Medicare Nation

Welcome, Medicare Nation! My guest today is Dr. Steven Loomis, an optometrist in Littleton, CO. Dr. Loomis is also the president of the American Optometric Association. Did you know that June is Cataract Awareness Month? It’s important to know what cataracts are, how they develop, and how to treat them. Dr. Loomis is here to discuss those topics and others related to general eye health. Join us! Many people don’t understand the difference between an optometrist and ophthalmologist. Can you explain?  Think of an optometrist “like a family doctor for your eyes.” These are medical doctors with four years of undergraduate education and four years of specialization. They deal with eye issues such as blurred vision, diabetes, and glaucoma. Optometrists actually diagnosed 240,000 cases of diabetes in 2014! An ophthalmologist is an eye surgeon who works in conjunction with a patient’s optometrist. We know we need comprehensive eye exams, but how often should we get them, and what is included in that exam? An a

Welcome Medicare Nation! Today we’re talking about Shingles. I recently had shingles and my eyes were opened to how painful it is. It’s really a terribly painful illness, so I wanted to give you some facts and tips to help you diagnose your symptoms early.         What is Shingles?   A virus that is a type of herpes zoster virus. You can only get shingles if you’ve had chicken pox. The virus stays dormant in your spine and attach itself to some of the nerves in your spine. Then something comes along and activates it when you have a lower immune system. If you are on auto-immune suppressing drugs, you are more susceptible to the virus.   Increased stress can also trigger an outbreak of shingles.       What are the symptoms?   A blistery rash that generally starts around your back and wraps around your side. I got a blister on the palm of my hand. About a week before the outbreak, you can begin having pain from the nerve endings being affected.    Patches of blisters will grow and then they are painful. You can

Welcome, Medicare Nation! I’ve had a busy two weeks and have just returned from a conference in Miami for the National Osteoporosis Foundation. I have been flooded with emails, so today’s episode will be a Q&A session in which I address as many of those questions as possible. Join me! From Steve in Texas: “I’m turning 65 in July and your program has been helpful to me. Can I change Part D prescription options over time without having to pass insurability determinations?” The options can be confusing. You can change Part D plans during the annual enrollment period, from October 15-December 7. You can change plans every year, if needed. You should review your plans yearly, based on your prescription needs and usage.   From Dottie: “I have a Medicare Advantage Plan with Blue Cross. When I get the benefits summary, do the fees reflect those set by Medicare or do the doctors make these up?” Every Medicare insurance carrier negotiates with each doctor and facility so they have a contract for how much t

Welcome, Medicare Nation! Can you believe the month of June is here? The year is rolling right along, and you may not be aware that June is Aphasia Awareness Month. If you’re not familiar with aphasia, you should know that it’s an acquired disorder that affects a person’s ability to speak and to process language, but it does not affect intelligence. Let’s learn more about this disorder. Here are a few basic facts about aphasia: Often, aphasia is the result of brain injury, brain tumor, neurological disease, or stroke. (25-40% of stroke survivors will have aphasia.) About 2 million Americans are affected by aphasia, with 180,000 acquiring it yearly. Aphasia can affect any age, race, ethnicity, and gender. Those over age 60 have the highest aphasia rates, with those over age 40 being the second highest. The rate of occurrence is the same for all other age groups. Aphasia can’t be cured but can be treated and improved with speech and occupational therapy, and these are covered by Medicare, depending on the plan

Welcome Medicare Nation! Today’s episode is Part 2 of our interview series live from the Interdisciplinary Symposium on Osteoporosis held by the National Osteoporosis Foundation in Miami, FL. Today’s episode features some of the leading Osteoporosis practitioners in the country, as well as an important summary of Medicare Benefits that relate to the treatment of Osteoporosis.   Today’s episode features:     Medicare Benefits for Bone Mass Measurement (Bone Density) Testing     How often is it covered?   Medicare Part B (Medical Insurance) covers this test, which helps to see if you're at risk to broken bones, once every 24 months (more often if medically necessary) for people who meet the criteria below. Medicare only covers this test when it's ordered by a doctor or other qualified provider.   Who's eligible?   All qualified people with Part B who are at risk for osteoporosis and meet one or more of these conditions: •A woman whose doctor determines she's estrogen deficient and at risk for osteoporosis, base

Welcome Medicare Nation! I interviewed clinicians and global experts in the bone health field gathered during the Interdisciplinary Symposium on Osteoporosis  held in Miami, Florida from May 12 to 15, 2016. May is the National Osteoporosis Awareness Month. Clinicians and Academicians Joined  the National Osteoporosis Foundation to Identify Solutions for Reducing the Two Million Broken Bones Caused by Osteoporosis Each Year. This conference was sponsored by the National Osteoporosis Foundation (NOF), the organization dedicated to preventing osteoporosis, promoting strong bones, and reducing human suffering through education, advocacy, and research.  NOF is committed to promoting bone health among the elderly through healthy diet and safe exercise.  Both can help stop the loss of bone mass and help prevent fractures.    Leading medical and scientific experts in the bone health field discussed  the latest information on preventing broken bones and lead in-depth educational sessions on the prevention, diagnosis a

