Podcasts about medicare nation

Tonight our guest is Ms. Diane Daniels Host and Founder of the most successful podcast in the nation on the topic of Medicare.This is Diane's fifth appearance on the show and tonight we discuss the very timely subject of “Medicare for All” a proposal presented by Senator Bernie Sanders to cover all Americans!Does this plan have merit, strengths, or weaknesses?Tune in tonight and find out as our National Medicare expert gives her views on this relevant topic for all! Diane Daniels is a Medicare Advisor, who brings ten years of health care experience to her community. Ms. Daniels is the owner of Medicare Nation, which provides superior Medicare education to groups and individuals. Ms. Daniel's belief in educating overselling has provided Medicare Nation the ability to offer a large portfolio of Medicare products, which allows the individual to choose a Medicare plan that “fits” their lifestyle.Michael L. BannerPresident & CEOProfessional Mortgage Alliance, LLC.E-Mail – mbanner@pmanow.comCell – 727-224-3859NMLS# - 386692Ms. Diane Daniels MEDICARE NATION, LLC.1645 Sun City Center Plaza,#6067, Sun City Center, FL 33571Call: 813-731-1237Fax: 855-855-7266 See acast.com/privacy for privacy and opt-out information.

Tonight we bring back one of our favorite guests, Ms. Diane Daniels.Diane is a nationally known Medicare consultant, who brings over ten years of health care experience to her community. She is the owner of Medicare Nation, which provides superior Medicare education to groups and individuals.Diane is the host & producer of Medicare Nation, an iTunes Top 200 podcast, dedicated to educating retirees and the adult children of seniors, everything they need to know about Medicare. Diane interviews expert guests, who discuss illnesses, injuries, and chronic ailments which affect Medicare benefits. Diane collaborates with politicians and national associations to advocate for her clients. You can listen to Medicare Nation on smartphones, tablets, and computers (www.TheMedicareNation.com).Just recently Medicare Nation was named the #1 podcast in the nation on the topic of Medicare.Our topic tonight: What type of effect has COVID 19 had on our seniors, and even more importantly, what does this unsure future we now live in do to our seniors?Michael L. BannerPresidentProfessional Mortgage Alliance, LLC.28870 U.S. Hwy 19 N.Suite 320Clearwater, Fl. 33761E-mail- mbanner@pmanow.comCell – 727-224-3859Ms. Diane Daniels.1645 Sun City Center Plaza,#6067, Sun City Center, FL 33571http://themedicarenation.com/Call: 813-731-1237 See acast.com/privacy for privacy and opt-out information.

Tonight we bring back the nation's leading expert on the topic of Medicare and Medicare Supplemental policies, Ms. Diane Daniels.Diane, Founder and Host of Medicare Nation, and the Medicare Nation podcast, works with a political organization, social organizations, companies, and individuals answering their questions and solving the Medicare needs.Recently, the Medicare nation podcast was named the #1 podcast in the Country on this incredibly relevant subject.Tonight we discuss which insurance carriers are doing right by their clients, and which are doing wrong, during the COVID 19 crisis.And as a former New York City Police officer, we are going to discuss the current attitude towards this nation's great police.And believe me, Diane isn't going to hold back!!!!Michael L. BannerPresident & CEOProfessional Mortgage Alliance, LLC.E-Mail – mbanner@pmanow.comCell – 727-224-3859NMLS# - 386692Ms. Diane Daniels.1645 Sun City Center Plaza,#6067, Sun City Center, FL 33571http://themedicarenation.com/Call: 813-731-1237 See acast.com/privacy for privacy and opt-out information.

Tonight we bring back the nation's leading expert on the topic of Medicare and Medicare Supplemental policies, Ms. Diane Daniels.Diane, Founder and Host of Medicare Nation, and the Medicare Nation podcast works with a political organization, social organizations, companies, and individuals answering their questions and solving the Medicare needs.Recently, the Medicare nation podcast was named the #1 podcast in the Country on this incredibly relevant subject.Tonight we discuss which insurance carriers are doing right by their clients, and which are doing wrong, during the COVID 19 crisis.And as a former New York City Police officer, we are going to discuss the current attitude towards this nation's great police.And believe me, Diane isn't going to hold back!!!!Michael L. BannerPresident & CEOProfessional Mortgage Alliance, LLC.E-Mail – mbanner@pmanow.comCell – 727-224-3859NMLS# - 386692Ms. Diane Daniels.1645 Sun City Center Plaza,#6067, Sun City Center, FL 33571http://themedicarenation.com/Call: 813-731-1237 See acast.com/privacy for privacy and opt-out information.

Tonight we bring back the nation's leading expert on the topic of Medicare and Medicare Supplemental policies, Ms. Diane Daniels.Diane, Founder and Host of Medicare Nation, and the Medicare Nation podcast work with political organizations, social organizations, companies, and individuals answering their questions and solving the Medicare needs.Recently, the Medicare nation podcast was named the #1 podcast in the Country on this incredibly relevant subject. Tonight, we discuss changes in the Medicare industry, during the COVID 19 crisis, and what these insurance carriers have done right and wrong….And believe me, Diane is not going to hold back!!! Michael L. BannerPresident & CEOProfessional Mortgage Alliance, LLC.E-Mail – mbanner@pmanow.comCell – 727-224-3859NMLS# - 386692 See acast.com/privacy for privacy and opt-out information.

62 Who Knew ?!? Ep. 41Tonight our guest is Diane Daniels. Diane is a Medicare consultant, who brings over ten years of health care experience to her community. She is the owner of Medicare Nation, which provides superior Medicare education to groups and individuals. Ms. Daniel's priority in educating overselling has provided Medicare Nation the ability to offer a large portfolio of Medicare products. Diane is the host & producer of Medicare Nation, an iTunes Top 200 podcast, dedicated to educating retirees and the adult children of seniors, everything they need to know about Medicare. Diane interviews expert guests, who discuss illnesses, injuries, and chronic ailments that affect Medicare benefits. Diane collaborates with politicians and national associations to advocate for her clients Michael L. BannerPresident & CEOProfessional Mortgage Alliance, LLC.E-Mail – mbanner@pmanow.comCell – 727-224-3859NMLS# - 386692Medicare Nation1645 Sun City Center Plaza,#6067​, Sun City Center, FL 33571Call: 813-731-1237Fax: 855-855-7266http://themedicarenation.com/ See acast.com/privacy for privacy and opt-out information.

62 Who Knew ?!? Ep. 061Tonight, we bring back one of our favorite guests, Ms. Diane Daniels. Diane is a nationally known Medicare expert, who brings over ten years of health care experience to her community. She is the owner and Founder of Medicare Nation, which provides superior Medicare education to groups and individuals. Diane is the host & producer of Medicare Nation, an iTunes Top 200 podcast, dedicated to educating retirees and the adult children of seniors, everything they need to know about Medicare. Diane interviews expert guests, who discuss illnesses, injuries, and chronic ailments that affect Medicare benefits. Diane collaborates with politicians and national associations to advocate for her clients. You can listen to Medicare Nation on smartphones, tablets, and computers (www.TheMedicareNation.com). Just recently Medicare Nation was named the #1 podcast in the nation on the topic of Medicare Michael L. BannerPresident & CEOProfessional Mortgage Alliance, LLC.E-Mail – mbanner@pmanow.comCell – 727-224-3859NMLS# - 386692 See acast.com/privacy for privacy and opt-out information.

62 Who Knew ?!? Ep. 056Tonight we bring back one of our favorite guests, Ms. Diane Daniels.Diane is a nationally known Medicare consultant,who brings over ten years of health care experience to her community. She is the owner of Medicare Nation, which provides superior Medicare education to groups and individuals.Diane is the host & producer of Medicare Nation, an iTunes Top 200 podcast, dedicated to educating retirees and the adult children of seniors, everything they need to know about Medicare. Diane interviews expert guests, who discuss illnesses, injuries, and chronic ailments that affect Medicare benefits.Diane collaborates with politicians and national associations to advocate for her clients. You can listen to Medicare Nation on smartphones, tablets, and computers at www.TheMedicareNation.comJust recently Medicare Nation was named the #1 podcast in the nation on the topic of Medicare. Every generation faces different complications when preparing for retirement. It will always be this way…But this generation is facing an issue like none other before it.And that issue is Longer lifespans! That's right, people are living longer than ever before! But make no mistake about it, longer life spans are a double-edged sword.Michael L. BannerPresident & CEOProfessional Mortgage Alliance, LLC.E-Mail – mbanner@pmanow.comCell – 727-224-3859NMLS# - 386692 See acast.com/privacy for privacy and opt-out information.

62 Who Knew ?!? Ep. 052Tonight our guest is Ms. Diane Daniels Host and Founder of the most successful podcast in the nation on the topic of Medicare.This is Diane's third appearance on the show and tonight we discuss the very timely subject of “Medicare for All” a proposal presented by Senator Bernie Sanders to cover all Americans!Does this plan have merit, strengths, or weaknesses?Tune in tonight and find out as our National Medicare expert gives her views on this relevant topic for all!Founder of Medicare Nation, the largest podcast in the nation on the topic of Medicare,and well know national expert.Here we have the government-funded Medicare industry representedas well as the privately funded long term care insurance world,by two of the best professionals in both worlds.These two industries should be working hand in hand to ensureall Americans have the proper coverage.Every generation faces different complications when preparing for retirement. It will always be this way…But this generation is facing an issue like none other before it.And that issue is Longer lifespans! That's right, people are living longer than ever before! But make no mistake about it, longer life spans are a double-edged sword.Michael L. BannerPresident & CEOProfessional Mortgage Alliance, LLC.E-Mail – mbanner@pmanow.comCell – 727-224-3859NMLS# - 386692 See acast.com/privacy for privacy and opt-out information.

