Tuesday, August 14, 2018

Medical Mistakes and How to Avoid Them

Did you know medical mistakes are the third leading cause of death in the United States, after cancer and heart disease?  According to a report on the WebMD site, Johns Hopkins researchers estimate that medical errors cause over 250,000 deaths each year.  Fortunately, they also learned there are a number of steps which patients can take to reduce their risk of becoming a victim.

While there are no guarantees your physician will never make a life-threatening error while treating you, the more you do to reduce your risk, the safer you will be.  As a result, it is important you learn everything you can about your health conditions and any procedures which could be involved in treating them.

How to Reduce Your Risk of Medical Errors


Ask Questions About the Medications You are Prescribed:  You do not want to be given the wrong medication or the wrong dosage, so double-check your prescription every time you fill it. Ask questions about any change.  Does it look or taste differently?  Has the pill size or color changed?  It is possible you were given the wrong dosage.  In addition, any time you visit a doctor take a list of your current medications with you, so your doctor will know what you are already taking.  Repeat this process every time you go.  You cannot assume your doctor will remember what you are taking, nor can you assume everything written in your record is 100% correct.

Do Not Ask For Unneeded Antibiotics:  Antibiotics are only useful against bacteria, not the viruses which cause colds and the flu.  Do not press your doctor to prescribe an antibiotic if you do not absolutely need it.  You want to make sure antibiotics will work for you when they are really necessary.

Stay in the Hospital a Reasonable Length of Time:  Researchers have discovered that people who stay in the hospital either too long or too short a time are more likely to become ill again.  Do not rush your doctor to send you home and do not beg to stay longer than necessary.  If you are going to be transferred to a rehab facility, such as after hip replacement surgery, you may need to stay in the hospital for at least three nights before Medicare will pay for the rehabilitation.  Discuss this with hospital staff so your stay in the hospital is the optimal length of time, both for your health and your wallet.

Mark the Spot Before a Surgery:  The last thing either you or your doctor wants to happen is for you to have surgery in the wrong place or on the wrong organ.  Before you are given anesthesia, you or your doctor should mark the exact spot where they will be operating.  Try to confirm what is happening with the surgical assistants as often as possible while you are still conscious.  In well-run facilities, the nurses and other staff will often repeat to you several times the location and type of procedure they will be performing.  Do not get impatient with this repetition.  It is for your protection.

Pay Attention to How You Feel After the Surgery:  Of course it is normal to feel weak, tired and have some pain after surgery.  You may also be groggy from the anesthesia.  However, if the pain is severe, there is unusual swelling, you have a high fever, nausea or bowel problems, let your doctor know.  You could have an infection and it is even possible the surgeon left a sponge or instrument in your body.  That might seem impossible, but it does happen more often than you realize!

Be a Responsible Patient:  Follow your doctor's instructions.  Schedule tests, take your medications, get rest, go to physical therapy, get back on your feet and walk when asked, and carefully follow the medical advice your physician recommends.  By doing your part, your outcome is likely to be better.

Be an Educated Patient:  Choose a physician and, when possible, a hospital which has the best possible record for treating your condition.  Learn everything you can about your illness or injury and the different types of treatment. Use reliable sites such as WebMdMayoClinic.org, or the official organization for your disease to learn everything you can.  After learning all you can online, follow-up with any specific questions you have by talking to your doctor.  If your physician contradicts what you have read, do not be afraid to ask why.  Be sure you get your questions answered and, if you still have concerns, get a second opinion.

Ask for Help:  If you are receiving treatment from a specialist, be sure to keep your primary care doctor in the loop.  They will know about your other medical conditions and can help coordinate your care. For example, when my husband had a heart attack, the hospital and surgeon had to take special precautions because of my husband's kidney disease. The heart surgeon discussed my husband's treatment with his nephrologist (kidney doctor) before the surgery.  This was very reassuring to us. The more different health issues you have, the more you will need the help of a primary care doctor to coordinate your care.

In addition, ask a family member or a friend to be nearby when you have surgery and to keep track of what is going on during a hospital stay.  If you are under anesthesia, in a medically induced coma, or sleeping continually, you will be much safer if there is someone else who can speak to the doctors and make sure their instructions are being carried out by the hospital staff.

While it may be impossible for patients to avoid all the possible causes of medical errors, it is their responsibility to make sure they do not contribute to any mistakes.

