The A, B, C, D’s of Medicare

Posted on October 24th, 2014

Categories: Affordable Care Act,Health Insurance,Medicare,Medicare Part A,Medicare Part B,Medicare Part C,Medicare Part D,Obama Care

claim formMedicare open enrollment occurs every year from October 15 to December 7.  This is the period in which you can change your Medicare coverage.  Today’s blog is just a quick primer on the basics of Medicare.  Next week I will discuss what changes you can make during this annual open enrollment period!

Medicare is government sponsored health insurance for seniors 65 or older and people under 65 with certain disabilities.

Medicare Part A remains a type of hospital insurance that covers inpatient care in hospitals, skilled nursing facilities, receiving hospice care and home health care.  Most Americans do not have to pay a premium for Part A insurance.

Medicare Part B continues to help cover services from physicians, outpatient care, durable medical equipment and some preventive services.  Beneficiaries of Medicare Part B continues to pay a premium.

Medicare Part C (also referred to as Medicare Advantage) is Medicare run by private insurance companies and includes all benefits and services covered under Parts A and B and usually includes Part D which is Medicare prescription drug coverage.

Finally, Medicare Part D helps cover the cost of prescription drugs and is also run by private insurance companies. Most Medicare Part D beneficiaries pay premiums and co-pays.  Most Part D plans continue to have a coverage gap (often referred to as the “donut” hole”).  Typically during this coverage gap, the recipient is responsible for paying for the entire cost of prescriptions during the gap or until the out of pocket limit is reached.

But changes in Medicare have occurred and will continue to do so with under the Affordable Care Act of 2010 (also referred to as Obama Care).

Medicare now offers more preventive care such as screenings for depression and annual wellness visits.  Also, the cost recipients pay out of pocket for prescription drug costs is going down and by 2020 the drug coverage gap (donut hole) will be closed completely.

Medicare is pushing health care providers to provide more coordinated care by providing them incentives to do so.  As a care manager, I have seen the chaos in seniors’ lives when no one is coordinating care.  The result of this chaos can even worsen an elder’s health!  Family care givers end up confused and frustrated by a series of disjointed care.  Have you been there?

Finally, under the Affordable Care Act, steps have been taken to reduce the administrative costs charged by private insurance companies for recipients of Medicare Advantage plans (Part C).  This means more Medicare dollars go toward your elderly loved one’s direct health care!

As Medicare continues to evolve, I will continue to provide more updates.  It is impossible to cover Medicare in its entirety in just one blog!

If you need more specific information or just need to gain a more in depth understanding of Medicare for you or your loved one, I welcome the opportunity to assist you.  Please contact me at

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Caregiver Angst

Posted on October 16th, 2014

Categories: Aging Advocacy,Caring For Elderly,Gerontology,Grief,Helping Seniors,Resources,Senior Care Management

sunset-14Throughout this care giving journey we have shared along the way, I have discussed many emotions elicited by my own care giving experience.  In turn, many of you have responded with your own.

To be sure there were happy, loving and even humorous thoughts we have shared.  But more often, our emotions have been sad.  Grief.  Worry.  Stress.  Doubt.  Anger.  Anxiety.  That’s a big one!

The Online Urban Dictionary defines anxiety as such:  “A small word which can describe a large set of emotions, which usually can be worry, worried, frightened, scared, paranoid” and the list goes on!

Sure, as a caregiver I have felt worried or stressed or even anxious many times while caring for my parents and husband.

And as a care manager, I do worry for my elderly clients on a continuous basis.

But interspersed with my worry is always hope that things will improve and joy for the small gains made.

But anxiety by its very nature precludes the notion of joy and hope.  So if not anxiety, then what is it that I am feeling as a caregiver?

Again, I turn to the Online Urban Dictionary for help.  Turns out I am feeling angst!

Angst combines worry about what is with hope of what is to come!  Yes, our elderly loved ones suffer setback after setback.  But if we watch closely, they will still surprise us!

So as a caregiver, I do worry.  But when given the option:  I will always choose hope!

“We must accept finite disappointment, but never lose infinite hope”,   Martin Luther King, Jr.




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Air Travel and Oxygen Tank: Plan Ahead!

