Cutting Through the Puzzling Maze of Medicare

With the recent health reform and talks about more restructuring, health insurance is a cloud of confusion for everyone. It is especially important for seniors to understand the benefits and limitations of Medicare. Many retirees find Medicare’s plans puzzling, and choose to wait until their first hospital visit to address it. However, learning about your insurance when the time comes to pay for it could add additional stress to already existing stressful time.

Here are some pointers for understanding Medicare. Remember this is a general guideline. For detailed information on your plan you should contact your provider and speak with a representative.

Medicare Basics
If you are 65 years or older you are entitled to Medicare benefits. There are generally two parts to the average Medicare Plan: Part A and Part B.
Medicare Part A – pays for inpatient care in a hospital or skilled nursing facility, some home care, and some hospice care.
Medicare Part B – helps to pay for doctor’s services and other medical needs that are not covered by Part A. Part B can be deferred if the beneficiary or his/her spouse is working. There is a lifetime penalty (10% per year) imposed for not enrolling in Part B unless actively working

Be Aware of Medicare Advantage Plans
Some individuals may opt for Medicare Advantage Plans which is Medicare coverage that works in conjunction with private insurance (ie. Secure Horizons). Many people in these programs forget Medicare Advantage Plans have a group of in-network providers that they must use. Any doctor not in-network with the given plan is considered out-of-network and the patient must pay an out-of-network cost to see the doctor. If it is an out-of-network private practice, patients may even be turned away and referred to another doctor.

So, be sure if you are seeing a specialist and you would like to continue your relationship with them, it is best to inquire which Medicare Advantage Plans they are in before signing up for an Advantage Plan.

What is Supplemental Insurance?
While Medicare is very comprehensive, not everything is covered. For example, if Medicare covers 80% of a procedure, the supplemental insurance will step in and cover the other 20%. This may vary according to each supplemental insurance plan as well as the premiums paid. It is important to research the possibility of adding supplemental insurance well before it is needed, as many seniors are surprised when they are reimbursed for only a portion of their hospital bill.

Work with Your Doctor’s Administrator
A majority of health facilities have an administrator and insurance specialist. If you are retired and live near a hospital you would like to frequent in the future, you can call an insurance specialist at the facility to find out which providers they are in-network with. These specialists are also acquainted with procedural billing and may be able to help you calculate how much of a procedure is covered and how much you will have to pay out-of-pocket.

Do Your Research
Keep up to date on health care reform and changes in Medicare policies. A great way to do this is by researching online websites which are updated frequently.

AARP’s Medicare section is straight-forward and updated frequently:
http://www.aarp.org/health/medicare-insurance/

To refresh your mind on Medicare basics, take a look at their Wikipedia pages:
http://en.wikipedia.org/wiki/Medicare_(United_States)

Medicare’s General Website should be your go-to:
http://www.medicare.gov/

Trouble understanding bills and reimbursements? Free Medicare counseling can help:
http://www.cahealthadvocates.org/HICAP/

Join Valencia Terrace for the "Medicare Made Clear" seminar on Wednesday, October 20th. We will be discussing the changes in our healthcare system and will be available to answer any of your questions!

Video Chatting is More Than Just Talk

From staying in touch with family to communicating with friends, video chatting online is a great way for seniors to interact from the convenience of their home. The tools are minimal – an Internet connection, webcam (comes standard with most new laptop computers), and video chat software.

Video conferencing allows face-to-face interaction not available through typical phone conversations as well as fun, creative ways to connect with family and friends online.
In addition, chatting gives grandparents the ability to see their grandchildren grow and develop. Conferencing frequently also gets a family involved in each other’s daily lives.

Video chatting does not have to be limited to holding conversations online. There are tons of interactive activities you can do make it fun:

When talking to your grandchildren:
- Play an online game like checkers or cards while video chatting
- Tell a bedtime story with books or puppets
- Ask them to recap their day with you and show you the projects they did at school

When talking to your children:
- Set up a time to three- or four-way video conference so the whole family can have a conversation. The key to these chats is choosing a time everyone can agree on, even if it is just once a month. You can set up an event on Facebook and ensure everyone RSVPs.

When talking to friends:
- You can follow a simple fitness plan by doing stretches or stationary exercises together via webcam.
- You can “share dinner” by scheduling a chat time during dinner time and eating together while catching up on webcam

Want to get started? Here are some of the best video chat programs to download:

www.skype.com
www.windowslivemessenger.com
http://mail.google.com/videochat
http://www.oovoo.com/

Lifelong Learning: Volunteering for your Community

Lifelong learning can encompass many activities – ranging from taking community college classes to trying out new activities and taking on a new hobby. The whole point of lifelong learning is to expose yourself to experiences that will expand your horizons and subsequently stimulate the brain. A perfect opportunity for lifelong learning is volunteering in your community.

Volunteering is a great activity for seniors because it gets them involved in their local community and exposes them to new activities and skills. Community service breaks the monotony of everyday activity and as a result stimulates the brain’s cognition. Its social aspect allows seniors to make friends with different age levels and exposes them to activities that they may not normally participate in. Studies have shown that volunteering can lower mortality and depression rates as well as increase overall well-being. So the earlier you start serving your community the better!

There are plenty of different opportunities seniors can take. From volunteering at state parks to helping at a local library – there are many activities to suit individual’s taste and goals. Distributing goods at food drives and helping to counsel low-income seniors are beneficial activities as well. As they say, philanthropy is great medicine for your health - so get involved today!

Some resources to get started:

Help our national parks:
http://www.nps.gov/getinvolved/volunteer.htm
A resource guide for various different volunteer opportunities:
http://www.seniorcorps.gov/
http://seniorjournal.com/Volunteers.htm
Become a health advocate to help others understand Medicare:
http://www.cahealthadvocates.org/HICAP/