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

You are reading from the blog:  http://www.baby-boomer-retirement.com

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Wednesday, August 8, 2018

How Medicare-for-All Would Work

One topic which nearly all of us have heard about over the past few years has been Medicare for All.  Opinions about it vary widely, with some people believing it would be the simplest, lowest cost, and most efficient way to provide healthcare to everyone in our country; other people fear that it will cost too much and take away benefits from the senior citizens who have paid into the system during decades of working. 

Both the enthusiasm about potential cost savings and the concern about potential risks are valid.  Because of the confusion around this topic, I asked our Medicare expert, Danielle Roberts, to explain to our readers how Medicare currently works, how a Medicare for All plan might potentially work, and why some people have legitimate concerns about the plan.

It is important to remember that NO final decision has been made about whether our federal government will consider such a program, let alone how the final plan might actually work.  Although the currently proposed plan, as described in the guest post below, calls for zero co-pays, premiums and deductibles, I personally feel this is unlikely to be the final decision, should some version of Medicare-for-All be implemented.  Under our current Medicare program, the government has been trending towards Medicare supplement plans which combine private insurance, co-pays and deductibles with the government backed medical isurance program. They want patients to "have some skin in the game" so they do not run to the doctor for every splinter or sore throat.  As a result, it is likely the final Medicare-for-All plan would require at least some private insurance company involvement, premiums, minimal co-pays, and possible other costs to the consumers.

I also wanted to mention that a recent study, paid for by conservative Republican donors, the Koch brothers, estimated that even without consumers paying deductibles and co-pays, the state, local and federal governments together would save trillions of dollars with Medicare-for-All.  This does not mean that the plan will be cheap for the government to administer; but it does mean it would be much less costly than the current system in which various government agencies reimburse hospitals and other providers for some of the costs they incur when sick people cannot pay.  In addition, other studies have indicated that hospitals are more likely to remain open in poor and rural communities when virtually everyone in those communities has some insurance coverage.

Change is hard and rarely goes smoothly.  Even positive changes, such as a new baby, job or home, can create stress, confusion and fear.  We can expect the same to be true with any major change to our medical care system, whether it is Medicare-for-All or something else.  

Keeping those thoughts in mind, below is the fair and balanced report by Danielle Roberts, explaining both the pros and cons of the Medicare for All plan which is currently proposed ... the one in which patients would have no co-pays or deductibles. She does an excellent job of covering the details and issues more thoroughly than I have, since she is a Medicare expert, licensed to practice in nearly every state in the U.S.

Medicare for All 


The Medicare for All movement may have been on the back burner for a bit, but it is certainly not forgotten. The idea and terminology became popular during presidential candidate Bernie Sanders' campaign and his subsequent legislative bill which was filed in September of 2017. 

You can expect it to be a particularly hot topic in the upcoming November elections. Democrats recently launched a Medicare for All congressional caucus made up of 70 founding members.
But what does it mean really? And is there a chance it is actually going to be in our future?

Universal Health Coverage

Many Americans may not realize it, but we already have a form of national health insurance in place here in America and that’s Medicare. It is a health insurance program financed and overseen by the federal government. So, the term Medicare-for-all began with the idea of expanding our current Medicare system to all Americans.

Medicare-for-All is another term, albeit more positive-sounding, for national health insurance or a single-payer health care system. Proponents of Medicare for All point out that most other free-market countries, like Canada and Britain, all have some sort of universal health care system in place.
In these countries, citizens have access to healthcare regardless of their age. Supporters say that such a system would be more efficient and result in lower costs for health care and prescriptions for all Americans. They believe that better healthcare would be the result and therefore it would improve life-expectancy. In its purest form, it would eliminate the role of private insurance carriers in health coverage, although some versions call for both private and public insurance to be an option.

The Medicare for All movement calls for coverage of all medically necessary services as a basic right, instead of as a privilege. Medically necessary services would include preventive care, physician’s services, inpatient care, outpatient care, emergency care, prescription drugs, durable medical equipment, palliative care, mental health services, substance abuse services and approved dietary and nutritional therapies.

It would also extend beyond our current healthcare system to cover long-term care, dental, vision, hearing, and chiropractic care. The government would also be able to negotiate with drug manufacturers to lower prices on the nation’s behalf, and this is certainly important to many people as costs of prescriptions in the United States are some of the highest in the world.

