Medicare broker or Medicare advisor in your area, simple Google “Medicare Advisor” - and your county or location. An example would be - Medicare Adviser Tampa, Florida

 

Politics and Medicare:

This isn’t an endorsement for any candidate. This is just a summary of the candidates platform for Medicare and/or Healthcare

On The Republican Side:

Donald Trump:

Does not want to make cuts to Medicare

Favors health savings account

Does not favor current Obamacare

Favors taking away boundaries on state lines to encourage competition between states

 

Ted Cruz:

Wants to save Medicare by gradually increasing the eligibility age from 65 to a higher age

Wants to move to a “Premium Support System”, whatever that means

 

Marco Rubio:

Wants to raise the eligibility age gradually

Supports a voucher type program in Paul Ryan’s budget proposal

 

John Kasich:

Hasn’t specifically talked about Medicare, only Healthcare

Believes in the “value over volume” system of Medicare reimbursements

Advocates healthcare savings accounts

 

On The Democratic Side:

Hillary Clinton:

Continue Obamacare and build on it

Protect seniors from rising costs

 

Bernie Sanders:

Advocates a single payer plan - administered by the government

Comprehensive coverage for all Americans paid for by the government

This will be paid by a 6.2% healthcare premium paid by employers

2.2% income based premium per household

This would be a government run system

No matter who you support, please make sure you exercise your right to vote!

 

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

 

 

email me:

support@themedicarenation.com

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

 

 

 

 

Mar 4, 2016

Kevin Harrington, creator of the infomercial and the chairman of the As Seen On TV brand, is my guess today. Kevin has launched over 500 products to the tune of $4 billion! He is one of the original sharks on ABC’s Shark Tank. Kevin is an author who has helped me greatly with this podcast and my book, The Medicare Survival Guide.

  • What would you suggest to people in our generation who might be affected if age requirements for Medicare benefits are changed in the near future due to political change in America?

I would advise people to explore second income opportunities. If you’re working, then keep your job, but plant some seeds in case you need to work an extra 2-5 years than you originally planned. I suggest considering internet and mobile marketing opportunities. Anyone can do these jobs from home, connecting with people and selling products. Many entrepreneurs have started these small businesses and have become very successful for part-time or even full-time income.

  • You have a new book coming out. Would you tell us about it?

My book, Key Person of Influence, was written with Daniel Priestley. It’s an amazing program that takes you step-by-step through establishing yourself as a “guru.” For me, the turning point was becoming a KPI in As Seen On TV products. There are five essential skills, which include raising your profile, developing your pitch, and partnering with people. You can follow the system and become a guru in your industry. 

Visit www.keypersonofinfluence.com!

Visit www.kevinharrington.tv for links to my books and KPI information.

 

  • Changing gears just a bit, today is March 4th, which is Colon Cancer Awareness Day. Last week’s show was about this topic. Let’s all wear our blue today to promote colon cancer awareness!
  • Judy, from Tampa, asked a question about the DNA Stool Test, so I want to give some detailed information. This test is relatively new, done at home, and less invasive than some others. It is covered by some Medicare plans, but you need to check on yours specifically. The test assesses your risk but does not replace the colonoscopy. The test is allowed every 3 years for those ages 50-85 who have no symptoms of colorectal disease, no Crohn’s, IBS, colitis, or polyps. Visit www.cca.org for more information.
  • If you have questions about this show or others, please contact me. I love to hear from you and answer whatever questions you have! Thanks for listening!

 

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

 

email me:

support@themedicarenation.com

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

 

 

Feb 27, 2016

Do you know how your Medicare benefits would be affected by the changes in government that would come from a new President? It's time to think about it and weigh in on what you think is best for you and for the country. Listen as Diane talks to real people who have an opinion. 

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

 

email me:

support@themedicarenation.com

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

 

 

Feb 19, 2016

Welcome, Medicare Nation! Today’s guest is Lee Silverstein, who is a colon cancer survivor. Lee is here to discuss the risks, prevalence, and treatments for this disease. Colorectal cancer is the most commonly diagnosed but also the most preventable through proper screening. The American Cancer Society estimates that 95,000 people will be newly diagnosed with colon cancer in 2016. Over their lifetimes, 1 in 21 men and 1 in 23 women will be diagnosed! Colon cancer is clearly not “the old man’s disease” that many of us have been led to believe. Let’s hear Lee’s amazing story!