Posted on October 9th, 2014

Categories: Active Senior Living,Caring For Elderly,Helping Seniors,Medical,Planning


With tightened airport security in the past several years, many rules have changed for airline passengers. Some of these changes can be quite an inconvenience, especially for elderly passengers. What about a passenger that needs to be on oxygen at all times? If not correctly prepared for traveling, airport changes could be dangerous to oxygen-dependent travelers.

If you or someone you know is planning to fly while on oxygen, here are a few tips courtesy of the Transportation Security Administration’s (TSA) website to keep in mind for a smoother travel experience:

  • Discuss all plans for air travel with your doctor prior to booking your flight.
  • Make arrangements for taking oxygen on board the plane before arriving at the airport. Notify the carrier when you make your reservation that you will need to use supplemental oxygen aboard the aircraft(s).
  • Arrangements must be made for both departure and return flights separately.
  • Note that not every airline offers supplemental oxygen service, or may not offer it aboard all types of aircrafts. Inquire whether: 1) the airline provides oxygen service, 2) it is available on the flights you wish to take, and 3) you must provide a doctor’s letter or permit them to contact your doctor directly to verify your medical need.
  • Your oxygen equipment will need to be cleared by security. Ask your doctor if you can safely disconnect yourself from your oxygen in order to have it inspected. If your doctor says that you cannot disconnect, inform security of this and ask for an alternate inspection process.
  • Check the airline’s website or call the company directly if you have any other questions or concerns. Different airlines can have different procedures or rules for those flying with oxygen.

For more information, visit TSA’s website and you can also download the “Airline Travel With Oxygen” brochure for more answers.

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Senior Citizens and Fire Safety

Posted on October 2nd, 2014

Categories: Aging Advocacy,Caring For Elderly,Helping Seniors,Planning,Prevention,Senior Care Management

House on fireOctober is National Fire Safety Month.  Much of the emphasis is placed on teaching kids about fire danger and fire safety; two incredibly important lessons for young minds!

But did you know that seniors are at most risk of dying in a fire?  In particular, those over age 85 die in fires at the rate of five times higher than the general population?

This is a very scary statistic.  Why is this?

  • Many older folks live alone without the help of others in an emergency
  • Many of our elderly are on medication that affects quick decision making
  • Cognitive as well as physical slowing  (sight, hearing, mobility) in the elderly also inhibits them from taking fast action
  • A higher percentage of seniors live in older housing with faulty wiring
  • The use of alternative heating methods such as space heaters and wood stoves
  • Unsafe smoking
  • Kitchen fires from unattended food on the stove
  • Lack of sprinklers

So what can we as caregivers do to minimize these risks for our elderly loved ones? According to the U.S. Fire Administration  there are several things we can do!

  • Install and maintain smoke alarms on each level and near or in all sleeping areas
  • Test alarms monthly and replace batteries annually (I change them twice a year!) Survival from fire almost doubles with use of smoke alarms!
  • Practice, practice, practice  escape routes with your seniors  (I really believe in doing this!!!!!)
  • Make sure you have made physical accommodations such as ramps and widened doorways if needed
  • Never, ever smoke in bed
  • Let fire department and/or building management know of any special needs (medications that cause drowsiness, poor mobility, oxygen, hospital bed, etc.)
  • Do not overload electrical outlets or extension cords
  • Try to live/sleep near exit to building
  • If possible, have electric stove versus gas. Don’t cook with loose clothing. Unplug stove when safety becomes an issue
  • Check for safety in space heaters, chimneys, etc.
  • Look for housing with sprinkler systems when at all possible

So while we enjoy this beautiful month of October, let’s be mindful of those seniors we care for by minimizing their risk for fire!


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It’s that time of year: Try not to be SAD!

Posted on September 25th, 2014

Categories: Caring For Elderly,Gerontology,Helping Seniors,Senior Care Management

Red Maple TreeHere in Minnesota, we have been enjoying such beautiful September weather!  It is the time of year in which we don’t have to run either the air conditioning or furnace.  Just last week, if I squinted my eyes, I could look at trees and see only green leaves.  I was able to ignore the gold tinge of color at the top of the Ash trees.  I could still pretend that it was August and that winter was months away!