All U.S. residents would be able to access at least all of these services with no cost-sharing. This means that at the time of service there would be no deductibles, co-pays or coinsurance of any kind due by the patient.

Supporters envision a world where there would be no major medical bills, no medical bankruptcies and a simpler healthcare system with less bureaucracy. People could get their healthcare without fear of creditors or bills which later show up in their mailbox.

Medicare as it is Now

It is important to note that our current form of Medicare does NOT offer this feature. Medicare beneficiaries pay monthly premiums for their Part B and D coverage, and they also are responsible for paying considerable cost-sharing in the form of deductibles and coinsurance. 

Even in this format, with Medicare collecting premiums and cost-sharing, trustees this year warned in their annual report that the current Medicare fund will begin to fall short in 2026. This outlook is even worse than it was last year when the fund was projected to fall short in 2029. If Medicare is already unsustainable, how could it bear the burden of all Americans joining Medicare and paying no premiums, deductibles, co-pays, or coinsurance?

There are Different Potential Versions of Medicare-for-All

While the idea of Medicare-for-All is noble, Congressional members may have a long way to go in structuring the type of program that would be sustainable and affordable for our nation. The National Review reported recently a study which projected that Sanders’ version of Medicare-for-All would cost the nation $32.6 trillion over the next 10 years. Medicare-for-All caucus members must look at how other countries finance their single-payer systems and how the United States might do the same.
In Bernie Sanders’ version of Medicare-for-All, health insurance would be permanently separated from employment. Americans’ eligibility for Medicare would initially drop from age 65 down to age 55 and also cover children up to age 18. Over the following four years, the age of Medicare eligibility would continue to drop until all Americans became eligible for Medicare. Out-of-pocket costs would be eliminated, and benefits would be expanded. 

The plan would be financed by employers, an income-based premium paid by households, and progressive income tax rates. Under Sanders' plan, capital gains and dividends would be taxed as ordinary income, there would be limited tax deductions for wealthy people, as well as an increase in estate taxes for the wealthiest Americans.

Opponents of the program, however, say that Medicare for All would be so expensive that it would quickly become Medicare for None. They claim it would also divert the focus of Medicare from seniors, ultimately hurting them and moving them to the back of the line for care behind younger persons. Cuts to pay for doctors and hospitals might, they say, make it harder for seniors to find doctors who accept their coverage. They have also argued that if millions of new beneficiaries are brought into the program, there would be fewer doctor appointments to go around because Medicare already faces shortages of primary care physicians.

Supporters have responded that while the program would surely be costly, Medicare-for-All would make that up by streamlining operations to reduce high administrative costs and to lower prescription drug costs. Would the savings from new efficiencies in care be enough to take on the extra expense? This remains to be seen, but it’s a step in the right direction that Congress is still talking about health care solutions and recognizes that what we have done thus far is not enough.

The key may lie in finding the happy medium between private and public-sector insurance. There are varying iterations of how a Medicare for All program might ultimately look. Some versions of Medicare for All call for a mixture of private and public insurance rather than a single-payer plan, and this might be very important if they hope to eventually gain the support of insurers and insurance industry lobbyists.

We can only hope that both parties will come together to find one solution that works for the good of all Americans.

About this Guest Post Author:  This guest post was written by our Medicare expert, Danielle Roberts, one of the co-founders of Boomer Benefits and a frequent contributor to this blog.  As always, we greatly appreciate her willingness to share her expertise and her ability to calmly explain difficult to understand issues in plain English.

You are reading from this blog:  http://www.baby-boomer-retirement.com

Photo credit:  Google images - healthmarkets.com

Wednesday, August 1, 2018

What Medicare Does Not Cover

Most adults in the United States over the age of 65 are covered by Medicare.  American workers paid premiums in advance into the program during our working years.  We did this so our premiums for basic Medicare insurance coverage after retirement would be affordable.

Once we sign up for our basic Medicare insurance, we can also add a supplement, sometimes called a Medigap policy, through a private insurance carrier; or, we can choose a private Medicare Advantage plan, like Kaiser Permanente or SCAN, to handle our Medicare insurance for us.  Adding a private insurance supplement or using a Medicare Advantage plan will assure us that our out-of-pocket costs will be reduced.  However, many people assume all their future medical expenses will be completely covered after they reach the age of 65.  Unfortunately, they are often shocked to discover they will still have to pay out-of-pocket for some important expenses, including premiums, co-pays, deductibles and a number of health needs which are NOT covered by Medicare.

