Wednesday, March 21, 2018

Medicare Coverage of Heart Disease

We are fortunate to have another guest post from Medicare expert, Danielle Kunkle, who has provided us with a helpful explanation of how your Medicare benefits cover your medical expenses if you develop heart disease.  This is important information, because heart disease is one of the top causes of death for senior citizens.  It is also important for retirees on Medicare to understand that your coverage will vary depending on whether you have Original Medicare only, a Medicare Advantage plan, or Original Medicare plus a Medicare supplement (Medigap) plan.  Danielle Kunkle's post provides information which is likely to affect nearly everyone during their retirement years. 

How Does Medicare Cover Heart Disease?

Heart disease is a broad term which covers a lot of different conditions which affect the heart and blood vessels. It’s the number-one killer of both men and women in the United States, according to The Heart Foundation. More people die of heart disease, also called cardiovascular disease, than from all types of cancer combined.

Although a heart disease diagnosis is serious, there are things you can do to treat it and lower your risk of serious complications. The good news is that there are Medicare benefits for people with heart disease or who are at risk of developing it.

What is Heart Disease?

Heart disease shows up in different ways in the body. It may cause a heart attack, stroke, or heart rhythm problems, for example. According to the American Heart Association, most of these heart conditions are caused by atherosclerosis.

Atherosclerosis develops when fatty substances, called plaque, build up on the walls of the blood vessels. The plaque narrow the vessels, making it difficult for blood to flow freely. Often, the plaque ruptures and causes blood clots to form.

When a blood clot blocks the flow of blood to a part of the heart, a heart attack occurs. If the clot interrupts blood flow to parts of the brain, it causes an ischemic stroke.

How is Heart Disease Diagnosed?


Some of the most common risk factors for heart disease include:

       High blood pressure
       High cholesterol
       Being overweight

If you are at high risk for developing heart disease, your doctor may order screening and diagnostic tests. These might include blood tests for cholesterol and triglycerides, blood pressure checks, and lab work to rule out diabetes.

If you have symptoms of heart disease, your doctor may order other tests to confirm the diagnosis. You may have an electrocardiogram (ECG), an ultrasound of the heart, a stress test, or even an MRI or CT scan. In some cases, you may have cardiac catheterization, an outpatient procedure which lets the doctor see your heart and blood vessels to check for abnormalities.

What Does Medicare Cover? 

PartB covers cholesterol screening blood tests once every five years at no cost to you if your doctor accepts Medicare assignment. If you have symptoms of heart disease, Medicare may pay for a diagnostic cholesterol test, if your doctor thinks it is medically necessary. You pay 20% of allowable charges once you meet your deductible. You may also qualify for heart disease counseling with your doctor once each year at no cost to you.

If you have risk factors for diabetes, Medicare may pay for two screening exams a year at no cost to you if your doctor accepts assignment.

Part B generally pays for any diagnostic tests and exams your doctor thinks are medically necessary based on your symptoms and risks for heart disease. You pay your 20% coinsurance after you’ve met your deductible. 

How is Heart Disease Treated?


There’s no one-size-fits-all treatment for heart disease. Your doctor may recommend any combination of the following types of treatment, depending on your exact condition and how severe it is:

       Changes in lifestyle to lower your risk of life-threatening complications. This may include losing weight, reducing the fat and cholesterol in your diet, and exercising more. If you smoke, your doctor will help you try to quit.
       Prescription medications to control your disease and risk factors. Your doctor may recommend medications to treat high blood pressure, lower the cholesterol in your blood, or better manage your blood sugar.
       Surgical procedures to repair damage. If the heart disease is severe, you may need angioplasty, stent placement, or even cardiac bypass surgery.

What Different Medicare Plans Will Cover

Depending on where you get treatment, Part A or Part B covers medically necessary heart disease treatment. For example, if you are hospitalized for heart surgery, Part A pays after you meet your deductible. You may also have coinsurance if your stay goes beyond 60 days. If you get outpatient treatment, Part B pays for your care.

If you smoke, Part B covers 8 face-to-face smoking cessation sessions each year with a qualified provider. If your provider accepts assignment, you pay nothing for these sessions.

You may also qualify for weight loss counseling if you are very overweight. Again, these are covered 100% under Part B if your provider accepts Medicare assignment.

Depending on the type of heart disease you have, your doctor may recommend a cardiac rehab program. If you qualify, Part B will pay 80% of the allowable charges after your deductible is met.