62 Who Knew ?!? Ep. 044Tonight's 62 Who Knew Synopsis:As we start our conversion into a “panel of experts show” tonight we welcome back Mr. Mark Goldberg, President of FPS Insurance, and Nationally known long-term care insurance expert and Ms. Diane Daniels, Founder of Medicare Nation, the largest podcast in the nation on the topic of Medicare, and well know national expert.Here we have the government-funded Medicare industry represented as well as the privately funded long term care insurance world, by two of the best professionals in both worlds.These two industries should be working hand in hand to ensure all Americans have the proper coverage.Our guest is Ms. Julie Hollender, Franchise Owner & Travel Advisor with Cruise Planners, an American Express Travel Representative. Cruise Planners is an award-winning travel company and a top producer with cruise lines, tour operators, and land vacation retailers throughout the world.Join us tonight and learn how to plan your next great vacation! Michael L. BannerPresident & CEOProfessional Mortgage Alliance, LLC.E-Mail – mbanner@pmanow.comCell – 727-224-3859NMLS# - 386692 See acast.com/privacy for privacy and opt-out information.

Hey Medicare Nation! www.TheMedicareNation.com Today, I'm finishing up my series on the Medicare Plan Sponsors that CMS has issued Sanctions and/or Civil Money Penalties for in 2020! THREE more plan sponsors to discuss! CMS sent notice to Ms. Aparna Abburi, President of Health Care Service Corporation (HCSC), on February 28, 2020, that CMS was imposing a Civil Money Penalty in the amount of $381,272.00! HUGE Penalty people! According to CMS Summary of Non-Compliance, HCSC disclosed to CMS that it "discovered" a backlog of unprocessed Part C (Medical) Appeals. The Majority of these appeals were from claims from providers (doctors and/or facilities) or ..... reimbursement requests from enrollees. HCSC has the right to Appeal CMS Decision.   NEXT Up..... is Triple-S Management Corporation! CMS sent a Notice to Ms. Madeline Hernandez-Urquiza, President of Triple-S Management Corporation, on February 28, 2020. CMS notified Triple-S that they had made a determination to impose a civil money penalty in the amount of $329,872.00! CMS reported that Triple-S failed to comply with Medicare requirements related to Part D Formulary and benefit administration. Triple-S has the right to Appeal CMS decision. Last up..... is Tufts Health Plan, Inc.  CMS sent notice to Mr. Thomas Crosswell, President and CEO of Tufts Health Plan, Inc., to advise them of CMS' determination to impose a Civil Money Penalty in the amount of $28,302.00. CMS Auditors reported that Tufts failed to comply with Medicare requirements related to Part D Formulary and benefit administration and coverage determinations, appeals, and grievances in violations of Medicare regulations. Tufts has the right to Appeal CMS' decision. If YOU are unhappy with any of the three Medicare Advantage Plan Sponsors, give Medicare a call. You can request a "Special Election Period," based on your experience with any of these companies. Call Medicare at  800 - 633 - 4227  24hrs a day, 7 days a week. www.TheMedicareNation.com   Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!  

Hey Medicare Nation! Medicare Nation CMS Imposes a Civil Money Penalty against HUMANA! CMS conducted an "Audit" of Humana's Medicare Operations from June 3, 2019 through June 21, 2019. Humana failed to comply with Medicare requirements related to Part D formulary and benefit administration and coverage derterminations, appeals, and grievances in violation of 42 C.F.R. Part 423, Subparts C and M. Humana's failures in these areas were systemic and adversely affected, or had the substantial likelihood of adversely affecting, enrollees. CMS provided notice to Humana's CEO, Mr. Bruce Broussard, on February 28, 2020, that CMS imposed a Civil Money Penalty in the amount of ........ $257, 262! Humana failed to properly administer the CMS "transition" policy. This means if you are enrolling in a new plan, and you take a prescription that is NOT on the new plan's formulary (drug list), the plan MUST allow you to "transition" by allowing you a 31 day supply of your prescription drug.  This allows you time to speak with your doctor to see if there is an alternative prescription drug on the new plan ...... or...... you can request a "Formulary Exception." This means your doctor is requiring you to take this medication, because it is the one that is stablizing or correcting your condition, and that you need to continue to take it. If the drug is NOT on the new plan's formulary and they Approve the formulary exception, you WILL be charged a higher amount for taking a drug that is not on their formulary. Humana has the right to appeal the decision by requesting a hearing. The notice is signed by John Scott, Acting Director of the Medicare Parts C and D Oversight and Enforcement Group. Medicare Nation NEXT CMS Penalty is given notice to......... SOLIS Health Plans out of Miami, Florida On December 4, 2019, CMS gave notice to Mr. Daniel Hernandez - CEO of Solis Health Plans. CMS imposed a CIVIL MONEY PENALTY of $41,552.00! CMS stated in their summary that Agents employed by SOLIS engaged in an aggressive marketing campaign that was conducted by a contractor provider clinic. Solis Agents conducted a marketing presentation in a secluded area and enroll patients upon conclusion of the presentation. CMS determined that Solis violated the communication and marketing requirements, which had the substantial likelihood of adversely affecting its enrollees. Solis Failed to oversee and manage the marketing process to ensure its agents and brokers did not engage in inappropriate marketing practices including "misleading" beneficiaries. Solis may request a hearing to appeal CMS's determination. Both notices are signed by John Scott, acting director of the Medicare parts C and D Oversight and Enforcement Group. Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels    

Hey Medicare Nation! Medicare Nation Today, I'm informing you about The Centers For Medicare & Medicaid Services Notice, given to Mr. Art Carlos, CEO of Delaware Life Insurance Company. In a notice dated January 31, 2020, CMS notified Mr. Carlos that they were immediately imposing Intermediate "Sanctions" against Delaware Life Insurance Company. CMS determined that Delaware Life Insurance Company is "in substantial violation of Medicare Advantage and Prescription Drug Plan requirements." SIX specific violations were listed in the notice to Carlos. LISTEN to the episode to learn about the violations and what you can do if YOU are a beneficiary under one of Delaware Life Insurance Company's Medicare Advantage Plan or Prescription Drug Plan. www.TheMedicareNation.com Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels Medicare Consultant

Hey Medicare Nation! www.TheMedicareNation.com Medicare has taken many steps to assist you during the COVID-19 crisis. Coronavirus tests Medicare Part B (Medical Insurance) covers a test to see if you have coronavirus (officially called COVID-19). This test is covered when your doctor or other health care provider orders the test. I spoke about testing for COVID-19 in the previous episode, dated April 1, 2020. Listen to episode 101 to learn more about COVID-19 Testing. Your costs in Original Medicare for COVID-19 Testing. You pay nothing for this test. NADA! This includes the newly available COVID-19 “Antibody” test, which determines if you have antibodies in your blood, that were created to recognize the COVID-19 Virus in your body. Hospitalization Medicare covers All medically necessary hospitalizations. This includes if you're diagnosed with COVID-19 and might have been discharged from the hospital after an inpatient stay, but……. instead you need to stay in the hospital under quarantine.   Your costs in Original Medicare ZERO!   3     VACCINE FOR COVID-19 At this time, there's no vaccine for COVID-19.  However, If and when one becomes available, it will be covered by all  MEDICARE Prescription Drug plans -  Which is Part D of Medicare.   TELEHEALTH  SERVICES During the National Emergency for COVID-19, you will be able to receive a specific set of services through telehealth These services include: Evaluation and management visits (common office visits), mental health counseling and preventive health screenings  without a copayment if you have Original Medicare.  Your costs in Original Medicare  $0  Co-Pay if you have Original Medicare. You can use your smart phone or computer to access Telehealth services. 5.    Virtual check-ins virtual check-ins (also called “brief communication technology-based services”) with your doctors and certain other practitioners. What is it ? Virtual check-ins allow you to talk to your doctor or certain other practitioners, like nurse practitioners or physician assistants, using a device like your phone, integrated audio/video system on your laptop or computer, or captured video image without going to the doctor’s office. Your doctor or other practitioner can respond to you using: Phone Audio/visit Secure text messages Email Use of a patient portal   Virtual Check-Ins can be used for treatment for the Coronavirus from ANYWHERE……including places of residences….HOMES. Nursing Homes, AND Assisted Living Facilities.       Things to know You must talk to your doctor or other practitioner to start these types of visits. The communication must not be related to a medical visit within the past 7 days and must not lead to the medical visit within the next 24 hours (or the soonest appointment available). You must verbally consent to the virtual check-in, and your consent must be documented in your medical record. Since January 1, 2020 your doctor may obtain a single consent for a year’s worth of these services.        Your costs in Original Medicare      Normally, you would pay for “Virtual Visits” under Part B of Medicare.      During the National Emergency, your co-insurance and deductible will be waived, and you will have “No Co-insurance, or deductible” for Virtual Visits for COVID-19 services.   Certain Skilled Nursing Facility Care requirements have been waived during the National Emergency for COVID-19. During the COVID-19 Pandemic, some people may be able to get renewed SNF coverage without first having to start a new benefit period.  Original Medicare covers up to “100 consecutive days” in a Skilled Nursing Facility.” For each benefit stay. During the National Emergency for COVID-19, your Doctor may request an extension of days for your benefit period.   If you’re not able to be in your home during the COVID-19 pandemic or are otherwise affected by the pandemic, you can get SNF care without a qualifying hospital stay.   if you have a Medicare Advantage Plan, you have access to these same benefits. Medicare allows these plans to waive cost-sharing for COVID-19 lab tests. Many plans offer additional telehealth benefits beyond the ones described above and many plans have waived Hospital co-pays during the pandemic. Check with your plan about your coverage and costs for ALL services covered for COVID-19. Review your Summary of Benefit Booklet for 2020 from your Medicare Advantage Plan Carrier. Don’t have one……… Go to the plan’s website to download a digital copy. OR…… Call the Customer Service number on the back of your Identification card and ask them to mail you a “Formulary” for your Specific plan.     Preparing for healthcare needs   Be sure you have over-the-counter medicines and medical supplies like tissues….cough drops…. Tylenol…etc.  to treat fever and other symptoms.   Most people will be able to recover from COVID-19 at home.   Have enough household items and groceries on hand…..Soup, Macaroni and Cheese, Bread for Toast…. Whatever it is you will eat & drink when you’re sick….so that you'll be prepared to stay at home for a period of time.   Check out the following websites for updates on COVID-19   Centers for Disease and Control - CDC.gov …..  has the latest public health and safety information from the CDC and for the medical and health provider community on COVID-19.   USA.gov -  has the latest information about what the U.S. Government is doing in response to COVID-19.   CoronaVirus.gov - is the source for the latest information about COVID-19 prevention, symptoms, and answers to frequent questions.   Visit your State Department of Health for local COVID-19 Information about YOUR State.   You can search on Google for your State’s Health Dept. by typing in ……… NY State Health Depart……… CA State Health Dept……..Florida State Health Depart……    Visit my website for a LIST of EVERY State Health Department’s Phone Number…… By going to www.TheMedicareNation.com/COVID19     Many of you are turning 65 and have no idea what to do to enroll in Medicare or what Plan to enroll in. I invite you to contact me….. so that I can assist you with all this. Send me your question to Support@TheMedicareNation.com   I answer ALL emails myself! No Assistants, NO Virtual Assistants….. I do! I will answer your question in one paragraph. If I cannot, I will let you know how to contact me if you wish to reach out to me for a consultation. Until next time……. Practice Social Distancing…..Do things to Make you Happy……. AND Stay Healthy!! Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!   The information on this podcast and/or website is not a substitute for examination, diagnosis, and medical care provided by a licensed and qualified health professional, which neither I nor anyone else associated with Medicare Nation LLC is not! Please consult with your physician before undertaking any form of medical treatment and/or adopting any exercise program or dietary guidelines. If you think you may have a medical emergency, call your physician and/or 911 immediately. Medicare Nation LLC reserves the right to add, remove or edit content on this page at its’ sole discretion.