You Should be Prepared for Uncovered Medical Bills

It is important for everyone to realize that basic Medicare does not cover a number of important conditions which could affect almost everyone during the last few decades of life.  By knowing what is not usually covered, you can search for policies which will help fill in some of the gaps or you may want to put aside extra money for your future medical costs.

Hearing Aids Are Usually Not Covered

Basic Medicare and most Medigap plans do not cover normal hearing tests or hearing aids.

Solutions:  Look for a Medicare Advantage plan which includes hearing care, sometimes for an additional premium.  You might be able to sign up for a discount plan for hearing aids.  There are also some special discounts for low income people.  Within a few years, it may be possible to buy certain types of hearing aids without a prescription, due to new legislation recently passed by Congress.  This could bring down their cost.  However, be prepared for the fact that hearing aids can cost thousands of dollars.

You May Want a Dental Care Supplement

Basic Medicare and most Medigap plans do not cover either routine check-ups or major dental work such as root canals or dentures.  If you lose teeth as you age and need dentures or dental implants, these items are not covered, either, and they can be quite expensive.

Solutions:  You may find a Medicare Advantage plan which offers reduced cost dental care, either as part of their basic plan or for an extra premium.  It is also possible to purchase an individual dental insurance plan or private dental discount plan.  You may also be able to get low-cost dental care from a local dental school.  It is important that you NOT wait until you actually have an abscessed tooth or other serious dental problem before you look for dental insurance.  Find a policy as soon as you start Medicare and expect to have out-of-pocket expenses, even with the dental insurance.

You Will Need a Vision Care Supplement

Medicare, combined with most Medigap plans, will cover certain types of eye diseases or damage such as cataracts.  However, those plans do not cover the cost of routine eye exams or corrective lenses such as glasses and contact lenses.  In addition, they often only cover the least expensive type of replacement lens after cataract surgery.  If you want the more advanced lenses, you could be expected to pay thousands of dollars out-of-pocket.

Solutions:  Some Medicare Advantage plans do cover a portion of your vision care costs, usually for an extra premium.  If you need your vision corrected or anticipate vision problems, it may be worth it to purchase a vision insurance policy to help control your out-of-pocket costs.  However, no matter what plan you have, you should still expect to pay out-of-pocket for certain expenses, such as contact lenses, eyeglasses, co-pays and deductibles.

Ask About Podiatry Coverage under Your Supplement or Advantage Plan

Medicare does not cover routine medical care for feet, such as having a callus removed. However, it will cover more serious foot problems.

Solutions:  If you have foot problems and need the care of a podiatrist, try to find a Medigap or Medicare Advantage policy which will cover your costs.  Otherwise, put aside extra money to cover your care.

Plastic Surgery for Cosmetic Reasons is Not Covered

Are you hoping to get a tummy tuck or facelift as you age?  Medicare will not generally cover those expenses.  However, if your eyelids sag so much that it affects your vision, Medicare may cover an eyelid lift.

Solutions:  If you believe you are going to want cosmetic surgery as you age, you will need to put aside the money to cover the cost.  You may also want to consider getting the treatments you want at a local medical school.  They will still charge you, but less than an established board certified plastic surgeon in private practice.

Emergency Medical Care Outside the U.S. is Generally Not Covered by Medicare

Basic Medicare and most Medicare Advantage plans do not offer coverage for beneficiaries when they are outside the U.S.

Solutions:  If you plan to retire outside the United States, as hundreds of thousands of other Americans have done, your best bet is to buy a health insurance plan in the country where you will be living.  If you travel back and forth between the U.S. and other countries, you may consider one of two options.  First, you could look for a Medigap policy which will cover you whether you are in the U.S. or outside the country.  The other option is to have a Medicare plan which will cover you while you are in the U.S. and a health insurance plan in the country where you spend the most time.  If you can afford it, this would give you the widest range of choices for care.

If you live in the United States and only need coverage when you travel on vacation, some Medigap plans cover overseas medical costs.  However, many frequent travelers purchase travel insurance policies which cover basic healthcare expenses while you are traveling.  You may also want to consider "medevac" insurance which will cover either the cost of transportation to a medical facility overseas or a return trip home in the event of a medical emergency.