Unfortunately, most prescription medications to treat heart disease aren’t covered under Original Medicare. If you have Medicare Part D coverage for prescription drugs, your heart disease medications are likely covered.

If you have a Medicare Advantage plan, you may have extra benefits beyond Part A and Part B. Medicare Advantage plans are offered by private insurance companies approved by Medicare. They must cover everything that Original Medicare covers at a minimum, but they often have other benefits helpful to people with heart disease. For example, your plan may cover Silver Sneakers, which gives you free access to participating gyms. Most Medicare Advantage plans also include Part D prescription drug coverage. Some may even help with over-the-counter medications such as aspirin your doctor recommends for heart disease.

If you have Original Medicare and worry about your out-of-pocket costs for heart disease treatment, you may want to consider a Medicare Supplement Plan. These plans pay some or all of your Part A and Part B costs after Medicare pays. They don’t, however, pay your Part D prescription drug costs.  You can purchase a separate plan to help with drug expenses.

About the author:

Danielle Kunkle is the co-founder of Boomer Benefits, an insurance agency specializing in Medicare-related insurance products.  They help baby boomers new to Medicare learn about their benefits and coverage options across 47 states.

If you have not prepared your tax returns yet, you have until June 17 in 2018.  You may be able to do it yourself with H&R Block software.

If you are interested in learning more about Medicare, Social Security, financial planning, where to retire, common medical problems and more, use the tabs or pull-down menu at the top of the page to find links to hundreds of additional helpful articles.

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Tuesday, March 13, 2018

Socializing Reduces Dementia Risk

Did you know that many of the causes of dementia are within our control?  For example, following the MIND diet, getting adequate sleep, and engaging in a variety of types of exercise have all been shown to dramatically reduce your risk of dementia, including Alzheimer's Disease.  Socializing is another important way to improve your brain health and lower your dementia risk.

Social Isolation Causes Many Health Problems

Some people become socially isolated as they get older.  They may have trouble walking or driving, making it more difficult to go out.  They may not see friends or family members as often.  Their former friends, spouse and other family members may have died.  Approximately one-third of older Americans report being lonely.  While this is about the same percentage as the loneliness reported by younger adults, the loneliness in older adults can have more serious consequences if they start to believe they no longer have a reason to leave their home.

Surprisingly, people in large urban areas are more likely to report loneliness than people who live in small towns.  This may be a good reason to either retire to a small town or become more active and involved in your neighborhood within your current city.

Not only does isolation lead to a poor quality of life, it has also been connected to depression, anxiety, high blood pressure, decreased physical health and an increased risk of death.  It is also linked to the development of dementia.

How to Become More Socially Active

If you have lost loved ones, you may begin to give up your attempts to socialize.  However, it is important to be proactive and seek out new friends throughout your life, not just when you are young.  Below is a list of a few ways to do this:

*  Visit your friends and family as often as possible.
*  Call your loved ones when you cannot visit them.
*  Volunteer in your neighborhood.  There are many organizations which would love the help!
*  Get involved in a church, synagogue, mosque or temple.  Many of them offer a wide variety of social activities.
*  Join a gym or club.  Take group classes in yoga, dancing or other fun activities.
*  Start a book club, dinner club, movie club, quilting club or other social club.
*  Start a walking group.
*  Seek out a Senior Center in your community.  They have regular activities all day long.  Be sure to participate often.
*  Take classes and learn a new skill with other people.  
*  Immerse yourself in hobbies which you love.  One study indicated that people in their 60s are in the most productive decade of their lives, especially if they are historians, inventors and writers.  Make an effort to get to know other people with similar interests.  Give them encouragement and they are likely to do the same for you.

The Benefits of Being Socially Active

*  Your mental health will be enhanced, with less depression and a lower risk of dementia. You'll have a more positive outlook on life.
*  New friends will give you a sense of belonging and create lasting bonds.
*  Your self-esteem will improve and you will feel more confident.
*  Your physical health will improve and your immune system may be stronger.  If you share meals with other people, your nutritional intake will be better.  You are also more likely to have an active lifestyle.  All these things can improve your health.
*   According to research at the University of Rochester Medical Center, socializing keeps your brain sharp.  It encourages us to continue to learn new things and respond to the world around us.
*  Being social and engaging with other people encourages us to get dressed, stay clean, be well-groomed and go out.  In turn, this improves our state-of-mind.
*  Being social gives our lives meaning and helps us remember why life is worth living.  That, alone, is a good reason to be more socially active.

