Medicare Nation

Latest Episodes:

Medicare Dis-Enrollment and Cigna Suspension Alerts - What you need to know NOW! Feb 05, 2016

Show notes

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
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?

Call 1-800-Medicare if you have questions
support@themedicarenation.com

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

Do You Know the FAST Steps to Recognize Stroke Symptoms? Jan 29, 2016

Show notes

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’:

Never smoking
Body Mass Index
Physical activity
Diet
Total cholesterol less than 200
Blood pressure not higher than 120/80
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

2016 Medicare Changes You Need to Know About Now! Jan 22, 2016

Show notes

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

Preventing and Treating Heart Disease through the Advocate Heart Institute with Dr. Vincent Bufalino Jan 15, 2016

Show notes

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

National Flood Experts can SAVE you thousands in flood insurance with no risk Jan 08, 2016

Show notes

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

The PACE Program Provides Services and Long Term Care with Peter Fitzgerald Dec 25, 2015

Show notes

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 the model. Now, people enroll in the program, which is sponsored by local healthcare provider organizations. PACE meets all the healthcare needs of the seniors except housing, but provides transportation, day centers, therapy, rehabilitation, meals, doctor visits, and home care services. The overall goal of the program is to keep seniors living in the community rather than in nursing homes.
Is it true that the PACE program is its own network of doctors and facilities combined into one? Yes, it’s designed to be a complete system. PACE programs employ their own doctors, nurses, practitioners, home health aides, home health nurses, and transportation services. The program secures contracts with hospitals for Medicare services and other needs.
Which Medicare coverage will pay for the PACE program? Upon enrollment, the PACE program becomes the source of all Medicare benefits and replaces traditional Medicare or Medicare Advantage Plans. Medicare actually pays the PACE program monthly for patient care, so in reality, it’s like another Medicare Advantage Plan.
Who is eligible for PACE? Enrollees must be 55 or older and live within a PACE service area, which is usually about a 45 minute driving radius. The program becomes all-encompassing health care, so patients must have access to a PACE center within a reasonable distance. The program is designed for those with complex and chronic needs. However, if someone has to enter a nursing home during their care, then the program does continue for them, even though they were not able to remain at home.
Almost one-half of PACE enrollees have some sort of dementia diagnosis, so do you think those numbers will continue to increase? The dementia and Alzheimer’s diagnoses are a potential area of growth for PACE. The president recently signed into law the creation of some new PACE programs that allow enrollment for some people under age 55. Early intervention may help people improve and maintain their quality of life.
What would the average cost be for a private pay patient under the PACE program? It would vary greatly from state to state, but the average would probably be around $3000/month with no co-pay or deductible. The rate is determined by the state, but remember that long-term care is included in the program, AND you get to stay in your home with your loved ones.
Is PACE considered “for profit” or “not for profit”? The program originally began as “not for profit,” but has since allowed “for profit” sponsorships. There is currently only one “for profit” PACE program operating in PA, but these will become more widely available in the future.
How many PACE programs are there? In 32 states, there are 116 PACE organizations currently serving 220 communities. You can find out more about the program and its availability in your local area by visiting www.pace4u.org or www.npaonline.org. You can also call 703-535-1565, find them on Facebook, or on Twitter @TweetNPA.
Can individuals volunteer or donate within the PACE program? YES! There are many ways to volunteer and donations are always accepted. Check with your local organization for further information.

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

Will You Contract Pneumococcal Disease? Let's Hope Not. It's Deadly! Dec 19, 2015

Show notes

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 health information and raise awareness. I’m partnering with Pfizer to get the word out about pneumococcal pneumonia, especially to older Americans, who are at a greater risk.”
Most people probably don’t understand that vaccinations are free under Medicare. Can you explain? “Vaccinations are included in preventive services, and so they are free and without a co-payment, even for those with private insurance. These vaccines are available at doctors’ offices, clinics, health centers, and drugstores. The goal is to make them easy and accessible.”
Is there a season in which pneumococcal pneumonia is more prevalent than others? “Not really—this disease is not weather-related. It is more related to the immune system of the patient. For some reason, African-Americans seem to be at a higher risk.”
Can an older person get more than one vaccination at a time, like a flu shot AND the pneumococcal pneumonia shot? “It varies according to the person, so it’s important to talk to your doctor. In general, the vaccinations probably can be given together if there aren’t other special conditions.”
What are the signs and symptoms of pneumococcal pneumonia? “Anybody can get this disease, even a very healthy person. Those over age 65 are at a greater risk. The symptoms include a sudden onset of high fever, shortness of breath, coughing, and chest pain. The average hospital stay is about five days and it can even cause death. Prevention is the key!”
For pneumococcal pneumonia, is there a live strain of the bacteria in the vaccination, or is it a synthetic form? “Most vaccinations today have an ‘attenuated’ form, which means they are live but not active. The goal is for your immune system to ‘think’ you have had the disease when you haven’t, so the antibodies are produced. There are different types and different brands of the vaccine. Your doctor can help decide which form of the vaccine is best for you.”
What are the best ways to keep from getting this disease? “Handwashing is the best preventive. You should also exercise, eat well, and live a healthy lifestyle. Pneumococcal pneumonia is spread by coughing and sneezing, or by touching surfaces where someone has coughed or sneezed. We can’t avoid people completely, so that is why the vaccine is so important.”
Dr. Benjamin, what was the most wonderful thing about your job as US Surgeon General? “My favorite thing was getting to meet people in their communities and talk about the prevention of disease and the promotion of good health.”