But this week, the gorgeous reds and golds of Autumn are too prevalent to ignore.  And why would you want to?  Fall is the most spectacular time of year in the upper Midwest!

Well-because one of the things that triggers the beauty of Autumn is the waning daylight hours.  The flip side is that the nights are getting longer too!  Bottom line:  less and less daylight as we inevitably march toward Winter.

Some people are uniquely affected by this waning of daylight.  The lack of sunlight can cause a depressed mood: once referred to as seasonal affective disorder or SAD.

If you notice a bit of mood change in the Fall, there are ways to combat it:

  • Move more-even just a little bit
  • Set regular bed times so you are not tempted to oversleep
  • Eat well
  • Socialize
  • Be outdoors in the sunlight as much as you can

If your winter blues are severe enough to interrupt your sleep, leave you with no energy, and you feel extremely depressed:  it is time to contact a mental health professional or your doctor.

Professional help for depression associated with  winter may include:

Remember that as a family caregiver, your resources are already tapped by the emotional and physical demands of providing care. Be sure to take care of your own health and reach out to a professional if you feel overwhelmed.

Hopefully you will enjoy the beauty of Autumn however it unfolds in your part of the country!




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Prostate Cancer Awareness

Posted on September 18th, 2014

Categories: Active Senior Living,Cancer,Medical,Prevention

man clip artGentlemen, listen up!  We want to remind you that September is National Prostate Cancer Awareness Month.

The chance of developing prostate cancer increases as men get older.  According to the National Cancer Institute (NCI), there are 217,730 estimated new cases and 32,050 deaths from prostate cancer in the United States so far in 2014.  The NCI recommends avoiding cancer risk factors such as smoking, being overweight, and lack of exercise.

Not every patient experiences symptoms of prostate cancer.  Many times, signs of prostate cancer are first detected by a doctor during a routine check-up.

Take charge of your health!  Help spread cancer awareness by eating healthy, exercising and seeing your doctor regularly.  Make sure to encourage your friends and loved ones to do the same.  Improve yourself not only  because September is also Self Improvement Month, but every day of every month.  You keeping you healthy and happy makes for a much richer life.

Ask yourself, “Am I doing everything I can to stay healthy?”  Spread what you are doing to keep yourself healthy and help others!

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Honoring Patriot Day – September 11

Posted on September 11th, 2014

Categories: Active Senior Living,Grandparents,Helping Seniors,Terrorism's affect on seniors

Every generation has experienced a memorable event in our nation’s history, such as the bombing of Pearl Harbor, the assassination of President John F. Kennedy, and the end of the Cold War.  Do you remember where you were when you heard the news of the terrorist attacks on the morning of September 11th?  There are still many senior citizens alive today that remember them all.

Tragic events in our lives can make such lasting impacts on us that we know we can never forget.  Today, take the time to talk to your children or grandchildren about the value of freedom and why it is necessary to be thankful for those who have sacrificed their lives for all of us. Make sure you pass down your memories of major events in your own life – because we can all learn from history.

In addition, be sure to share your positive memorable experiences so that you can pass along happy memories and stories to your family as well.

May peace and comfort envelop the loved ones of those hit hardest by the tragic events of September 11, 2001.

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September is National Self Improvement Month

Posted on September 4th, 2014

Categories: Aging Advocacy,Caring For Elderly,Grandparents

MirrorWhen you look in the mirror, what’s the first thought that comes to mind?  Was it a positive or negative thought?

If you find more flaws than strengths, take a step back and ask yourself:   “Are these imperfections (both internal and external) within my control?”  If they are, now’s the time to make a change!

Since September is National Self-Improvement Month, celebrate by taking the time to do something for you.  Go for a walk to enjoy the final days of summer, have lunch with a friend, or do an unexpected favor for a loved one.

Improve your health, stress levels or overall outlook on life by finding time to make yourself a better and happier person.

How do you find ways for self-improvement?  Share your ideas and help someone improve their life!

Doc: Please Treat Me Like I’m Human!