No matter how much or how little you are able to do, you will be healthier, happier and mentally sharper if you reach out to other people and stay in touch frequently!  Get out there and have some fun!

If you are interested in learning more about medical concerns such as dementia, Alzheimers or other problems as you age, where to retire, financial planning, Social Security, Medicare or more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional articles.

Watch for my book, Retirement Awareness: 10 Steps to a Comfortable Retirement, which is scheduled to be published by Griffin Publishing in 2018.

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Wednesday, March 7, 2018

Find Your Purpose in Retirement

You are never too old to find your purpose in life, although some people give up long before they should.  Two of my friends were talking recently about how they spend their days now that they are retired.  One said she does a lot of reading and goes to a water aerobics class a couple of times a week.  The other one said she was still trying to "find herself."  She was not sure, yet, what she wants to do with the rest of her life, despite the fact that she is in her mid-60s and recently retired from a long career.

This conversation made me sad.  Both of these women could afford to explore a wide variety of activities, yet something is holding them back.  Upon reflection, it seems that neither of them have found their purpose in life. They are still looking for something meaningful to do in retirement.  Unfortunately, they do not realize that this is the very time in their lives when they have the time to really immerse themselves in something meaningful!

Even if you have spent your entire adult life simply taking care of your responsibilities, working at a job, raising children, and caring for other family members, it is never too late to find a purpose in life.

Meaningful Opportunities are All Around You

Unlike the women above, another friend of mine began her retirement by signing up to spend three years in the Peace Corp, beginning at age 62.  She spent most of that time in Ukraine, where she made lifelong friends.  More than a decade after completing her Peace Corp tour, she still meets with former Peace Corps members once a month and occasionally makes speeches to other organizations about her experiences and what she learned during her years abroad.  While this was a life changing experience for her, I have discovered that many other people are not aware they can still join the Peace Corp in their 60s and 70s.  What a wonderful way to find a purpose in life and explore the world!

My husband and I have found meaning by volunteering at our local homeless shelter, pictured above.  Preparing food and feeding the homeless helps us appreciate our own lives.  We have also become involved in the political campaign of someone we know who is running for Congress.  In addition, we regularly spend time with our grandchildren and help out one of our daughters who is raising two teenage children on her own.  For me, even writing this blog and providing people with a wide variety of useful information about retirement has given my life meaning.  All these activities give my husband and me a purpose in life.  

Other retirees I know have found meaning in second careers or volunteer opportunities.  Below are just a few of the choices our friends have made to bring joy and meaning to their retirement years:

A retired school principal opened her own delicatessen
A retired semi-conductor salesman became an actor
A former WW II veteran reads to school children once a week
Several women have built new careers involving art or crafts
A number of retirees I know have written and self-published books
Countless other retirees volunteer in churches, hospitals, food banks, schools and for non-profits.  All these organizations need volunteers and the people who offer to help are greatly appreciated.

A Thought-Provoking Movie

While you are thinking about how to live a meaningful life, you may want to watch the Shirley MacLaine movie "The Last Word."  It tells the story of a wealthy, but very lonely, elderly woman who asks the obituary writer for the local newspaper to write her obituary while she is still alive. When she reads the first draft, she decides to make changes in her life.  This decision takes both women on a journey of self-discovery.

This movie will make you laugh, but it will also make you think.  It could also help you change your life!

How to Have a Meaningful Retirement

The time to start planning what you want to do in retirement is before you retire, if possible, although it is never too late to try something new.  Do you have an unfulfilled dream?  Is there a different job you have always wanted to try, but didn't think it would pay you enough while you were raising a family?  Is there a place you would like to visit?  Are there people you would like to help?  Is there an organization which is meaningful to you, where you could volunteer?  The ways you can find meaning are endless.

Below are a few places you can contact to get ideas:

Your place of worship
Your local school district
Your local hospital or animal shelter
Your local homeless shelter - A site which helps match people to potential second careers or volunteer opportunities with non-profits in their community.

Don't Settle for a Boring Retirement

After living in a retirement community for nearly 14 years, I have learned that retirees can either choose to be bored and lonely, or they can choose to live their dream life.  This is your opportunity to write a book, start a business, help people in need, travel, volunteer or try a new career.  You can use this second chance at life to improve your own financial situation or the lives of other people.   Don't settle for a boring retirement.