Hey Medicare Nation! www.TheMedicareNation.com It’s April 1st and over One Million People have been diagnosed with the COVID-19 Virus Worldwide! On this week’s episode….. I provide a time-line of the events of the Pandemic as well as updates on COVID-19 testing and Important phone numbers should you have symptoms or questions about COVID-19. I also have a “list” of phone numbers, for EACH Health Department in All 50 States! You can email me at  Support@TheMedicareNation.com for the list or check the show notes for an attachment. Here is an important phone number for the CDC HOTLINE on COVID-19 800 -232- 4636 - CDC Hotline Advent Health 24hr Hotline -  877 – 847 – 8747 You can also download the Advent Health App on iTunes or Google Play in order to have a “Virtual” visit with an Advent Health Doctor.  Bay Care Virtual Doctor Hotline -  800 – 229 – 2273 You can also go to this website for a “virtual” visit with a Bay Care Doctor – www.BayCareAnywhere.org  The Florida Department of Health Hotline is  866 – 779 – 6121   State Health Department List of Phone Numbers   Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Contact Me! Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!

Hey Medicare Nation! We're smack in the middle of a Corona Virus Pandemic! The Medicare Nation I wanted to give you an episode that is full of USEFULL information. I know you've been hammered by the news, internet and newspapers about the Corona Virus. Let's start with a very important fact: Human coronaviruses were first identified in the mid-1960s. The 1960's people! the coronavirus gets its name from a distinctive corona or in a scientists world…a “Crown of Sugary Proteins,” that projects from the surface of the virus. There are four main types of Human Corona Viruses Alphacoronavirus,  Betacoronavirus,  Gammacoronavirus, and  Deltacoronavirus. The first two only infect mammals, including bats, pigs, cats, and humans.   Gammacoronavirus mostly infects birds such as poultry (chickens) and Deltacoronavirus can infect both birds and mammals. Do you recognize the Virus named SARS? Severe acute respiratory syndrome abbreviated as …. (SARS-CoV) SARS-CoV (the beta coronavirus.  Guess what it causes?  It causes severe… acute…..respiratory syndrome, SARS was first recognized as a distinct strain of coronavirus in 2002. The source of the virus has never been clear, though the first human infections can be traced back to the Chinese province of Guangdong in November of 2002. The virus then became a pandemic, causing more than 8,000 infections of an influenza-like disease in 26 countries with close to 800 deaths. In the United States, only eight persons were laboratory-confirmed as SARS cases. There were NO  SARS-related deaths in the United States. All of the eight persons with laboratory-confirmed SARS had traveled to areas where SARS-CoV transmission was occurring. By July of 2003….. the World Health Organization declared the outbreak over. On February 11, 2020 the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak, first identified in Wuhan China. The new name of this disease is….SARS-COV-2 aka coronavirus disease 2019, abbreviated as COVID-19.  ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease. The Medicare Nation COVID-19 is a new disease, caused by a novel (or new) “coronavirus” or strain of “Corona Virus” that has not previously been seen in humans. What are the Symptoms of COVID-19?  The CDC (Centers of Disease Control) have listed these as the most common symptoms of COVID-19: Fever Cough Shortness of breath Symptoms may appear 2-14 days after exposure. Reported illnesses have ranged from mild symptoms….like a dry cough…. to severe illness, with high fever and shortness of breath, requiring hospitalization and there have been deaths reported for confirmed coronavirus disease 2019 (COVID-19) cases.   Currently……according to the WHO… as of March 13th….there are over 132, 758 reported cases of    COVID-19 …. Worldwide. Of those cases….. there are 4,955 Deaths worldwide. Over 80% of the reported cases are recovering. In the U.S…… there are currently 1,629 reported cases…… in 47 of the 50 States. No reported cases yet….in Idaho, Alabama and West Virginia. There have been 41 Deaths reported in the U.S. ….. with 37 Deaths coming from the State of Washington. The deaths mainly being reported from a nursing facility, with those being elderly and having underlying medical conditions prior to contracting the CoronaVirus. What do we mean by Underlying medical conditions????  If you have a blood disorder.... like sickle cell disease... or ... you have chronic kidney disease.... you're currently receiving chemotherapy or radiation. You may have congestive heart failure or coronary artery disease. You may have chronic asthma or chronic obstructive pulmonary disease or you may need oxygen at home. All of these conditions..... as well as many more..... may raise your risk of contracting COVID-19. You may NOT contract the virus. Just be more cognizant of your surroundings and who you are in contact with. What do you do if you believe you have symptoms of the COVID-19? NUMBER 1…. Call your Primary Doctor. Speak with the Nurse or Physician’s Assistant. Tell them your symptoms and they will advise you of what to do.  IF You CANT get Through to your Doctor……. If you have a Medicare Advantage Plan…… the Plan most likely has a 24 hr. Nurse’s Line.  CALL THEM!!  Tell the nurse  your symptoms. They will advise you. Call your STATE Health Department for Advise. Each State has an information line dedicated to the COVID-19 Crisis and will be able to assist you with answering question. If you have any severe symptoms….. as in Difficulty Breathing, fluid in your lungs, High fever of over 104 degrees…. CALL 911!   If you do have symptoms, and your doctor wants you to have the test to confirm COVID-19…. Where do you go?? According to the FDA….. here is the current list of laboratories across the U.S. that will be offering testing for the COVID-19 very soon  Advent Health Laboratories  Lab Corp Quest Laboratories As well as many other public health, university and private labs will be available on the FDA list of laboratories to test for the COVID-19. Medicare IS Covering the Test for COVID-19 as a Preventative Diagnostic Test….and therefore ….. you will have NO COPAY when you take the test. There are currently  TWO Testing Codes for the COVID-19 Test Is for having the Test at a Public Health Lab ( your local community Health Department) which is U0001 The 2nd is for having the test at a commercial or private lab (like Lab Corp) which is U0002.   If you are diagnosed with COVID-19, self-quarantine yourself in your home, away from your family members and pets, until you have tested negative. We ALL need to SELF-Police ourselves and HELP STOP the Spread of COVID-19….. so we can curtail the spread and help stop the pandemic.  Remember to Drink lots of fluids….. eat plenty of chicken soup and crackers ….. and get lots of REST!! The Medicare Nation You can go to the Center for Disease Control website for daily updates on the Corona Virus 19 situation ….. go to….. www.CDC.gov   You can also go to the World Health Organization website…. Go to …. www.who.int   AND…. PLEASE go to your STATE”S Health Department website for local information by “Googling” your State.  That’s all for today Nation. Call your Parents….. Make sure they’re ok and help them subscribe to Medicare Nation…. So they can hear this episode as well as over 100 other episodes about Medicare and it’s Resources. Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!      

Hey Medicare Nation! www.TheMedicareNation.com It's still January...but February is right around the corner. Spring WILL come. I promise! Let me give you some good news! Medicare is now covering Acupuncture! As of January 21, 2020, The Center for Medicare & Medicaid Services (CMS), will cover acupuncture for "Chronic Low Back Pain." Let's look at the coverage in the Medicare National Coverage Determination Manual. Section 1862(a)(1)(A) of the Social Security Act  Up to "12" visits in 90 days are covered for Medicare Beneficiaries under the following circumstances: a. Chronic Low Back Pain which lasts "12 weeks or longer," b. the Chronic Low Back Pain is "non-specific," in that it has NO identifiable systemic cause (NOT associated with metastatic, inflammatory, infectious, disease). c. the Chronic Low Back Pain is NOT associated with surgery d. the Chronic Low Back Pain is NOT associated with pregnancy. An ADDITIONAL "Eight" (8) sessions WILL be covered for those patients demonstrating an improvement. No more than "20" acupuncture treatments may be administered annually. Treatment MUST be discontinued if the patient is NOT improving or is regressing. The Acupuncture must be Administered under the supervision of a doctor of medicine or osteopathy. Need more information?  Check out our website www.TheMedicareNation.com What plans cover Acupuncture? Acupuncture for Chronic Low Back Pain, will be covered under ORIGINAL Medicare.  If you present your Medicare ID Card to providers as your Health Insurance..... You may start utilizing this treatment now. If you present your Medicare ID Card, as well as a Medi-Gap (Medicare Supplement) Plan..... You may start utilizing this treatment now. If you have a Medicare Advantage Plan, you need to check your Summary of Benefits Book under your plan, to see if they cover Acupuncture. If you can't find it.... call the customer service number on the back of your ID Card and ask the representative. Acupuncture is NOT covered under Medicare Part D. Part D is ONLY for Prescription Drug Coverage. If you have any questions.... send them to Support@TheMedicareNation.com   Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels                                                                            Medicare Consultant Support@TheMedicareNation.com    