  • Why has colon cancer become so widespread for people under age 40?

“Over the last few years, the rates for diagnosis have remained steady, with a huge increase in the number of cases in people under age 40. It is scary, alarming, and unexplainable by doctors. I recently attended a conference on colon cancer and met a newly diagnosed 23-year-old. The common risk factors are being overweight, a lack of physical activity, a diet rich in red meat, heavy smoking and alcohol use. Keep in mind that you can have NONE of these risk factors and still be diagnosed with the disease, like what happened to me.”

 

  • Would you mind telling our Medicare Nation listeners your personal story?

“Not at all—I would love to share my story. I had NO risk factors and had just turned 50, living a very health-conscious life. I exercised regularly and was eating smart. I had a colonoscopy in March 2011, and the doctor couldn’t get the scope where he needed it to go. I wasn’t alarmed, but received a call from the doctor two days later saying I had a tumor in my transverse colon. This colonoscopy saved my life!”

 

  • Would you share what your treatment was?

“I had colon cancer and needed to have the tumor removed; the surgeon was confident that he could remove it all. My cancer was classified as Stage 2, which meant it was borderline as to whether there were benefits to undergoing chemotherapy. I got three opinions and determined that the benefits of chemo did NOT outweigh the risk. My follow-up exam included a CT scan and bloodwork, which showed a small spot on my liver. A biopsy was ordered and showed that my colon cancer had spread to my liver, even though it was a small spot and slow-growing. Surgery was recommended and chemotherapy. I went to Sloan-Kettering, which was the hospital I had been treated at as a child when I had a rare kidney cancer. The liver surgeon there was confident that I would be fine. Surgery was scheduled for January 2013 and I finished chemo treatments in August. In 2014, two small spots on my lungs were discovered. The doctor suspected that it was colon cancer that had metastasized to my lungs. He wanted to treat it with SBRT, a cyberknife-type targeted radiation procedure. In normal radiation, low doses are given over a wide area over a long period of time, with damage to the surrounding tissue. In this procedure, pinpointed high doses are given over a short time. I had the treatment with no side effects, and was even able to continue training for a race. The one spot disappeared and the other shrunk significantly. I’m not cancer-free, but I am stable. The goal of colon cancer treatment is to make it a chronic manageable disease.”

 

  • Can you tell Medicare Nation listeners about the Colon Cancer Alliance?

“I found this organization when I was first diagnosed. They are the largest patient support non-profit organization for colon cancer, based in Washington, DC. They do research and provide online support.”

 

  • Medicare  provides several levels of preventive care and testing for colon cancer:
    • Barium enema is allowed every 24 or 48 months, depending on the risk.
    • Colonoscopy is allowed every 120 or 48 months, depending on the risk.
    • Fecal blood tests are allowed every 12 months.
    • Flexible sigmoidoscopy is allowed every 48 months for people over 50.
    • Multitargeted DNA test is allowed every 3 years for people aged 50-85. This is a new test with many stipulations.
    • Plans, coverage, and co-payments differ.
    • Some procedures are free, but related surgical procedures (like to remove polyps) are NOT free.
  • Tell our listeners about your podcast.

“I started The Colon Cancer Podcast about a year ago. I interview survivors, caregivers, and medical professionals. We share stories of struggle, hope, and survival in the face of colorectal cancer.”

 

  • Tell us about the “Undie Run.”

“These are 5K events sponsored by the Colon Cancer Alliance. We run around in our underwear! Events are held 2-3 times each month, in different cities around the country from February through October. The events are to raise funds and raise awareness of the disease.”

Resources:

www.ccalliance.org

877-422-2030

Find the Facebook group: Blue Hope Nation

Special Bonus! Stay tuned to the entire show where Diane Daniels answers listener questions after the interview!

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

 

email me:

support@themedicarenation.com

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

 

Feb 12, 2016

Welcome, Medicare Nation! My guest today is Dr. Andrea Singer, who is a professor of  Obstetrics and Gynecology at Georgetown University Medical Center. Dr. Singer is the Director of Women’s Primary Care and the Director of the Bone Densitometry program. She is a trustee and clinical director for the National Osteoporosis Foundation and a national lecturer on the subject. Dr. Singer has published extensively on many women’s issues and is active in the education of medical students and residents at Georgetown University Medical Center. Dr. Singer is here to teach us about osteoporosis and how it affects our lives and health.