It is never to late to find meaning in your life!

If you are interested in more information about retirement planning, where to retire, Social Security, Medicare, common medical problems and more, use the tabs or pull-down menu at the top of the page to find links to hundreds of additional helpful articles.

Watch for my book "Retirement Awareness: 10 Steps to a Comfortable Retirement," which will be published by Griffin Publishing in 2018.

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Photo credit: Photo of homeless shelter taken by author

Tuesday, February 27, 2018

Sleep and the Dementia Connection

If you are concerned about reducing your risk of getting dementia, one step you may wish to take is to get enough sleep.   According to Dr. Bryce Mander, PhD of the Department of Psychiatry and Human Behavior at the University of California in Irvine, sleep is essential to the formation (encoding), consolidation and recall of memories.  In fact, more than two-thirds of people with Alzheimer's Disease have a history of at least one type of sleep disorder, usually sleep apnea or insomnia.

Sleep Apnea and Alzheimer's Disease

Lack of adequate sleep is a serious issue in people with the type of of dementia known as Alzheimer's Disease.  Researchers have discovered that having either sleep apnea or insomnia may not only increase your Alzheimer's Disease risk, but it may lower the age of onset of Alzheimer's Disease.  They have also discovered that treating sleep disorders can actually delay the age of onset for Alzheimer's Disease.

In addition, sleep apnea can increase your diabetes risk; insomnia may increase your risk of depression.  Both of these conditions are linked to a higher rate of dementia.

If simply getting more restful sleep at night is able to postpone the development of Alzheimer's Disease and other types of dementia, it can be life changing to see your doctor if you are having trouble sleeping.

Medical Intervention Can Improve Sleep Quality

What can you do if you do not believe you are getting enough sleep?  Your first step should be to consult your personal physician.  You may even want to have a sleep study done to help determine the specific reason behind your sleep problems.  There are medical interventions, such as a CPAP machine, which could significantly improve your quality of sleep.

You may also wish to talk to your doctor about other health issues which could be interrupting your sleep, such as loud snoring or the need to wake up frequently to go to the bathroom.  Anything we can do to improve our quality and quantity of sleep can help us age better. 

Lifestyle Changes May Improve Sleep Quality

In addition to seeing your doctor, there may be changes you can make in your lifestyle which will improve your sleep quality.  Many people sabotage their sleep without realizing their lack of adequate rest could be causing other health problems, not only dementia and Alzheimer's Disease.

Below is a list of activities you can try in order to improve your sleep quality:

*  Maintain a fairly consistent time to go to bed and wake up.
*  Have a goal of sleeping 7 to 9 hours a night; it should take you 20 minutes or less to fall asleep once you are in bed.
*  Set a relaxing routine in the evening, including reading, meditation or taking a warm bath.
*  Avoid using your bedroom as a place to watch television, play on your computer or engage in similar activities.
*  Keep your bedroom cool, but not freezing.  Cool temperatures promote better sleep quality than a warm or hot room.
*  Bright light suppresses your natural melatonin. Have muted lights at night, preferably in red or orange tones.  Avoid the blue and green light which you get from phones and televisions.
*  Turn off electronic devices within 30 minutes of bedtime.
*  Do not eat a large meal too close to bedtime. Eat as early in the evening as you comfortably can.
*  Live a generally good lifestyle, including exercise and a healthy diet.  This will improve your sleep quality.
*  Avoid caffeine after 3:00 p.m.
*  Avoid alcoholic beverages in the evening.  They contribute to poor sleep quality.  You may fall asleep quickly, but will wake up in the middle of the night when the alcohol wears off.

The bottom line is that everyone should make it a priority to get at least seven hours of high quality sleep a night if they wish to lower their risk of dementia, particularly Alzheimer's Disease.

Readers may also want to use the tabs or pull down menu at the top of the page to check out other articles in the Medical Concerns category of this blog to learn more about techniques for reducing your risk of Alzheimer's Disease and dementia, including following the MIND diet or the relationship between exercise and dementia.

Want to know more about financial planning, Social Security, Medicare, where to retire and more?  This blog contains hundreds of articles on those topics, as well.

Watch for my book, Retirement Awareness: 10 Steps to a Comfortable Retirement, which is scheduled to be released by Griffin Publishing in 2018.

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