Long-term Assisted Living and Nursing Home Care is Not Covered

Neither Medicare, Medicare Advantage plans, nor Medigap plans will cover the cost of permanently living in an assisted living facility or nursing home.  However, Medicare will cover the cost of a temporary stay in a rehab facility while you recover from surgery or a serious illness.

Solutions:  Everyone needs to have a plan for how they will be cared for, should they become seriously ill, too frail to live on their own, or develop dementia.  You may have an adult child who is willing and able to care for you during the final years of your life.  You may also want to purchase long-term care insurance to cover the cost of assisted living or the expense of having a home healthcare aide take care of you in your home.  If you have a large retirement income, you may be able to cover these expenses without insurance.  On the other hand, if you have a low income and few assets, Medicaid (a separate program from Medicare) often pays the cost of long-term care.  For veterans and their spouses, there are also benefits available to pay a portion of their long-term care.  However you decide to handle this issue, it is important you have a plan in place long before you need it.  The younger you are when you purchase long-term care insurance, the less expensive it will be.  In addition, once you have a serious health problem, you may not be qualified to purchase long-term care insurance at any price.

The bottom line is that everyone needs to know what will be covered by Medicare and they should either have a Medigap or Medicare Advantage plan to maximize their insurance coverage.  Once you know which uncovered needs you have, you should decide how those expenses will be handled as you age.  Your medical expenses could become quite high, even if you have Medicare and a supplement.  The more money you can save to cover these expenses, the better prepared you will be when you have large medical bills.

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

You are reading from the blog:  http://www.baby-boomer-retirement.com

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Wednesday, July 25, 2018

Medicare Expert Will Answer Your Questions

As a new service to my readers, we now have an official Medicare expert who will answer your questions.  The expert is Danielle Kunkle Roberts, a recognized Medicare insurance expert and Forbes Finance Council member.  Some of you may have already read the helpful guest posts which she has written for this blog over the past few months.  Expect to see more of her posts in the coming years. Medicare is an important consideration as Baby Boomers plan their retirement. You will find  Danielle's contact information listed permanently in the sidebar of this blog, so you can reach out to her with your questions whenever you wish.

Recent Blog Posts by our Medicare Expert

Below is a list of recent posts which have been written by Danielle Kunkle Roberts.  You will find helpful information in each of them:

Medicare, Substance Abuse, Addiction and Alcoholism - This article explains what your Medicare treatment benefits would be for substance abuse problems.  Whether you or someone you love needs help getting off opioids or has a problem with other addictions, this article will give you the information you need.

Medicare Coverage of Heart Disease - Another concern for retirees is how Medicare covers heart attacks and other heart disease issues.  Find out what coverage you will get through Medicare and how to supplement Medicare to optimize your benefits.

Medicare and Cancer Benefits - Prevention, Diagnosis and Treatment - A cancer diagnosis is terrifying and the last thing you want to worry about is your health insurance coverage.  This article explains what is covered by basic Medicare and how to supplement those benefits.

More Information About Danielle Kunkle Roberts

Although I have been approached by other people who have been interested in covering Medicare on this blog, I have found Danielle to be especially helpful and highly qualified to help my readers.  She is one of the founders of Boomer Benefits.

Her company is uniquely prepared to assist my readers with the many questions they have about Medicare.  Here is more information about the company from their website:

"Founded in 2005 in Fort Worth, TX, Boomer Benefits is an award-winning insurance agency for national insurance carriers such as Blue Cross Blue Shield, Aetna, Cigna, Mutual of Omaha and many other A-rated carriers. We are licensed in 47 states. Over the years, we’ve learned just about everything there is to know about Medicare, and we’ve become known as the baby boomers insurance agency. We pass that knowledge on to you – absolutely free. There is never a charge for our services. Boomer Benefits Consulting is free."

It is my sincere hope that my readers will take advantage of the services of Danielle Kunkle Roberts and the other agents at Boomer Benefits.  I will be interested in getting your feedback about this service.  You can use the contact section on the sidebar, under my picture, to leave your comments.

If you are interested in learning more about other retirement topics, including Social Security, financial planning, where to retire in the US and abroad, 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 articles on a wide variety of topics.

You are reading from the blog:  http://www.baby-boomer-retirement.com

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