  • Can you define osteoporosis for Medicare Nation listeners?

“Yes—I value this opportunity and hope it can be a call to action for your listeners. Osteoporosis is a disease of the bones in which too much bone is lost or the body simply makes too little bone. The bones become weak and can break from minor falls or simple actions, even like bumping into furniture or sneezing!”

  • How prevalent is osteoporosis in the US?

“It’s a very common disease and I’ll give you some statistics: 50% of people age 50 or older (54 million of the 99 million) have either osteoporosis or low bone mass. The number jumps to 65% of people age 65 or older who are at risk for broken bones.”

  • Do these numbers apply to both genders, or just to women?

“They apply to both genders, even though it’s commonly thought of as a woman’s disease. Interestingly, men have a harder time recovering after a broken bone incident. Of the population age 50 or older, 1 in 2 women and 1 in 4 men will break a bone due to osteoporosis in their remaining years.”

  • What are the risk factors for osteoporosis?

“Risk factors can be broken into two categories: non-modifiable and modifiable factors. Non-modifiable risk factors are those that you can’t control, like age, gender, family history, low body weight/frame, and previous bone fractures. Modifiable risk factors include lack of calcium/vitamin D, inactive lifestyle, smoking, and too much alcohol. Regarding previous fractures, those of the spine, hip, wrist, shoulder, and pelvis are classic osteoporosis fractures. Also, certain medications for other disorders can increase bone loss. If you have these risk factors, you should speak to your health care provider and ask about being evaluated for osteoporosis.”

  • How is osteoporosis diagnosed?

“Doctors will look at risk factors and do physical exams and lab tests, but the only real way to find osteoporosis is to do a bone density test. The lower the bone density, the greater the risk will be. The DXA scan is the bone density test, and is covered under the Welcome to Medicare package for women. Men are not covered for this test unless they fall into one of the following categories: on long-term steroid therapy, diagnosed with hyperparathyroidism, already on osteoporosis therapy, or has a vertebral abnormality or deformity found on an x-ray. The National Osteoporosis Foundation recommends that men be screened at age 70, but the bone density test isn’t covered unless one of the four criteria is met.”

  • Why are there not many people being screened for osteoporosis?

“Osteoporosis is under diagnosed, under recognized, and under treated. It’s thought of as ‘my grandmother’s disease,’ and many people don’t recognize the risk factors. In addition, there are fewer health providers doing DXA scans. For many, they lack the realization that broken bones over age 50 is a strong indicator of osteoporosis. We need to raise awareness so that people who are candidates for osteoporosis will get tested. I hope that this discussion empowers people to take charge of their bone health, be proactive and advocate for yourself to your doctor.”

  • How is the medical community treating osteoporosis?

“People need to get adequate calcium and vitamin D, either through diet or supplements. Weight-bearing, muscle-strengthening exercise can help stimulate the bones to remodel themselves and reduces the risk for falls. Fall prevention is a big part of treatment, and there are medications that can slow the bone breakdown or build new bone.”

  • What are the options for osteoporosis medications?

“Prescription pills can be taken daily, weekly, or monthly. These are covered under Medicare Part D. Injections can be given daily, once yearly, or 4x/year; these are covered under Medicare Part B or Part A, depending on where they are administered. The important point is that there is a medication to fit everyone who is at risk.”

  • Where can Medicare Nation listeners go for more information and resources?

Visit the website of the National Osteoporosis Foundation: www.nof.org. You can also find the Foundation on Twitter: @osteoporosisnof or on Facebook. There is also a new app available on iTunes or Google Play: Food4Bones. Check out these valuable resources for more information!

 

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

 

email me:

support@themedicarenation.com

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

 

Feb 5, 2016

 

 

Welcome Medicare Nation! I have some alerts for your today for some important changes to Medicare that are going on right now. I want you to know if you are affected, and what you need to do to make sure you have coverage. There are 2 main topics we need to discuss today:

 

  1. Dis-Enrolling from Medicare Advantage Plan
  2. Cigna Suspension

 

 

 

Jan 1- Feb 14 - the period in which you can dis-enroll from your Medicare Advantage plan - if you don’t like it.

