Medicare Nation

    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:   Dis-Enrolling from Medicare Advantage Plan 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 D

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 s

  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 increas

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, eve

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

Welcome! My guest today is Peter Fitzgerald, who is the Executive Vice President for Policy and Strategy for the National PACE Association (Program of All-Inclusive Care for the Elderly.) The PACE program helps guide the association policy and advocacy efforts at the federal and state levels. The program is always looking to improve services for those needing long-term care. What is the PACE program and its history? PACE provides all the programs that the elderly need, from health care services to long-term care, all designed to keep seniors living in a community-based setting at home. It began as a pilot program in Chinatown in San Francisco, because the Chinese culture is based strongly on keeping elders at home with their families and out of nursing homes. Alternatives were explored to keep them living in the community with some assistance. The program began with a Daycenter that provided meals and healthcare and remedied the social isolation that some seniors feel. Over time, more services were added to

Welcome! I’m honored to introduce you to my guest today, Dr. Regina Benjamin, who is the former U.S. Surgeon General under President Obama.  There has been some confusion about the position of US Surgeon General, so can you describe the position and tell us what it entails? “Most people associate the US Surgeon General with the warnings on tobacco products about the dangers. That’s not all we do, though. We are responsible to communicate the best health science that we have. The Surgeon General is also the leader of US Public Health Services. We are considered part of the military. I like to say we carry needles, and not guns.” Are you appointed or elected to the position? “The US Surgeon General is nominated by the president, and then confirmed by the Senate. The Senate also assigns the position for a 1-4 year term. I was fortunate to be confirmed unanimously without a hearing.” Can you explain the focus of your mission today? “Part of the division of Science and Communication is to get the word out about h

Welcome! My guest today is Jim Jenson, who is the owner of “Fit for Life,” an adaptive fitness business. He is a certified fitness instructor and the host of the podcast, “The Essential Boomer.” Jim is here to talk about the specific fitness needs for baby boomers. Tell us about “Fit for Life” and what adaptive fitness is.  I have been in business for about ten years, located 20 miles south of San Francisco. I work with special fitness issues like MS, wheelchair-bound clients, and balance issues. I usually travel in a 10-15 mile radius to visit clients in their homes to work with them. I love helping people improve their lifestyle and their health!   How are you certified to do what you do? I’m certified through the National Academy of Sports Medicine (NASM), with both basic and advanced certifications. Special training is essential to prevent injuries, so Baby Boomers need to make sure to work with someone trained in disabilities and chronic issues.   At this time of year, there are many offerings of “f

It's annual enrollment time and I know that the prescription drug coverage options can be confusing.  So, today I wanted to try to clarify what you need to look for in the best drug coverage plan for you. Original Medicare requires a stand alone plan for prescription drugs. These plans are a pain, and that’s exactly why this episode exists.   Do not be loyal to any particular drug plan.  You want the plan with the least out of pocket expense, and the ones that carry your drugs. You will pay a monthly premium, either a lower ($16-18 to $30-35) premium and then a higher deductible.  Or you can have a high premium (up to $180 monthly) and then almost no deductible. 3.  Make sure your particular drugs are on the plan before you commit to any plan.  This list is always changing and you have to double check it from year to year.   If you have several drugs, you could easily meet your deductible in the first month of the new year. It is important to do the math and see what your overall out of pocket expenses are

It’s that time of year!  You have 5 days left to choose your Medicare plan for the coming year.   Did you choose the right plan?   If you are confused, this is the episode for you!  I’m going to tell you exactly what you need to know to make the right choice.     3 Choices: Original Medicare - Part A and Part B Medicare Advantage Medigap to Original Medicare   Medicare for 62 and older and it was never designed to be free,   Part A - Stay overnight Part B - (Outpatient) Everything where you don’t stay overnight annual deductibles copayments   Medicare Advantage - networks, HMO and PPO healthcare providers.   HMO is smaller and PPO’s are larger and carry Medicare products in different states. Supplement is a private insurance (F Plan) and it is expensive, but the coverage is comprehensive.   All will have the same basics of Original Medicare Plan. Most of them include prescription drug coverage with co-pays Some have premiums and some do not - you just have to research.  I don’t recommend plans with a monthly

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, a

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 fo

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

  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

Welcome to today’s episode, which covers Medicare fraud.  The Medicare Strike Force and the Health Insurance Preventive Enforcement Action Team (HEAT) exist to stop fraud in its tracks.  Do you think fraud is a widespread problem?  Take a look at the statistics:  in 2011, $15-60 billion was lost to Medicare fraud, and the Center for Medicare Services (CMS) predicts that $65 billion yearly is issued in error.  Those are huge numbers!  My guest today will  help explain the ongoing efforts to stop the fraud! Anne Frederickson works for one of the volunteer programs trying to help in the fight against fraud.  Ann is a project manager in Ohio for the Senior Medicare Patrol at Pro-Seniors, which is a non-profit, long-term care and advocacy program in Cincinnati.  Ann has been in this position since 2002, and has also worked in geriatrics and hospital administration for 30+ years.  Ann hosts a weekly radio program, “Medicare Moment” on WMKV 89.3 FM. Explain what Senior Medicare Patrol (SMP) is all about. SMP volunte