Posted on August 28th, 2014

Categories: Aging Advocacy,Caring For Elderly,Gerontology,Health Insurance,Helping Seniors,Medical,Prevention,Senior Care Management

doctor patient relationshipA colleague of mine (Ross) relayed a recent experience he had while seeing a medical specialist.   Ross had a tiny growth in his mouth that needed to be diagnosed and removed.  So he was referred to an oral surgeon by his dentist.  Ross dutifully made the appointment and arrived on time.  He patiently waited for 30 minutes before being seen.

Finally he was led into the exam room.  The surgeon came into the room shortly thereafter.  The surgeon took a peek at the growth and then stood behind Ross scribbling his notes in a chart and occasionally making a comment to Ross from behind the chair.

Ross valiantly asked questions regarding the growth, its cause, and potential for greater harm. The surgeon, however, was abrupt and dismissive.  The whole appointment lasted less than five minutes.

At the end Ross was led to a counter outside the exam room and sat down with an office staff person.  This person presented him with information about the cost of the procedure he needed as well as various methods of payment they accepted.  She reviewed insurance information and office policy.  She made the appointment for him to have the growth removed.  She was professional and courteous throughout her discourse.  She spent significantly more time explaining payment than the oral surgeon had spent diagnosing and educating Ross on his problem.

Ross began to feel his anger rise.  He related his thoughts to the office staffer.  She listened courteously and he felt she understood what he was trying to say.  She offered to get the surgeon back to better explain his diagnosis and the procedure.  Ross declined her offer but did agree to speak with the office manager.  Unfortunately the manager only defended the surgeon and the policies of the clinic.  For example, the charting table was behind the patient chair.  For this reason, she quipped, the doctors could not look at their patients and write at the same time.  Ross wanted to suggest that doctors use a clipboard so they could sit next to the patient while they charted, but he thought attempting any reason would not be successful so he simply left.

As Ross drove home, his anger abated, and he decided to try another oral surgeon.  He researched other providers and selected one that his dentist assured him was more consumer friendly

At the first clinic, Ross felt like just another wheel rolling off the assembly line.  Even though you typically don’t develop a long term relationship with an oral surgeon, he wanted to be treated as a human being.  He felt he was worthy of being addressed face to face and have his issues explained.  He knew he would feel better with a little reassurance that things were going to be OK!

Finally, because Ross is a gerontologist and works with senior citizens, he knows the importance of taking time to explain the unfamiliar and provide reassurance.  So often the elderly are brushed aside in such a manner and it is just plain wrong.

As a care manager and care giver, I always stress the importance of attending medical appointments with seniors for this very reason.

Have you any similar experiences?  Please share………………….


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Our State Fair

Posted on August 21st, 2014

Categories: Aging Advocacy,Caring For Elderly,Gerontology,Helping Seniors,Senior Care Management

State Fair PosterThe Minnesota State Fair begins today.  Excuse me if I brag, but, it’s the “best state fair in our state”!  OK!  So I stole that line from the Rodgers and Hammerstein musical “State Fair”.

But really it is true!  Minnesota’s state fair is spectacular.  It draws hundreds of thousands of visitors during it’s ten days.  The fair is a microcosm of the state’s demographics.  From youngest to oldest.  From rural to urbane. For this reason it is often referred to as “the great Minnesota get-together”.

It also provides a juxtaposition of old fashioned and cutting edge:  affording attendees comfort of the familiar alongside excitement of what is new.

Not surprisingly, food is a focal point of this cultural event.  Minnesota state fair food (from pickles to pork chops) is commonly served on a stick.  This leads to anticipation each year of what could they possibly put on a stick next?

Unofficially, the state fair also signals the end of summer and back to school.  It foretells of winter and waning daylight hours.  It is part of the rhythm of life here in Minnesota. Comforting somehow.

But this year I feel wisps of melancholy.  Last winter was a doozy!  Extremely cold with deep deep snow.  The challenges of harsh weather added to the challenge of care giving the elders I love.

But although the state fair is a harbinger of things to come, it is also an augury of Autumn, the most breathtaking season of all.

And so it is that I push away any thoughts of sadness and prepare to enjoy the glorious beauty of the Fall and the familiar tempo of my life.

Our state fair……..



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