 

  • You cannot then switch to another Medicare Advantage Plan during this period
  • You would only be able to go back to original Medicare when you disenroll
  • You would have Part A and Part B
  • This means you have deductibles and co-insurance
  • There is no network - any provider contracted with Medicare will work for you
  • Part B deductibles are either $104.90 or $121.80, depending on your situation
  • Part A deductibles are $1288 for each new occurrence during the coverage period
  • First 60 days you are covered by the deductible
  • Day 61-90 you pay co-insurance of $322/day
  • Day 91-100 you pay $644/day
  • After that you have your 60 lifetime reserve days at $644/day also
  • Part B has annual deductible of $166 for 2016
  • After the deductible you pay 20% of Medicare allowable cost for every procedure
  • You can purchase a Medicare Supplement plan for which you would pay a monthly premium

 

Need Help?

 

 

 

Cigna Suspension:

 

The States - AL, AZ, FL, GA, NC, PA, SC, TN - are affected. They cannot enroll any new people for the plan. If you had it, you can stay on it. Or you can leave. This was a sanction from CMS for failing to comply with the Medicare Standards. They found that Cigna has a long standing history of non-compliance with CMS standards. The suspension is indefinite.

 

This sanction opens a “Special Enrollment Period”. This allows you to enroll in a different Medicare Plan. 

 

Need Help?

Contact Medicare - 1-800-633-4227

Medicare Website - www.medicare.gov/contacts

support@themedicarenation.com

 

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

 

email me:

support@themedicarenation.com

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

 

 

 

Jan 29, 2016

Welcome, Medicare Nation! My guest today is Dr. Ralph Sacco, who is the Executive Director of the Evelyn F. McKnight Brain Institute at the University of Miami. He is also the Chief of Neurology Services at Jackson Memorial Hospital. Dr. Sacco has published extensively in the areas of stroke prevention, treatment, risk factors, human genetics, and stroke recurrence.  He is the recipient of numerous awards and has lectured at national and international meetings and conferences. He was the first neurologist to serve as president of the American Heart Association and serves as the president-elect of the American Academy of Neurology. Dr. Sacco is here to give us valuable information about strokes and stroke prevention. Join us!

  • Tell us what you do at the University of Miami.

“I’ve been the Chairman of Neurology since 2007. Our department has grown and is ranked 15th in NIH funding. We are leading the way in treating various neurological diseases.”

 

  • Tell our listeners what a stroke is and what the signs and symptoms are.

“Stroke is a huge public health issue, especially as our population ages. About 795,000 strokes occur each year, which is one every 40 seconds! A stroke is like a heart attack in the brain. In a stroke, the brain is injured by bleeding or some other problem with blood vessels. The warning signs are often missed, but our current awareness campaign uses the acronym FAST to help people remember:

F-Face-Drooping on one side 

A-Arm-Weakness in one arm 

S-Speech-Slurred speech 

T-Time-Call 911 immediately!

Other common symptoms are numbness and tingling on one side, severe sudden headache, and difficulty walking.”

 

  • Are there similarities in treating stroke and treating heart attacks?

“Heart attacks usually allow a little more time for treatment than the brain does. With a stroke, you MUST get to a stroke center immediately. TIME IS BRAIN! A clotbuster drug can be used with success in blood vessel blockages up to 4.5 hours after the stroke begins.”

 

  • I’ve heard that people should chew on an aspirin if they feel they are having a heart attack. Is that the same advice for a stroke?

“No, some strokes—about 15%--are bleeding strokes. Aspirin can make it worse. We advise calling 911 and getting to a treatment center. We can use drugs and catheters to remove clots up to six hours after stroke onset. This improves outcomes tremendously.”

 

  • What happens if signs and symptoms aren’t recognized and several hours go by? Is there irreversible brain damage?

“Exactly—the longer we wait in opening that artery, the less chance we have of total recovery. Some recovery can happen between 6-18 hours, but it’s more difficult. Too many people ignore symptoms, and then it’s too late.”

 

  • One side effect of stroke can be paralysis on one side. What exactly causes that?

“Most symptoms occur on one side of the body since one side of the brain controls the opposite side of the body. Everyone should know FAST and know how to activate the 911 call.”

 

  • Are there any foods we can eat to promote good blood vessel health? Is there a type of diet that helps?

“Diet is a big factor of ideal cardiovascular health. The AHA estimates that less than 1% of people have ideal cardiovascular health. There are five key components:

Fruits and Vegetables: 4.5 cups each day

Fish: 2 servings each week

Fiber-rich Whole Grain: 3 servings each day

Lower your sodium intake: Sodium increases blood pressure, and high blood pressure is THE single leading modifiable risk factor for stroke. Most people get 3500 mg/day when the recommended limit is only 1500 mg/day!