Hey Medicare Nation! www.TheMedicareNation.com It's 2020!  Love the sound of that! Right now...... the Medicare Advantage Open Enrollment Period is in full swing. If you are on a "Medicare Advantage Plan," you have the opportunity to make a ONE TIME change, between January 1st through March 31st. You can change from one Medicare Advantage Plan to another Medicare Advantage Plan. You can "disenroll" from the Medicare Advantage Plan you're on and go back onto "Original Medicare." With Original Medicare, you can add a stand-alone-prescription drug plan and ..... you can enroll into a Medicare Supplement Plan (aka Medi-gap) to help defray the costs of Original Medicare. Here are options you can do during the Medicare Advantage Open Enrollment Period:  Change from a Medicare Advantage Plan back to Original Medicare. Switch from one Medicare Advantage Plan to another Medicare Advantage Plan. Switch from a Medicare Advantage Plan that doesn't offer drug coverage to a Medicare Advantage Plan that offers drug coverage. Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn't offer drug coverage. Join a Medicare Prescription Drug Plan. Switch from one Medicare drug plan to another Medicare drug plan. Drop your Medicare prescription drug coverage completely   I'm adding the EXACT language from the Medicare Managed Manual, regarding the Medicare Advantage Open Enrollment Period. 30.5 – Medicare Advantage Open Enrollment Period (MA OEP) 42 CFR 422.62(a)(3) (Rev. 1, Issued: July 31, 2018; Effective/Implementation: 01-01-2019) During the MA OEP, MA plan enrollees may enroll in another MA plan or disenroll from their MA plan and return to Original Medicare. Individuals may make only one election during the MA OEP. This chart outlines who can use the MA OEP and when: Who can use the MA OEP: MA OEP occurs: Individuals enrolled in MA plans as of January 1 – March 31 New Medicare beneficiaries who are enrolled in an MA plan during their ICEP The month of entitlement to Part A and Part B – the last day of the 3rd month of entitlement Individuals may add or drop Part D coverage during the MA OEP. Individuals enrolled in either MAPD or MA-only plans can switch to: • MA-PD • MA-only • Original Medicare (with or without a stand-alone Part D plan) The effective date for an MA OEP election is the first of the month following receipt of the enrollment request. NOTE: The MA OEP does not provide an opportunity for an individual enrolled in Original Medicare to join a MA plan. It also does not allow for Part D changes for individuals enrolled in Original Medicare, including those enrolled in stand-alone Part D plans. The MA OEP is not available for those enrolled in Medicare Savings Accounts or other Medicare health plan types (such as cost plans or PACE). You may also go onto Medicare.gov to view information on the Medicare Advantage Open Enrollment Period. If you decide to make a change during the MA OEP, you will be "locked-in" to the new plan, until the next enrollment period.... which is....the Annual Enrollment Period, from October 15th through December 7th. You may also make a change to your plan if you have a "special circumstance." These are listed under the "Special Election Periods" for Medicare on Medicare.gov You can also LISTEN to my previous show on Special Election Periods..... Episode 051, which was published on July 29, 2016. The episode is titled..... "Special Election Period Q & A" I go into detail about the Special Elections available. www.TheMedicareNation.com Remember Medicare Nation listeners........ an "Insurance Agent," is NOT allowed to "solicit" you during the Medicare Advantage Open Enrollment Period.  There are strict Medicare regulations regarding this. YOU must make the first move in contacting or telling your "Agent" or Medicare Specialist, that you are unhappy with your current plan. No one should be calling you, texting you, emailing you ..... or worse...... knocking on your door, telling you about the Open Enrollment Period. If someone does...... tell them to "Take a Hike!" You don't need a dishonest person like that helping you with your Medicare needs! If you need help finding a new plan during the OEP, contact you're Medicare Advisor. If you are all set with your Medicare Advantage Plan for 2020, You don't need to do anything! Just enjoy your family, friends and activities!    Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Contact me on my website - www.TheMedicareNation.com Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels                                                                          Medicare Consultant                                                                  Medicare Nation LLC.

Hey Medicare Nation! www.TheMedicareNation.com It's October! That means it's Medicare Time! The Annual Enrollment Period is just around the corner. Did you receive your "Annual Notice of Changes (ANOC)" for your Medicare Advantage Plan or Prescription Drug Plan? If not....contact your plan and request the ANOC. Today......I want to talk with you about Part D Prescription Drug Coverage for 2020! Medicare has set the maximum Part D Deductible for 2020 at $435.00. Medicare Advantage Plans and Stand-Alone Prescription Drug Plans have the option to charge the maximum deductible amount of $435.00...... or....... They can eliminate the Deductible altogether.... or...... They can charge an amount in between. You MUST do your "Due Dilligence" in determining which Prescription Drug Plan will fit your unique needs for 2020. Contact your Medicare Specialist and request their assistance in finding a Prescription Drug Plan for 2020. If you have a question about Medicare or your Prescription Drug Plan.... You can send me an email to Support@TheMedicareNation.com If I can answer your question in ONE Paragraph, I will answer your question! If I cannot ...... I will request you hire me as your consultant. I currently charge $199.00 an hour for my consultation services.  I always do my best to answer your questions in ONE paragraph. The "initial coverage period (ICP)" for Part D, has a threshold of $4,020.00 When you hand in a prescription, the total amount of the prescription is applied towards the ICP. If you have a Deductible, that is applied towards the ICP too. When the total amount of your prescriptions reaches $4,020.00..... you will now enter a new phase called the "coverage gap." In this stage.... you will now pay 25% of generic drugs.... and you will pay 25% of brand name drugs. If you reach $5,018.75 you will enter the next stage, which is called.... The "Catastrophic Stage." In the Catastrophic Stage, you will now pay a 5% co-insurance or $3.60 for Generic Drugs..... or.... $8.95 for Brand or non-preferred Drugs.... which ever is a greater amount. You will remain in the Catastrophic Stage until your out-of-pocket spending reaches $6,350 or..... when the ball drops on New Year's Eve! I know prescription drugs can be very expensive! There are programs available for those of you with lower incomes. The program is called "Extra Help," or "Low Income Subsidy." To apply for Extra Help, go to the social security website - www.socialsecurity.gov/extrahelp If your individual income is less than $1,562 a month, you would qualify for the LIS program. If your income is more than $1,562 a month, but is less than $1,900 a month....APPLY! You have nothing to lose! All they can say is No! You can also appy for the "Medicare Savings Program" If you qualify, CMS will pay for your Medicare Part B Premium. Depending on your qualifications, CMS may pay your premium, deductible and co-insurance. Apply for the Medicare Savings Program here: https://www.medicare.gov/Contacts/#resources/msps Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels  

How knowledgeable are you at Medicare? Diane Daniels, the CEO of Medicare Nation, talks about how she started her own podcast showcasing her knowledge about the health insurance program. Through her efforts, she has helped many understand what the insurance encompasses and clarifies many listener questions from it. Diane's award-nominated podcast may not have millions of audiences, but you can surely learn a thing or two from its invaluable content. Helping Medicare agents along the way, her podcast reminds other podcasters that podcasting is all about delivering the message rather than gearing towards earning more. Love the show? Subscribe, rate, review, and share!Here's How » Join the Binge Factor community today:thebingefactor.comFacebookInstagramLinkedInPinteresYoutube

Hey Medicare Nation! www.TheMedicareNation.com If you are turning 65 or still working on  an employer group insurance plan, you may need assistance in finding the Medicare plan that fits YOUR unique needs. You may have a loved one in a nursing home or in an assisted living facility, who is not receiving proper care. Call me! You can hire me as a consultant to assist you with Medicare issues! Call 855-855-7266 or eMail me at Support@TheMedicareNation.com Tell me the situation and I'll personally get back to you! Today, I am speaking to you about Shingles Vaccines! There are two Shingles vaccines licensed in the United States available. The first one is the "Zoster Vaccine Live," also known as "Zostavax." Many of you probably have received this vaccine, which is a "Live" vaccine and the CDC reports it as being 51% effective against Shingles. The second vaccine is the "Recombinant Zoster Vaccine," also known as "Shingrix" has been used since October of 2017. The CDC reports the Shingrix vaccine is about 91% effective against Shingles. The cost of the Shingles vaccine is covered under Medicare "Part D." You can look up the Zostavax vaccine or Shingrix vaccine in your plan's formulary, or you can call the customer service number on the back of your identification card. Every plan can have a different cost for either vaccine, so it is important you check with your plan, prior to getting the vaccine. There are side effects that can be associated with either vaccine. Go to the CDC website to learn more about Shingles and the vaccines  www.cdc.gov/vaccinesafety Learn more about how Shingles is transmitted, the sign & symptons and treatment for Shingles here: www.cdc.gov/shingles I'm not a doctor! If you have any health related questions regarding shingles and/or vaccines, due your own due diligence or contact your health care provider for more information. Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!    