Welcome Medicare Nation!  Today’s guest from the American Lung Association is Dr. Norman Edelman.  Dr. Edelman has an years of experience that includes:   Norman H. Edelman, M.D. is Professor of Preventive Medicine, Internal Medicine, and Physiology and Biophysics at the State University of New York at Stony Brook. From 1996 - 2006, he served in a dual capacity as Vice President for Health Sciences and Dean of the School of Medicine at Stony Brook.  A graduate of Brooklyn College, Dr. Edelman received his M.D. degree from New York University, where he was elected to the Alpha Omega Alpha honor medical society. He received postgraduate training at Bellevue Hospital in New York City and went on to be a Research Associate at the National Institutes of Health, National Heart Institute, and then Visiting Fellow in Medicine and Advanced Research Fellow of the American Heart Association, Cardiorespiratory Laboratory, Columbia University, College of Physicians and Surgeons, Presbyterian Hospital. What is the American

Welcome Medicare Nation!  Today’s discussion spells out the essential elements of Elder Law, and how the specialty is necessary for so many circumstances.  That’s why I am talking to an expert in the field today, who can help us clarify some common misconceptions, and also point us to the right resources to make sure you and your family are protected.   My guest today is Andrew Brusky, who is an attorney who specializes in elder law, offering services designed to provide greater options and security for the elderly and disabled.  Mr. Brusky regularly handles cases and is a frequent speaker on issues involving Medicaid eligibility, health care and financial powers of attorney, trust documents, as well as long-term care options for the elderly.  Andrew has worked for Legal Assistance to the Elderly in San Francisco, California and as an intern with the Center for Public Representation in Madison, Wisconsin.  Mr. Brusky received his Undergraduate degree in psychology and gerontology from Santa Clara University a

Welcome Medicare Nation!  Today’s guest is Melissa Joy Dobbins, a nationally recognized Dietician with more than 20 years of experience dealing with the nutritional needs of not just Seniors, but people with special dietary needs like diabetes.  Melissa will show us how to eat healthy on a fixed income, and the things we can to do use food to help improve our overall health!    1.  Family members and the senior need to feel like you are in control of your own choices.  This means you need to take an active role in making great food choices, and feel empowered to make good decisions for yourself.   2.  It’s important for adult children to not be afraid to be a backseat driver for your elderly parent. Intervene when needed, but involve them in as many decisions about their nutrition as possible.             How to eat healthy on a fixed income:   myplate.gov will give you a ton of information. Fruits and vegetables don’t have to be fresh to provide good nutrition Eggs are a healthy and affordable addition to t

  Welcome Medicare Nation!  We have a very distinguished guest with us today - Congressman Alan Grayson from the 9th Congressional District in Orlando, FL.  Congressman Grayson is here to talk about the bill he recently introduced in Congress, HR3308: Seniors Have Eyes, Ears and Teeth too!   Congressman Grayson lost his Father in 2000, and in the last years of his life, he had a broken front tooth.  This is when Congressman Grayson realized that Medicare arbitrarily excludes certain items for Seniors that are very important for their quality of life.  After he researched the Medicare details, he realized there were 2 sentences in the legislation that stated, “No care for Eyes and Ears”, and “No care for Teeth” for Seniors.   To rectify this situation, Congressman Grayson introduced a simple bill that just strikes those 2 exceptions from the statute.  He feels this is a common sense solution to a problem that affects so many Seniors.   Treating problems with eyes and teeth, can actually be a preventative measu

Hospice and End of Life Resources for Palliative Care   Welcome Medicare Nation!  Today we continue with Part 2 of our Death Series, as we talk about end of life resources that Hospice provides.  Most people are familiar with Hospice and the services they provide, but I wanted us to take a closer look at Hospice as it relates to Medicare.  Hospice provides several different levels of care, but the focus of our conversation today is routine care and respite care.   My guest for today is Judy Lund Person. Judy is with the National Hospice and Palliative Care Association.  She has worked in the national office since 2002 and is considered an expert in Compliance and Regulatory Leadership for Palliative Care.      We discuss some very important aspects of Hospice care and Medicare, so for more details on each of these questions below, please listen to the full episode here.     Who qualifies for Hospice services?   Hospice is for patients who have a life expectancy of 6 months or less. Hospice is covered under Pa