Limit sugar-sweetened beverages: This increases the risk for diabetes.”

 

  • What tips can you give about stroke prevention?

“Remember, what’s good for heart health is good for brain health, too. The AHA lists seven key factors, called ‘Life’s Simple Seven’:

  1. Never smoking
  2. Body Mass Index
  3. Physical activity
  4. Diet
  5. Total cholesterol less than 200
  6. Blood pressure not higher than 120/80
  7. Fasting blood glucose less than 100”
  • Doctor, for our seniors—or for anyone—is walking a daily exercise that you recommend?

“Walking is a great exercise. Just 75-100 minutes of walking over a week’s time can really help in the battle for ideal health.”

 

Resources:

  • Remember, part of Medicare benefits and preventive care includes nutrition counseling. You can talk to your primary care doctor for more information on how this service can help you. Visit www.medicare.gov for more information.

www.strokeassociation.org

www.heart.org

The FAST app for your smartphone is now available!

 

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

 

email me:

support@themedicarenation.com

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

 

 

 

Jan 22, 2016

 

Welcome Medicare Nation! Everyone keeps asking me about the changes to Medicare for 2016. There are quite a few changes, so today I will focus on the biggest ones you want to know about today.

 

How much will you pay for Medicare Part B (Outpatient Services)?

 

There is no COLA (Cost of Living Adjustment) for 2016. The Hold Harmless Rule comes into play. If there is no COLA, then there can be no increase in Medicare Part B. 

 

For everyone who is already on Medicare and receiving SS benefits, your Part B stays the same at $104.90. That’s 75% of the people that are on it. 

 

If you are turning 65 in 2016 and you are on Medicare, your premium will increase. If you delayed taking SS benefits because you continued working, your premium will increase. If you are on Medicare and Medicaid, your premium will go up. You may qualify for the state reimbursement for Medicaid costs. New premiums will be $121.80. Recommendations were that Medicare Part B premiums should be up around $159, but Congress limited the increase to $121.80. In actuality, Congress gave you a loan for the difference between $121.80 and $159, and charged you a fee for the loan until it can be repaid.

 

Over $65 Billion of Medicare dollars is lost to fraud. Instead of worrying about the fraud, your politicians gave you a loan! Oy Vey!

 

If you make over $85K in income, your premium will increase to a different amount, which you can reference on the website.

 

 

Medicare Part D (Drugs) - Medicare Advantage Plan majority will have drug coverage included already.

 

For 2016, know your deductible situation (max $360). Some have them and you will have to pay out first, and others will only be triggered with a brand name drug.

 

 

The Donut Hole - You don’t want to be in this category. $3310 is the maximum expense for this category. When you add up the amount of money you have paid and the plan has paid, and it exceeds $3310 and now you are in the donut hole. 

 

Now the government wants you to start paying more for your coverage. The new threshold is $4850 for this level. You will now pay 45% of the cost of the brand name drug and you will pay 58% for a generic drug. What you pay out of pocket plus a 50% manufacturer discount. Once you meet $4850, you now fall into the catastrophic coverage phase.

 

Catastrophic Phase - Last through the end of the calendar year. You will pay 5% of the cost of the drug or $7.40, whichever is higher. For generics you pay 5% of the cost of the drug or $2.95, whichever is higher.

 

The slate gets wiped clean as of Jan. 1 and your classification starts all over again.

 

 

Medicare Payout for Providers:

 

For 2016, payments will be reduced by 30%

 

They are looking at tying procedures together when there are multiple issues stemming from the procedure. Payment will be reduced when you are re-admitted to the hospital within a certain timeframe.

 

When a patient contracts an infection during a hospital stay, the payments will also be reduced.

 

They are looking at “Value over Volume”.

 

 

 

If you have been on Medicare for a year, you can have an annual Wellness medicare checkup. This isn’t your annual physical, but a Wellness Medicare Exam.

 

 

From now thru Feb. 14, you can drop your Medicate Advantage Plan and go back to original Medicare and have coverage for Part A and Part B. Then you would need to purchase Part D separately.  