Hey Medicare Nation! www.TheMedicareNation.com Help your PARENTS, Spouses and Friends "SUBSCRIBE" to Medicare Nation! With almost 100 episodes on Medicare and Medicare Resources available, your loved-one will be able to find answers to their Medicare questions! Use the "Purple" colored icon on an Apple phone or .... download Stitcher, Himalaya or Player FM when using Android phones. Search for "Medicare" and "click" on the Medicare Nation logo. You'll see the "subscribe" button on the page. "Click" subscribe and they'll get the NEWEST Medicare Nation episodes delievered to their phone. TODAY.... I'm discussing NEW information released from CMS.   CMS Decision Summary Ambulatory Blood Pressure Monitoring  Devices July 2, 2019…..The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to cover Ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension in Medicare beneficiaries.  What is hypertension (high blood pressure)? The American Heart Association (AHA) defines blood pressure as…. a force that pushes blood through a network of arteries, veins and capillaries. The blood pressure reading is the result of two forces: the systolic pressure occurs as blood pumps out of the heart and into the arteries; diastolic pressure is created as the heart rests between heart beats (American Heart Association, 2018). Elevated blood pressure, or hypertension, leads to harm by causing tiny tears in the interior lining of the arteries and coronary vessels…..stimulating a local immune response in the endothelial cells within the atrial walls.  In these regions, the arterial intima retains apolipoprotein B, which attracts lipid-rich macrophages (foam cells).   These preatherotic lesions develop into atherosclerotic plaques which become increasingly fibrotic and can form fissures, hematomas, thrombi, and calcifications (Swirski and Nahrendorf, 2013). The end result is stiff, thickened arteries that narrow the flow of blood to organs and limbs….which both increases pressure on target organs and limits oxygenation of them. There is also the risk of atherosclerotic plaque rupture, resulting in distal vascular obstruction and ischemia and infarction of end organs, such as stroke in the brain (U.S. Department of Health & Human Services, 2018). CMS is lowering the blood pressure threshold for hypertension… from the current policy of 140/90 down to 130/80 to align with the latest society recommendations regarding the diagnostic criteria.  This will allow more patients to use ABPM and receive appropriate treatment if needed. General Ambulatory blood pressure monitoring (ABPM) is a diagnostic test… that allows for the identification of various types of high blood pressure. ABPM devises are small… portable machines that are connected to a blood pressure cuff worn by patients…. that record blood pressure at regular periods over 24 to 48 hours while the patient goes about their normal activities..including sleep. The recording is interpreted by a physician or non-physician practitioner….and appropriate action is taken based on the findings. Diagnosis and treatment of high blood pressure is important for the management of various conditions…. including cardiovascular disease and kidney disease.   Ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension in Medicare beneficiaries is covered under the following circumstances: For beneficiaries with suspected “white coat hypertension,” which is defined as an average office blood pressure of systolic blood pressure greater than 130 mm … but less than 160 mm … or diastolic blood pressure greater than 80… but less than 100… on two separate clinic/office visits …..with at least two separate measurements made at each visit and with at least two blood pressure measurements taken outside the office which are 140/90 on at least three separate clinic/office visits with two separate measurements made at each visit; At least two documented blood pressure measurements taken outside the office which are

Hey Medicare Nation! www.TheMedicareNation.com Today, I'm discussing how the Centers for Medicare & Medicaid Services (CMS) SLAPPED Agewell New York LLC with a Civil Money Penalty of $39,200! CMS conducts audits to ensure Medicare Advantage Prescription Drug Plans are following conditions of the current contract as well as Medicare rules & regulations.  From March 9, 2018 through May 15, 2018, CMS Conducted an audit of Agewell's 2016 Medicare financial information. In a financial audit report issued on September 20, 2018, CMS auditors reported that Agewell failed to comply with Medicare requirements related to Part C (Medicare Advantage) cost sharing. Specifically, auditors found that in 2016 Agewell failed to comply with cost-sharing requirements by charging "incorrect" co-payments to enrollees for medical services. Enrollees were affected in the following area: Bronx, NY; Kings County Brooklyn, NY; Nassua County, NY, Manhattan, Queens and Westchester County, NY. Agewell's failure was "systemic," and "adversely affected" enrollees or the substantial likelihood of adversely affecting enrollees because they experienced out-of-pocket costs. CMS determined that Agewell was charging a $30 "specialist" co-pay was applied to "primary care physician" claims instead of a $0 co-pay as stated in the plan's Explanation of Coverage. Enrollees were NOT Refunded the overcharged amounts until AFTER the financial audit concluded, which was 2 years after the incurred cost. In 2016, If you paid a $30 co-pay to see YOUR Primary Physician, when you were only obligated to pay $0,  you should contact Agewell at 888-586-8044 and ask to speak to a supervisor, regarding the CMS penalty. Advise the supervisor of the date & time of your appointment with your Primary Doctor and that you have proof of a payment that you made of $30 for your visit. Advise the supervisor that you would like to be refunded the $30 immediately.  Write down the name of the supervisor, the date & time you called Agewell and what the supervisor stated Agewell would do for you. If you donot receive your refund within 14 business days, call Medicare directly at 800-633-4227 and advise Medicare of the situation. If you have any "complaints" regarding the way you were treated by any representative at Agewell, you can make an annonymous complaint to Agewell's confidential hotline - 888-336-7240. You can also make a complaint to Medicare directly by calling 800-633-4227. If you have a complaint, regarding any physician or facility in the Agewell network, you can call the Agewell confidential hotline to make your complaint - 888-336-7240. If you are uncomfortable making a formal complaint and you would like assistance with your complaint you can : 1. contact the Insurance Agent or Medicare Specialist who enrolled you into the Agewell plan  or 2. contact your local "SHIP" (State Health Insurance & Assistance Program) representative by "clicking" on your State here - https://www.shiptacenter.org/ when the page opens, go all the way to the bottom of the page and you'll see an "orange" button that reads - Find Your Local SHIP "Click" on that ORANGE buton and a list will come up of all 50 States. "Click" on the State where you reside, to contact your local SHIP center. If YOU need help with finding the Medicare Advantage Plan that is right for your UNIQUE needs, contact me at either: Support@TheMedicareNation.com or  call me at 855-855-7266 If I can answer your question in ONE paragraph in an email, I will directly answer your question! If it takes more than one paragraph to answer your question or I need to do research to answer your question....then....I will respond by advising you that you will need to contact me and request my consultative services.  I currently charge $199.00 an hour, and I consult with Medicare beneficiaries and the Adult Children of beneficiaries ALL over the country! Please SUBSCRIBE to Medicare Nation so that you will receive EVERY NEW episode that is published! Give Medicare Nation a ***** 5-Star Review on iTunes! The more reviews we get, the more people can find the show! Go to www.itunes.com and type MEDICARE NATION in the search bar. When the page opens, "Click" on the Review tab and leave your review! Thanks so much for listening! If you'd like to hear about a specific topic on the show or you'd like a specific guest on the show...... send me an email to Support@TheMedicareNation.com I appreciate your Support! Diane Daniels  

Multi Target Stool DNA Test  vs. Fecal Occult Blood Test  Hey Medicare Nation! www.TheMedicareNation.com Have you subscribed to Medicare Nation? Don’t know how? If you have an Apple iPhone……. Click on the “Purple” icon…. With the white microphone. When the page opens….Click on SEARCH. Type in Medicare. Medicare Nation comes right up… WHY……BECAUSE….. it’s a TOP 100 APPLE PODCAST Nation! Click on that Beautiful Flag “Medicare Nation” Logo. When the page opens….Click on the SUBSCRIBE button! That’s it. You’ll get the latest information on Medicare and you can search through the almost 100 episodes on Medicare Information! Are Your Parents subscribed to Medicare Nation? Come On “Sandwich Generation” Show your parents HOW to Subscribe to Medicare Nation! Once they subscribe…. They will STOP asking you questions about Medicare, because they WILL Find the answer by listening to Medicare Nation episodes! Let’s give YOU back some time…. So that YOU can have more time for yourself   Today…..I’m going to be talking to you about the Differences Between Multi Target Stool DNA Test  vs. Fecal Occult Blood Test Medicare offers these Preventative Tests to determine if you have blood in your stool and/or suspected cancerous characteristics. ColoRectal  cancer (CRC) is the second most frequent cause of cancer DEATH in the United States.  The Most Frequent Cause of Cancer Death is…… Lung Cancer. This year, an estimated 145,600 adults in the United States will be diagnosed with colorectal cancer. According to Cancer.net…… an estimated 51,020 of the 145,600 adults will die this year…..due to ColoRectal Cancer. When colorectal cancer is found early, it can often be cured. CURED Nation! This is due to improvements in treatment and increased screening….. which finds colorectal changes before they turn cancerous and cancer at earlier stages. Medicare Part B offers TWO Preventative Screening Tests The First…. Is a Fecal Occult Blood Test “Fecal Occult” Blood Test is just a scary way of saying….. “ Looking for Blood in your Poop.”  The test ONLY detects the “presence” or “absence” of blood in your stool. The test does not indicate potential sources of bleeding and it does not “Diagnos” disease. “Fecal” means……“Stool” or “Poop”….and…. “Occult Blood” means you can’t see the blood in your stool with the “naked eye,” so….. the specimen is sent to the lab for a closer look. Blood in the stool may indicate polyps…. or it may indicate cancer in the intestine or rectum….though not all cancers or polyps bleed. If blood is detected through the “Fecal Occult Blood Test,” additional tests may be needed to determine the source of bleeding as well as “diagnosing” an ailment or disease. Blood in the stool could also mean Hemorrhoids….which are swollen veins in the lowest part of your rectum and anus. Sometimes the walls of these blood vessels stretch so thin….. that the veins bulge and get irritated, especially when you poop! Straining while pooping is a major factor in Hemorrhoids.  EAT more Fiber Nation! Eat More Vegetables….try Metamucil or Miralax. Straining to poop is not good. Drink more water! You should try to drink at least 96 oz. a day. I use a 24oz bottle I fill 4 x a day….. to get my 96 oz of water. You can do it. It’s important. Hemorrhoids can cause itching & pain.  Hemorrhoids can also bleed. There are several types of Fecal Occult Blood Tests, I’m going to discuss the “newer version,” which is called a “ Immunochemical Fecal Occult Blood Test,” (aka iFOBT or FIT) The IFOBT or FIT test is less of a mess and easy to administer. Typically, you have a “spoon-like” device to collect the sample of stool and you place the device into a collection container then seal it. You either return the collection container to your doctor’s office, or you mail it. There are no dietary restriction with the iFOB-IT and the test can be performed on any random sample of your stool. Your Doctor will review the results and there are just two options: Negative Result, which means no blood was detected in the stool sample you provided. OR…….. Positive Result, which means blood WAS detected in the stool sample you provided.   This type of test ISN’T ALWAYS accurate. Your fecal occult blood test could show a negative test result when cancer is present (false-negative result) if your cancer or polyps don't bleed. If you had the test to screen for colon cancer and you're at average risk — you have no colon cancer risk factors other than age — your doctor may recommend waiting one year and then repeating the test.  If you have a “positive result,” You may need additional testing — such as a colonoscopy — to locate the source of the bleeding. Under Medicare…… The Fecal Occult Blood Test…. can be given ONCE every 12 months if you’re 50 or older, at ZERO Cost to you.        Now….. let’s take a look at Mult-Target Stool DNA Tests. You will know the “Multi-Target Stool DNA Test” more commonly known as “ColoGuard.” ColoGuard …….   addresses several barriers to colorectal screening. Patient concerns with colonoscopy. Include…having to schedule a separate and lengthy appointment at the testing facility. The need to undergo a “Stay Close to my Bathroom” bowel preparation the exposure to sedation or anesthesia……and the discomfort associated with an invasive imaging process…. Of sticking either the “colono-scope” during a colonoscopy or a flexible sigmoud device up your butt.   By comparison, the “Multi Target Stool DNA” screening test is a noninvasive, “multi-marker”, stool-based ColoRectal Cancer screening test….. that detects altered De-oxyribo-nucleic Acid (DNA), , as well as a fecal immunochemical test (FIT)… for blood released from cancer and precancerous lesions of the colon. The presence of fecal hemoglobin….. even in the absence of elevated DNA markers…..can lead to a positive result given the weighted nature of the Multi Target Stool DNA algorithm. Patients may collect and mail stool specimens from their homes with no bowel preparations and no dietary or medication restrictions.   Medicare covers this at-home multi-target stool DNA lab test…. once every 3 years…if you meet ALL of these conditions:   You’re  between the age of  50-85. You show NO CURRENT symptoms of colorectal disease including, but not limited to one of these: Lower gastrointestinal pain Blood in stool Positive Guaiac fecal occult blood test….which is an older version of the Immunochemical Test… where you “smear” stool onto a TEST Card with a wooden applicator or brush. The Guaiac test has dietary restrictions and you are required to collect “TWO” or more samples from the same Stool Sample for the test. Much Messier than the Immunochemical Fecal Blood Occult Test. OR…… A Positive Result from a Fecal Blood Occult Test ALSO    YOU NEED TO BE….. at average risk for developing colorectal cancer, meaning: You have no personal history of  (adenomateous ) polyps”  which are …..  a common type of polyp. They are gland-like growths that develop on the mucous membrane that lines the large intestine. They are also called adenomas: You have no personal history of  … colorectal cancer, or inflammatory bowel disease, including Crohn’s Disease and ulcerative colitis. OR…… You have no family history of colorectal cancers or adenomatous polyps, familial adenomatous polyposis, or hereditary nonpolyposis colorectal cancer.   If you meet the above criteria….. You pay nothing for this test if your doctor…. or other qualified health care provider accepts Medicare.   So that’s the difference between Multi Target Stool DNA Tests vs. Fecal Occult Blood Test.   If you haven’t had one of these preventative tests, speak to your primary doctor and get one. It could very well SAVE YOUR LIFE!   If you have any questions about Medicare…. Send me an email to – Support@TheMedicareNation.com   I answer ALL my emails. As long as I can answer your question in a paragraph, I’ll answer your question. If my response involves any research or it will take more than one paragraph to answer you….. I’ll send you a suggestion to hire me as your Medicare Consultant.   I charge $199.00 an hour. I’m one of the TOP Medicare Experts in the Country Nation…… I could easily command $400 or $500 an hour, but I CARE about each and every one of you! My time is extremely valuable and I want to help as many of you as I can with your Medicare problems and Medicare Plan Comparisons.   Also…..if you’d like to have me speak about Medicare … go to the website…  www.TheMedicareNation.com and click on the Contact tab and send me your information. I’ve already started booking speaking engagements for the Annual Enrollment Period…. Starting in October…so contact me now to schedule me for your corporation or event.   Thanks for listening to Medicare Nation! I appreciate your loyalty and referrals. Until next time…. I want YOU to have a Peaceful, Happy & Prosperous Week!   Diane            