Resources:

www.knowpneumonia.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

Maintaining Balance and Fitness for Life with Jim Jenson Dec 11, 2015

Show notes

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 “free memberships” in fitness programs. How can people get the most from this benefit? Always work with a trainer, and be sure they are certified for your needs and goals. You really need one-on-one training for success and injury prevention. Don’t be afraid to ask about their certification, and check with your primary doctor about beginning a fitness program.

What kinds of exercises do you teach those with special challenges? I am a big fan of resistance bands and I take them everywhere! They allow core exercises even while sitting and help with balance and stability. Recumbent bikes are great for cardio workouts. I even use foam swords for “sword fights” with wheelchair-bound clients! Check out my website for Predator Bands and a video about a total body workout with bands!

What are the primary causes of balance problems? De-conditioning is the biggest problem. This is due to the lack of use of the core muscles. Other causes include medication interaction, chronic conditions, and vision/hearing changes. Remember, a previous fall increases your chances for another fall!

What exercises can be done at home to reduce the risk of a fall? Strengthen your core muscles and practice your balance. Don’t be ashamed to use a cane or a walker for extra safety. You can even work with a certified trainer to improve your gait.

What about exercises to strengthen the core? There are many “mat work” exercises, and yoga that is geared toward seniors can increase core strength and flexibility. One of my very favorite resources is The Core Program: 15 Minutes a Day That Can Change Your Life, by Peggy Brill.

What other things can boomers do to maintain active lifestyles? For longevity, cardiovascular exercise is preferred. It’s GOOD to huff and puff and then let your body recover. For quality of life, resistance exercises (like bands) are a great option. Dancing is also wonderful for balance, stability, cardiovascular exercise, and FUN!

Do you take any insurance in your fitness business? No, there is no insurance that pays for personal trainers except on the rare occasion when it may be included in a workman’s comp claim.

Tell us about your podcast, The Essential Boomer. It is the Baby Boomer’s Survival Guide! It’s my passion and what feeds my soul. I started it in May, and it has grown. I interview knowledgeable guests to give information to Baby Boomers. The podcast is connected to a private Facebook group by the same name.

Resources:

The Core Program: 15 Minutes a Day That Can Change Your Life by Peggy Brill

www.essentialboomer.guide (Jim’s website)

jim@essentialboomer.guide (Jim’s email)

650-704-0377 (Jim’s phone number)

www.nasm.org or 800-460-6276 (Contact NASM for certified trainers in your area.)

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

Tips for Selecting Your Prescription Drug Plan - Medicare Annual Enrollment Part 2 Dec 05, 2015

Show notes

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 going to be.

Don’t assume that the generic drugs are always cheaper. Check your plan!

The Donut Hole:

Jan 1 you have $3310 to use towards prescriptions. This is a combination of copays and what the plan pays. Once you reach $3310 total, then everything else is in the donut hole.

So now, your cost of prescriptions will change. Once you reach $4850, you get out of the donut hole. After $4850, then you are now in the catastrophic phase of the plan. So you either pay the higher of 5% of the total price or the designated price for that prescription.

In 2020, the donut hole is eliminated, and then everyone will pay a flat 25% of the cost of the drug.

Silver Scripts - owned by CVS - it has a pretty good premium ($25.60 monthly in FL) and then you have no deductible. You just have to make sure your drugs are on the plane. silverscripts.com will tell you what the tiers are for the drugs and the monthly costs.

Always look at plans year to year and make sure you get the best plan for you.

If you have questions, you can reach out to me:

Call 855-855-7266

Twitter.com/medicarenation

themedicarenation.com

facebook.com/medicarenation

You always have an alternative as well, if none of this fits you. If you decide you made a mistake, you still can drop your plan in January and go back to Original Medicare and a stand alone plan. Listen to the episode and Diane will tell you what your options are.

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

Medicare Annual Enrollment Assistance - Part 1 Dec 05, 2015

Show notes

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 premium.
Don’t get a plan with a deductible
Max out of pocket is $6400 for the year for Medicare - so look for the lower maximum out of pocket expenses. It is for the same coverage.
Don’t fall for the plans that give you a discount on over the counter items. It isn’t worth it.
No monthly premium
No drug deductible
Lowest maximum out of pocket expenses
Make sure your doctors are on the plan that you are choosing

There is no binding agreement that keeps Doctors in the network, so they may come and go.

If you have the plan with no monthly premium, no drug deductible and a low maximum deductible with $3000 or so, then that is a great plan!

If you are looking for supplemental plans, you need to realize that the benefits are standardized. The F Plan is the most comprehensive and it will go away in 2019. They are also eliminating the C Plan in 2019 as well. The C Plan just doesn’t cover excessive charges. The G Plan means you are responsible for your Part B premium and also for excessive charges.

Compare the prices for the F Plan under each insurance agency, because they will be different and then you need to know what the financial rating of that company is. AAA+ is the best rating and F is the worst.

You can find more information and keep in touch with us in the following places.

855-855-7266 - Call us and we will help you!

www.themedicarenation.com

facebook.com/medicarenation

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