 

  • No premium for Part A (overnight stays in any type of facility) $1288 is the amount you pay for 60 days. Day 61-90, you pay an additional $322/day and after day 90, you pay $644/day. Every person has 60 lifetime reserve days for one time use only.
  • In skilled nursing 0-20, 21-100 (max) you pay $161/day.
  • Part B has a one time deductible of $166, and then 20% of Medicare allowable cost. Find out your co-insurance payment prior to the appointment.

 

Stand Alone Prescription Drugs Plans:

 

  • All have premiums
  • Check for the deductibles too
  • You can apply for a supplement for Medicare to help cover the cost of Original Medicare

 

 

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

 

email me:

support@themedicarenation.com

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

 

 

Jan 15, 2016

Welcome! My guest today is Dr. Vincent Bufalino from Illinois. He is board certified in Internal Medicine and Cardiovascular Disease. He is the Senior Vice President of the Advocate Heart Institute and the Senior Medical Director of Cardiology of Advanced Medical Group (AMG). AMG is ranked as one of the top five health systems in the US and has 140 physicians in cardiology practice! Let’s hear more from Dr. Bufalino!

  • Tell us what you do at AMG.

“We care for patients in 12 hospitals in the Chicago area. Last year, over 20,000 cardiac procedures were performed at AMG. We provide expert medical care to those with high blood pressure, high cholesterol, and diabetes. Our surgical program provides the latest in technology to provide the highest level of quality health care.”

 

  • Do you treat patients from all around the US?

“We service most of northern Illinois and have outreach clinics even in the rural communities. Most of our patients are from this area, but some continue to access our care for follow-ups, even after they’ve moved to other states.”

 

  • What is meant by the term “heart disease”?

“We look at risk factors, which are not managed as well as they should be. High cholesterol is very common, and we have many tools to treat it although not everyone needs to be on medications. Some people can be treated with diet and exercise, but those over age 35-40 with family risk factors should be evaluated. Those that are experiencing symptoms should be evaluated. The death rate from heart attacks has decreased from about 20% a few decades ago to just 2% today. Unfortunately, some patients develop heart failure and require advanced care, but there are still many treatment options available.”

 

  • What are some common signs and symptoms of heart attacks?

“Exertion-related symptoms are common, like discomfort, pressure, tightness, and burning. The two most common symptoms are chest discomfort and shortness of breath. You should also pay attention to rapid heartbeat and fluttering in the chest. Acid indigestion CAN be a symptom, especially if it doesn’t subside when you take an antacid.”

 

  • What is a stroke?

“Essentially, a stroke is damage to the brain, usually from a blood clot or a ruptured blood vessel. Sometimes a “warning” occurs, known as a TIA (transient ischemic attack). It is accompanied by numbness/weakness on one side, vision loss, and slurred speech. Time is critical since permanent damage can be done. Within the first 60-90 minutes, we can intervene and dissolve the clot.”

 

  • What are some procedures that Medicare allows to detect heart disease?

“For those over age 65, an ultrasound is allowed to assess the risk of Abdominal Aortic Aneurysm (AAA), which is the ballooning of the main artery going down into the abdomen. The ultrasound detects any enlargement of the aorta. Those with a family history of aneurysm, men with high blood pressure, and smokers have an increased risk.”

 

  • Can you explain the Cardiac Disease Screening under Medicare?

“There is a ‘Welcome to Medicare’ physical exam that is allowed during the 12-month period after you turn 65. There are also nutritional therapy services available, and most people don’t even know about them or take advantage of them. The purpose is to try to give people tips that can make a difference and help them live healthier lifestyles.”

 

  • How is salt tied to heart disease?

“Salt is tied to high blood pressure, and this isn’t just from the salt shaker! Sodium is packed into processed foods, so it’s important to read labels.”

 

  • You were president of the American Heart Association in Illinois. How can the AHA help people?

“The AHA supports the work we do at AMG with patient education and research. Their website offers resources and even cookbooks. Find them at www.heart.org.” 

 

  • Do you have any tips that people can follow RIGHT NOW to prevent heart disease?

“The two most important things are to eat better and exercise more.”

Resources:

www.heart.org

www.advocatehealthcare.com

www.meetup.com  (Find walking groups all around the country.)

 

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

 

 

Jan 8, 2016

Welcome! Today’s guest is Brad Hubbard of National Flood Experts. He has built a company and a career dedicated to helping people save huge amounts of money! Join us for more!

  • What is your background that led you to start National Flood Experts? 