Hey Medicare Nation! www.TheMedicareNation.com I'm not an expert on Reverse Mortgages......in fact, I don't know much about them. I have heard about Reverse Mortgages on commercials, in newspapers and on FaceBook feeds. I never had the need to learn about Reverse Mortgages, so...... I never did......until...... a client asked me about them. When a client asks me a question about Medicare..... I know the answer. I'm a Medicare Expert....I'm in the business of knowing as much as I can about Medicare.  Because my clients trust me with their Medicare needs and concerns, they ask me all kinds of questions. When I know the answer.... I tell them. When I don't know the answer..... I get the answer for them! So....when my client asked me about Reverse Mortgages.... I started reading about them. When I was introduced to Michael Banner, President of Professional Mortgage Alliance, LLC, I had many, many questions. Michael Banner was very patient and answered every question I had..... truthfully. An hour and a half later..... I had a much better idea about reverse mortgages, and I invited Michael Banner to come onto The Medicare Nation Podcast to share his knowledge with our Medicare Beneficiaries and Sandwich Generation! Here are the highlights of my interview with Michael Banner: * What is a Reverse Mortgage? *  Do I pay a higher intersest rate with a Reverse Mortgage? *  If I "Will" my home to my children.... what happens to the      Reverse Mortgage? *  What is a Non-Recourse Loan? * What does it mean if the value of my house is "upside              down?" *  What is No-Debt Service? *  Is a Reverse Mortgage Safe? *  If a person leaves the home to live in an assisted living          facility, what happens to the Reverse Mortgage? *  Can a person "out live" a Reverse Mortgage? * What are the "5 Ways" payments are made with a Reverse     Mortgage? Want to learn more about Reverse Mortgages? Reach out to Michael Banner at : MBanner@PMAnow.com Website for Professional Mortgage Alliance, LLC Professional Mortgage Alliance Michael Banner's Phone Number -  (727) 224 - 3859 Where to purchase Michael Banner's Book - MBanner@PMAnow.com   The 62 Who Knew Show www.WeBeamTV.com   Have Questions About Medicare? Send me an email to - Support@TheMedicareNation.com If you'd like to hire me as a Medicare Consultant, starting  June 1, 2019.... my rate is $199.00 an hour.  Contact me by either email at .... Support@TheMedicareNation.com or ... call me ..... 855 - 855 - 7266. Thanks for listening to Medicare Nation! SUBSCRIBE to Medicare Nation and get the latest episodes delivered to you! Give us a Rating & Review on iTunes! This helps others find Medicare Nation so that they can have their Medicare questions answered too! www.TheMedicareNation.com Until next time.... have a happy, peaceful & prosperous week! Diane Daniels

Hey Medicare Nation! www.TheMedicareNation.com On the Last episode.....I spoke to you about Medicare Supplement Plan "F" and High Deductible Plan F. Today....I'm going to talk about Medicare Supplement Plan "G" and Plan "N" Plan "G" allows you to "purchase" an insurance policy, where you pay a monthly premium to the carrier...... in return...... Medicare Supplement Plan G, will pay ALL your Medically necessary out-of-pocket deductibles, co-insurance and co-pays...... EXCEPT for ..... The Annual Part B Deductible. YOU will be responsible for the Annual Part B deductible each year. Currently.... in 2019, the Annual Part B Deductible is $185.00. So..... when you seek medical care in the beginning of the year.... you will pay out-of-pocket until you hit the $185.00 Part B Deductible. After you pay the $185.00 Part B Deductible....you will NOT be responsible for ANY other deductibles, co-pays or co-insurance under Medicare Supplement Plan G, that are medically necessary under Medicare. Plan "N" allows you to "purchase" an insurance policy, where you pay a monthly premium to the carrier...... in return...... Medicare Supplement Plan N, will pay ALL your Medically necessary out-of-pocket deductibles, co-insurance and co-pays...... EXCEPT for ..... 1. The Annual Part B Deductible ($185.00 in 2019) 2. A co-pay of up to $20.00 for each doctor visit. 3. A co-pay of $50.00 if you go to the Emergency Room and you are "Discharged" from the Emergency Room. If you are "admitted" to the hospital from the ER... you will NOT incur a $50.00 co-pay. If you have paid all of your Part B Deductible, you will have NO other out-of-pocket costs while you are an inpatient in the hospital. 4. If you seek treatment, testing or diagnostic testing from a physician or facility that does NOT accept Medicare, you WILL be responsible for 100% of the cost of that service. The provider or facility can legally charge you 15% above and beyond the Medicare Allowable charge. It is vital that you always ask prior to receiving care, a test or doctor visit....if the physician or facility "accepts Medicare."  If they do.....your charges are outlined above. If they do not accept Medicare..... you may be responsible for ALL of the charges, up to 15% of the Medicare Allowable charge. ASK BEFORE YOU SEE A DR or RECEIVE TREATMENT! Prices for Medicare Supplements VARY by zipcode! Get quotes from MANY different insurance carriers prior to enrolling in a plan. You could save hundreds....sometimes over a thousand dollars a year! HAVE a Question for ME? Send it to me at  Support@TheMedicareNation.com I will answer ALL emails I receive.... personally! If the answer to your question will take me more than 1 paragraph to answer... or .... it is necessary to do some research for you in order to answer the question.... I will respond and advise you to hire me as your consultant. Many of your questions may be answered on the official Medicare website - www.Medicare.gov Always do YOUR Due Dilligence before you enroll in a Medicare Plan! Consider leaving a review & rating on the Medicare Nation Podcast page in iTunes.  http://nation.reviews/medicare8   Thanks for listening to Medicare Nation! Show your Parents how to "Subscribe" to Medicare Nation. With over 100 episodes... most of their questions will be answered by listening to my episodes. This way... your parents are NOT bothering YOU for information about Medicare! Enjoy time for yourself and your family! Teach people how to "subscribe" to Medicare Nation! YOU will be responsible for the Annual Part B deductible each year.