May 10th was World Lupus Day. So today, we wanted to highlight the disease so that we can get the word out.     Linda Ruescher, author, public speaker and Lupus advocate is our guest today. Linda actually has Lupus as well.   How many people in the US have Lupus?   1.5 Million people in the US.   What is LUPUS?   An auto-immune disease in which your body mistakes other body parts are toxins and invaders and tries to kill them. Lupus doesn’t have one particular body part that it targets. It can go after any part of your body.   Lupus can be difficult to diagnose because:   It flares instead of being chronic The symptoms are the same as other diseases There is no definitive test for Lupus Generally they try to diagnose other things first A rheumatologist can be necessary to get a diagnosis     Lupus is like having a never-ending flu. The symptoms are the same, and the body reacts in the same way.   After 38 years undiagnosed, Linda was diagnosed in 2003. She is treated today with immune-suppressing drugs. She

Today’s topic is the Medicare Savings Program. It can help you pay part of your Medicare premiums. It’s based on certain criteria of your income and resources.   2016 Medicare Savings Programs:   Resources include stock, bonds, 401K, IRA.   It does not include your home, 1 vehicle and other personal items.     4 Levels of Coverage:   QDWI Plan: (Qualified, Disabled, and Working Individual) Monthly income limit - $4045 (Married $5425)  Resource limit - $4000 (Married $6000)       QI Plan: (Qualifying Individual)   Monthly income limit: $1357 (Married $1823) Resource limit: $7280 (Married $10,930) Pays Part B Premium - $104.90 New to Medicare - $121.80     Specified Low Income Medicare Beneficiary Program (SLIM-B)   Monthly income limit: $1208 (Married $1622) Resource limit: $7280 (Married $10,930) Pays Part B Premium - $104.90 New to Medicare - $121.80     Qualified Medicare beneficiary (QMB)   Pays Part A, Part B Premium, Deductibles, Co-pays Monthly income limit: $1010 (Married $1355) Resources limit: $7280

Welcome Medicare Nation!  Today, I want to tell you about the federal government program called The Extra Help program, also called Limited Income Subsidy (LIS).  If you never heard of this program, you may be missing out on some additional subsidies for your prescription drug purchases. So let’s walk through the program to see if you qualify. Qualifications for the Program: 1. Must be a resident of one of the 50 states in America 2. Your resources (savings, stocks, bonds, 401k etc.) cannot exceed $13,640 (married $27,250) 3. Your annual income cannot be more than $17,820/yr (married $24,030) 4. If you support someone else who resides with you (not your spouse), you may qualify for a higher threshold   How to Apply for Extra Help: The easiest route is to apply through Social Security 1. Apply online: www.ssa.gov - click benefits and then apply for extra help  2. Call Social Security directly at 800-772-1213 3. Go to your local Social Security office - find locations at www.ssa.gov  Make sure you keep a paper

Welcome Medicare Nation! Hot Topic – The Comprehensive Care For Joint Replacement Model (CJR Model) Hip Replacements & Knee Replacements are the MOST COMMON Inpatient Surgery for Medicare Beneficiaries. In 2014 over 400K procedures were done, which cost Medicare over 7 Billion $ for the Hospitalization for these procedures ALONE. Hip & Knee Replacement Surgeries can require long recovery time & long Rehab periods. I KNOW!  I’m not even on Medicare yet, and I’ve had TWO Arthroscopic Knee Surgeries, and each surgery took me about a good 6 MONTHS to recover.   This is the SCARY PART!   The Quality & Care you receive VARIES from one Hospital to the next! Complications like – Infections received at the hospital …….OR Implant Failures Can be 3X Higher Performed at Some Hospitals More Than Other Hospitals. To me……that is just NEGLIGENCE!  When you go into a hospital……you expect to receive the best care, a clean environment and YOU SHOULD NOT  CONTRACT  ANY INFECTION OR DISEASE from the Hospital y

Welcome Medicare Nation! It’s tax season! Today is April 15th and it’s the dreaded tax deadline day! It’s this time of year that people realize they need to make some changes to their Medicare plan. However, many people don’t realize that you can’t just make changes anytime you want to a Medicare Advantage Plan. There are specific times that you can make changes, and then you have to live with them until the opportunity arises to make changes again.   Here’s quick guide to making changes to your Medicare Advantage Plan:   You make your initial selection of your Medicare Advantage Plan when you enroll at 65. During annual enrollment from October 15 to Dec 7th. You can dis-enroll from January 1- Feb 14th, but you would have to go on to original Medicare because you cannot switch to another Medicare Advantage Plan at this time. You may have a “Special Election” that allows you to change your plan.   That Special Election for Medicare Advantage is what we want to focus on today.  There are certain circumstances

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:   Eliminate rugs in the bathroom and other rooms of the house Check the types of shoes to make sure they don’t contribute to a fall Falls happen in the middle of the night going to bathroom, so install rails Is walker or cane eas

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 M

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 dama

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. Medi

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 con

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

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    

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

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