“I worked for 12 years as a civil engineer, working with FEMA (Federal Emergency Management Agency) on flood zone issues. When I grew tired of working as an engineer, I began working as an insurance agent specializing in flood issues. I noticed how many homeowners were required to carry flood insurance even though there was almost no risk for flood. I found out FEMA has a process to take these homes out of the flood zone and save the homeowner from paying for flood insurance. Before long, I helped 20-30 clients and then created NFE to help millions of Americans who shouldn’t be paying for flood insurance.”

 

  • Why would someone be required to have flood insurance?

“There are two requirements to have flood insurance: having a mortgage and living in a flood zone, as determined by FEMA. Being near water doesn’t necessarily mean you MUST have flood insurance, and both residential and commercial properties are subject to these requirements.”

 

  • How are flood insurance rates determined?

“There are different factors that vary according to different agents. The rates are not standardized but are affected by how high the home is built and how high the speculated flood may be.”

 

  • Is FEMA in charge of determining flood zones?

“Yes. FEMA created the NFIP (National Flood Insurance Program, which oversees all federal flood insurance in conjunction with local municipalities. They categorize flood zones and update maps every 10-15 years. NFE actually benefits FEMA by helping make their maps more accurate.”

 

  • So, as homeowners, is it accurate to say that we can actually CHALLENGE FEMA’s flood zone designation?

“Yes. Challenge is exactly the right word for what we can do. Most people don’t even know that this is possible, because we assume when the government says something, then that’s the end of it.”

 

  • Can you give us an example of how NFE can help a client?

“Yes. I have a client who lives in a 55+ neighborhood and was paying $1800/year for flood insurance. Our company did an Elevation Certificate and determined that we could help her. We charged her $500 for our services, submitted our report to FEMA, and they took her out of the flood zone within three days. She talked with her mortgage lender and her insurance agent and received a $900 refund from her escrow account and $1800 back from her previous year’s flood insurance. When you are taken out of a flood zone, then you’re entitled to a refund of every penny that you paid in flood insurance from the previous year! In addition to the $2700 refund, her mortgage payment dropped by $200/monthly—all of this was accomplished in just a few days’ time!”

 

  • How do homeowners get an Elevation Certificate?

“It’s part of the package with a survey and appraisal when you purchase a home or purchase flood insurance. Only about 20% of people don’t have one. Our crew can complete an Elevation Certificate for $150-500. If your home has been built or improved upon in the last 20-30 years, then an Elevation Certificate probably exists. Every municipality is required to keep these as public record in order to have FEMA participation.”

 

  • Does your service fee vary according to whether a home is in a low-value area or a high-dollar area?

“No, our services are based on a flat rate no matter where you live.”

 

  • What can NFE do for Medicare recipients?

“In all 50 states, Puerto Rico, and anywhere that FEMA regulates, NFE has a way to make it easy. There is a 24-hour recorded message line: 888-289-3134. You can access our free consumer’s guide to purchasing flood insurance. Our services are 100% guaranteed, with a total refund if we can’t help them, so there is NO RISK! If you mention this podcast when you call, then you will receive a $50 discount.”

 

  • Tell us what you can do to help our listeners.

“For some, we can get you out of a flood zone designation and eliminate your need for flood insurance. For others, we can reduce your insurance premium in several different ways in reviewing your property and options.”

 

  • Can you give us a summary of what your company does when a client calls?

“When you call and leave a message, all we need is your name and address to begin our research. We will be in touch with you within 24 hours and give our recommendations regarding how we can help. There is no payment required until a determination is made that we can help. The initial review is free and the only charge happens when we KNOW that we can help (and don’t forget the MONEY-BACK GUARANTEE!)”

 

  • How does your fee differ from residential and commercial clients?

“The pricing is a little different, based on how much we can save a commercial client in a year, but the process and the guarantee are the same!”

 

  • What if a residential homeowner has had flooding? Can they still contact you?

“Yes and no. If you’ve had a flood claim, then FEMA is not going to remove you from the flood zone, but there still are things you can do to reduce your premium. Keep in mind that FEMA defines a “flood” as rising water over more than two acres and where two or more properties are affected. Flooding does NOT include broken pipes or a water main break. Your normal homeowners’ insurance covers those water damage issues.

 

If you are paying for flood insurance, you should give NFE a call at 888-289-3134 or visit their website: www.nationalfloodexperts.com.

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

 

 

 

 

« Previous 1 2