Hey Medicare Nation! www.TheMedicareNation.com It's almost Spring time! For many people, this has been a terrible winter. Many Medicare Nation listeners have been emailing me to find out if Medicare covers "Emergencies" while traveling across the U.S. or abroad. That's a great question! Original Medicare and Medicare Advantage Plans Do cover "Emergency Care" AND  Urgent Care ANYWHERE in the United States and it's Territories. An "Emergency" is Life-Threatening. An example would be if you were having chest pain and you believed you were having a heart attack. In this situation.....you would go to the nearest hospital to seek emergency care. Even if it turns out you were diagnosed with "heart burn," Original Medicare AND Medicare Advantage plans will cover the medically necessary treatment for this situation because you believed you were in a "life-threatening" situation.  "Urgent Care" is defined by Medicare as: Care that you get outside of your Medicare health plan's service area for a sudden illness or injury that needs medical care right away but isn’t life threatening. If it’s not safe to wait until you get home to get care from a plan doctor, the health plan must pay for the care. An "Urgent Care" example would be if you were walking in St. Peter's Square at the Vatican, and you slipped on a banana peel and fell onto the ground, breaking your ankle. That's an injury that isn't life threatening, but requires immediate medical care. So......if you are traveling ANYWHERE in the U.S. or it's Territories, AND you have an Urgent Care or Emergency situation.....you can go to the nearest hospital or Urgent Care Center to receive care AND it will be covered by Original Medicare and Medicare Advantage Plans. If you are traveling outside of the U.S. Medicare generally DOES NOT cover emergencies or urgent care needs. There are a few circumstances where Original Medicare WILL cover Emergency Care AND Urgent Care. www.TheMedicareNation.com 1.  If you are on a CRUISE and you require EMERGENCY care from a doctor who is stationed on the ship while the ship is in a U.S. port.....Your Emergency Care WILL be covered by Original Medicare. 2. If the ship is Departing or Arriving to/from a U.S. port within 6 hours and you have a medical emergency and require to be treated by the ship's doctor......Your Emergency Care will be covered by Original Medicare. 3. If you are in Alaska and you are traveling directly to another State without unreasonable delay, and you require Emergency Care at a hospital in Canada, because it was the closest hospital at the time of the emergency......Your Emergency Care will be covered by Original Medicare. If you have a "Medicare Advantage Plan," you may have coverage for Emergency and/or Urgent Care Coverage on your plan. You must do your own due dilligence to understand the benefits of your plan while you are traveling abroad. Some Medicare Advantage Plans have a deductible for emergency care outside the U.S. Some Medicare Advantage Plans have a deductible and a co-pay for emergency care outside the U.S. There is an annual maximum out-of-pocket amount for your plan. Some are around $1,500.00 all the way up to $6,700.00  READ Your Plan's EVIDENCE OF COVERAGE Booklet. Some of you have "Medi-Gap" or Supplement to Original Medicare Plans. Plans "C" through "G" and also plan "M" and "N" have coverage for Emergency Care while traveling abroad. Some Medi-Gap plans have a deductible. Some plans have "Maximum Lifetime Amounts." It is important to READ your Medi-Gap Policy to determine coverage while traveling abroad. Travel Insurance www.TheMedicareNation.com   I always recommend purchasing "Travel Insurance," while traveling abroad. I use these different websites to look for policies: 1. www.TravelGuard.com 2. www.AllianzTravelInsurance.com 3. www.TravelInsurance.com Cost will depend on - a. Total Cost of the Trip b. Your Age c. What country you're visiting d. Types of coverage you're adding (ex: Air evacuation, cancel for any reason etc.) If you have ANY questions, and I can answer your question in ONE paragrapn, send them to me by email. Support@TheMedicareNation.com If I need to do research or write more than one paragraph, I will let you know that I am available for a consultation to solve your problem at $150.00 an hour. Reach out to me.....I answer all emails personally! Thanks soo much for listening to Medicare Nation! I appreciate your time and I love to educate you on all things Medicare! Diane Daniels    

Hey Medicare Nation! htpps://www.TheMedicareNation.com   Today, I'm going to speak with you about the Medicare Advantage Open Enrollment Period. CMS...Centers For Medicare & Medicaid Services has issued a new regulation that began January 1, 2019. Under 42 CFR 422.62(a)(3)....CMS published the following: During the MA OEP, MA plan enrolles may enroll in another MA plan or disenroll from their MA plan and return to Original Medicare. Individuals may make only one election during the MA OEP. Who can use the Medicare Advantage Open Enrollment Period? 1. Individuals enrolled in Medicare Advantage plans as of January 1. 2. New Medicare beneficiaries who are enrolled in an Medicare Advantage plan during their Initial enrollment into Medicare       a. The month of entitlement to Part A and Part B up until the last day of the 3rd month...after the month of their entitlement to Part A and Part B. Can Medicare Advantage beneficiaries add or drop their Part D coverage during the Medicare Advantage Open Enrollment Period? Yes. Individuals who are already enrolled in a Medicare Advantage Plan with Prescription Drug Coverage can switch to: a. Another Medicare Advantage Prescription Drug Plan b. A Medicare Advantage Plan ONLY (with NO prescription drug coverage) c. Go back to "Original Medicare" and add a stand-alone prescription drug plan or don't add one. d. Go back to "Original Medicare" and add a Supplement to Original Medicare Plan.     How long is the Medicare Advantage Open Enrollment Period? It runs from January 1st through March 31st each year.   How many times may a Medicare Beneficiary change Medicare Advantage Plans during the MA OEP? A Medicare Beneficiary may make only ONE change during the MA OEP.   If you have ANY questions regarding the MA OEP.... and you would like me to answer it in ONE paragraph, send me an email to  Support@TheMedicareNation.com I ALWAYS answer emails if I can answer them in ONE paragraph. If I can not answer your question in one paragraph, you may hire me and I charge $150.00 hr. I can answer ANY question about Medicare and I can solve ANY problem you have with Medicare. Looking for more information on Medicare? Go to www.TheMedicareNation.com  website. Looking for a SPEAKER at your conference or event? Just click on the "Contact" tab on the website.   Thank you so much for listening to Medicare Nation. I appreciate it very much! If you feel I'm delivering important content, I would love it if you would leave a rating & review on the Apple Podcasts review page (formerly iTunes). Until next time Nation.....I want each of you to have a Happy, Peaceful and Prosperous week! Diane Daniels

Hey Medicare Nation! I have a special show for you today. The FDA has issued a "Voluntary Recall" on Westminster Pharmaceuticals of all lots of their Levothyroxine and Liothyronine (Thyroid Tablets). Westminster Pharmaceuticals, LLC, which has its Corporate HQ in Tampa, Florida, is voluntarily recalling all lots, within the expiration date, of Levo-thyroxine and Lio-thyronine (Thyroid Tablets) dosages of 15 mg, 30 mg, 60 mg, 90 mg, & 120 mg up to the wholesale level. These products are being recalled by Westminster Pharmaceuticals as a precaution, because they were manufactured using active pharmaceutical ingredients that were sourced, prior to the FDA’s “Import Alert”  of Sichuan Friendly Pharmaceutical Co., Ltd., which is out of China.   The Recall comes as a result of a 2017 inspection where deficiencies were found with “Current Good Manufacturing Practices” (cGMP). Substandard cGMP practices…..could represent……the possibility of risk….. being introduced into the manufacturing process. To date, Westminster Pharmaceuticals has not received any reports of adverse events related to this product. Levothyroxine and Liothyronine (thyroid tablets, USP) for oral use is a natural preparation derived from porcine thyroid glands. Thyroid tablets contain both tetra-io-do-thyronine sodium (T4 levothyroxine) and lio-thy-ronine sodium (T3 liothyronine). Levothyroxine and Liothyronine tablets (thyroid tablets, USP) are indicated as replacement or  supplemental therapy in patients with hypothyroidism. Because these products may be used in the treatment of serious medical conditions, patients taking the recalled medicines should continue taking their medicine until they have a replacement product. According to the U.S. Food & Drug Administration Report..... [8/17/2018] FDA is alerting active pharmaceutical ingredient (API) repackagers and distributors, finished drug manufacturers, and compounders that Sichuan Friendly Pharmaceutical Co. Limited, China, is recalling certain lots of porcine thyroid API due to inconsistent quality of the API. FDA recommends that manufacturers and compounders not use Sichuan Friendly’s porcine thyroid API received since August 2015. This thyroid API comes from porcine (pig) thyroid glands and is used to make a non-FDA approved  drug product, composed of levothyroxine and liothyronine, to treat hypothyroidism (underactive thyroid). FDA laboratory testing confirmed the Sichuan Friendly API has inconsistent levels of the active ingredients – levothyroxine and liothyronine – and should not be used to manufacture or compound drugs for patient use. Risks associated with over or under treatment of hypothyroidism could result in permanent or life-threatening adverse health consequences. These lots were distributed nationwide in the USA to Westminster’s direct accounts. These lots were distributed nationwide in the USA  NDC Product Lot Expiration 69367-159-04 Levothyroxine and Liothyronine (Thyroid Tablets, USP) 15mg X 100ct 15918VP03 2/29/2020 15918VP02 2/29/2020 15918VP01 2/29/2020 15918007 3/31/2020 15918006 3/31/2020 15918005 2/29/2020 15918004 12/31/2019 15918003 12/31/2019 15918002 12/31/2019 15918001 12/31/2019 15917VP03 10/31/2019 15917VP02 10/31/2019 15917VP01 10/31/2019 69367-155-04 Levothyroxine and Liothyronine (Thyroid Tablets, USP) 30mg X 100ct 15517VP01 8/31/2019 15517VP02 8/31/2019 15517VP03 8/31/2019 15518001 12/31/2019 15518002 3/31/2020 69367-156-04 Levothyroxine and Liothyronine (Thyroid Tablets, USP) 60mg X 100ct 15618011 3/31/2020 15618009 2/29/2020 15618008 2/29/2020 15618004 12/31/2019 15618002 12/31/2019 15617VP06 11/30/2019 15617VP05 11/30/2019 15617VP04 12/31/2019 15617VP03 7/31/2019 15617VP01 7/31/2019 15617VP-02 7/31/2019 69367-157-04 Levothyroxine and Liothyronine (Thyroid Tablets, USP) 90mg X 100ct 15717VP-01 7/31/2019 15717VP-02 7/31/2019 15717VP-03 7/31/2019 15718004 3/31/2020 15717002 12/31/2019 69367-158-04 Levothyroxine and Liothyronine (Thyroid Tablets, USP) 120mg X 100ct 15817VP-01 9/30/2019 15817VP-02 9/30/2019 15817VP-03 9/30/2019 15818001 3/31/2020 Westminster is notifying its direct accounts by email and by phone to immediately discontinue distribution of the product being recalled. The FDA Advises Consumers who have the recalled products, should not discontinue use before contacting their physician for further guidance. There are several manufacturers who make “generic” Levothyroxine and Liothyronine (thyroid tablets) that your doctor can give you a new prescription for.  Call the Pharmacy where you receive your Levothyroxine or Liothyronine, and ask the pharmacist who the manufacturer of their supply is. They should be able to easily tell you that. Customers and patients with medical-related questions, information about an adverse event or other questions about the Westminster’s product’s being recalled……. should contact Westminster’s Regulatory Affairs department by phone at: 888-354-9939 ….. Live calls are received Monday-Friday, 9:00AM - 5:00PM EST with voicemail available 24 hours/day, 7 days/week or you can send an email to  recalls@wprx.com. Adverse reactions or quality problems experienced with the use of this product may be reported to the FDA's MedWatch Adverse Event Reporting program either online…..by regular mail……or by fax. To Complete and submit the report Online…....just “click” on the link & it will take you directly to the FDA MedWatch Page. FDA Med Watch Page   If you’d like to report Adverse Reactions or quality problems by Mail or Fax: Download form www.fda.gov/MedWatch/getforms.htm  Med Watch Reporting Form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form……or…….submit by Fax to 1-800-FDA- 0178   It’s almost the Annual Enrollment Period! Beginning Monday, October 15th through Friday, December 7th, many of you will be able to switch Medicare Advantage Plans, Switch Medicare Prescription Drug Plans or return to Original Medicare, with the majority of you having NEW effective dates of January 1, 2019. There are MANY Changes coming to Medicare for 2019, so I will be busy Posting Changes for you Starting the Week of October 1st. Medicare Nation, will be going back to a “weekly” episode during the Annual Enrollment Period, so that I can bring to you the most up-to-date information I can. Remember, I am here to answer ANY Medicare question you have, as long as I can answer your question in ONE paragraph. If I need to “research” anything or…..if it takes me more than one paragraph to answer your question, I will advise you that you can contact me to help you with your Medicare needs by hiring me to “consult” with you about your Medicare needs. Many of you contacted me last Medicare Annual Enrollment Period for consultations and I am here again to assist you or your parent’s Medicare Questions or concerns. Need help choosing a Medicare Advantage Plan or Prescription Drug Plan where you live? I can help you with that. Need help comparing your employer insurance plan benefits to a Medicare plan? I can help you with that too. Contact me by email at Support@TheMedicareNation.com or call the toll free number 855-855-7266 and tell me how I can help you with your Medicare Needs.   If you like Medicare Nation, I’d love for you to give Medicare Nation an honest Rating and Review on Apple Podcasts.   How to leave an iTunes rating or review for a podcast from your iPhone or iPad Launch Apple's Podcast Tap the Search Enter Medicare Nation in the search field. Tap the blue Searchkey at the bottom right. Tap the album art for Medicare Nation. Tap the Reviews Tap Write a Reviewat the bottom. Enter your iTunes passwordto login. Tap the Starsto leave a rating. Enter title text and content to leave a review. Tap Send.   If you have an ANDROID phone…..open up your “Stitcher” App or Download the Stitcher App from your Google Play App. OR……just go to ……. subscribe on Android.com When the page opens, just type in Medicare Nation into the field. Hit enter and voila! Click on the Medicare Nation Full LOGO and “click” Subscribe on Android. That’s it! Folks You now will receive my up to date Medicare Weekly episode to get you through the AEP   Thanks for listening to Medicare Nation! I appreciate it. Until next time….I want each of you to have a …..Happy, Healthy and Prosperous Week!      

Hey Medicare Nation! Medicare Nation The topic of Medical Marijuana is BOOMING! I had to bring back Dr. Rachna Patel to update us on what's going on in the Medical Marijuana Community. Currently, there are 9 States, plus the District of Columbia (DC), that have "Legalized" the "Recreational" use of Marijuana. The 9 States are: 1. Alaska 2. California 3. Colorado 4. D.C. 5. Massachusetts 6. Nevada 7. Oregon 8. Vermont 9. Washington Twenty-Nine (29) States, have Legalized Medical Marijuana usage. The 29 States are: 1. Alaska 2. Arizona 3. Arkansas 4. California 5. Colorado 6. Connecticut 7. Delaware 8. Florida 9. Hawaii 10. Illinois 11. Maine 12. Maryland 13. Massachusetts 14. Michigan 15. Minnesota 16. Montana 17. Nevada 18. New Hampshire 19. New Jersey 20. New Mexico 21. New York 22. North Dakota 23. Ohio 24. Oregon 25. Pennsylvania 26. Rhode Island 27. Vermont 28. Washington 29. Washington D.C. 30. West Virginia   Dr. Patel commonly treats patient with the following conditions for Medical Marijuana: 1.  Chronic Pain - especially patients with Fibromyalgia, Arthrittis, Back Pain, Migraines, Neuropothy 2. Anxiety 3. Insomnia Dr. Patel is consulting with patients across the U.S. to help guide patients step-by-step on the usage of Medical Marijuana. You can reach Dr. Patel by going to her website, www.drrachnapatel.com You can also go to her Facebook page, Facebook.com/DoctorRachnaPatel Here's her YouTube Channel with GREAT videos! The Medical Marijuana Expert - Dr. Rachna Patel Thanks for listening to Medicare Nation! If you find my content interesting, please give us a Review on Apple Podcasts!  

Hey Medicare Nation! The Center For Medicare & Medicaid Services has finally announced 2018 Premiums and deductibles for Part A & Part B of Medicare. Just as I had anticipated...... CMS has increased the Part B premium in 2018. A hefty amount....I might add. The 2018 Part B Premium for 2018 will be $134.00. Over 50 Million Medicare beneficiaries were protected by the "held harmless" regulation in 2017. Those Medicare beneficiaries did not see an increase in their Part B Premium for 2017, since the Part B Premium increase of $134.00 was higher than the Social Security COLA (Cost of Living Adjustment) of .3%. When Social Security approved a 2% COLA (Cost of Living Adjustment) for 2018, that gave Medicare the "go ahead" to increase the Part B premium.  As long as the Medicare Part B Premium is equal to or less than the Social Security COLA adjustment, the Part B Premium increase will go into effect.  Such is the case for 2018. With a 2% COLA increase in Social Security benefits, the majority of Social Security beneficiaries will see an increase of about $24-$25 in their Social Security benefit checks. Those same Social Security beneficiaries, make up about 70% of the Medicare population. CMS planned this out perfectly! The majority of Medicare beneficiaries that make up the same 70%, currently pay about $109.00 for their Medicare Part B Premium. If you add $25 to $109.00, you get........ $134.00! CMS adjusted the amount to become $134.00, to be aligned with the remaining 30% of Medicare beneficiaries, who currently already pay $134.00 for their Part B Premium. Now the majority of Medicare beneficiaries will be paying $134.00 a month for their Part B Premium in 2018. It's not rocket science people. Medicare needs more money to stay solvent.  When you take over 50 million people and add $25 a month in premiums.....that equates to BILLIONS of dollars A MONTH! Let's look at the remaining 2018 Deductibles: Part A Hospital Deductible - $1,340.00 per benefit period.  In English.....that means you pay $1,340.00 each time you are admitted to the hospital as an inpatient. Whether you are an inpatient for one day or sixty days, you will pay a $1,340.00 deductible. That's an increase of $24.00 from 2017. If you need to remain in the hospital for over 60 consecutive days, you will pay $335.00 per day from days 61-90 of a hospitalization. If you require more than 90 consecutive days in a hospital, you can use your "lifetime reserve" days. You are given 60 lifetime reserve days. When you use a lifetime reserve day....it's gone....forever.  Let's say you have a piggy bank that has 60 pennies in it. If you break open the piggy bank and take 1 penny out to use....you have 59 left in the bank. Works the same way for lifetime reserve days. Each lifetime reserve day you use, will cost you $670 per lifetime reserve day in 2018. An increase of $12. from 2017. Skilled Nursing Facility Medicare allows up to 100 consecutive days in a Skilled Nursing Facility. Days 1-20 as a inpatient in a Skilled Nursing Facility will cost you $0. Days 21-100 of extended care services in a Skilled Nursing Facility in the same benefit period will have a co-pay of $167.50 per day. If you require more than 100 consecutive days in a Skilled Nursing Facility, you are responsible for 100% of the charges.   Part B of Medicare Aside from paying $134.00 a month for being a "member" of Medicare Part B, you will also have out-of-pocket costs when you use outpatient services. The annual deductible for Part B in 2018 will be $183.00. That is the same amount as 2017. There will be on increase in the Part B deductible. Once you pay your Part B deductible, you will be responsible for 20% of the remaining Medicare allowable charge....under Original Medicare. Let's say you had to visit a Cardiologist and the Medicare allowable charge was $100.00 Medicare would pay 80% of the $100.00 and you would pay the remaining 20%. So....Medicare pays $80 and you would pay $20. You will continue to pay 20% of all Medicare allowable charges under Part B.   Advocacy Groups For Medicare Here are some national advocacy groups, fighting for your rights under Medicare, Medicaid and Social Security. Help the cause by volunteering or donating a few bucks to ensure the fight for your rights continue. National Committee to Preserve Social Security & Medicare   The National Committee is dedicated to protecting Social Security and Medicare benefits for all communities and generations.   Center For Medicare Advocacy   The Center for Medicare Advocacy’s mission is to advance access to comprehensive Medicare coverage and quality health care for older people and people with disabilities by providing exceptional legal analysis, education, and advocacy.   State Health Insurance Program   provide free, in depth, one-on-one insurance counseling and assistance to Medicare beneficiaries, their families, friends, and caregivers. SHIPs operate in all 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands, and are grant-funded projects of the federal U.S. Department of Health and Human Services (HHS), U.S. Administration for Community Living (ACL).     Consulting During Medicare Annual Enrollment   If you would like to hire me as a consultant to assist you in comparing Medicare Plans or employer coverage, I am available to assist you.   Send me an email to Support@TheMedicareNation.com and send me your information and how I can assist you.   You can also go to the website - www.TheMedicareNation.com and "click" on the contact tab.   I am also available as a professional speaker or emcee for your event.   Thank you for listening to Medicare Nation!   I appreciate your support!   Diane Daniels  

2018 Medicare Part D Prescription Drug Cost Sharing It's October folks! Medicare season has begun! As of October 1st, licensed health insurance agents may begin speaking about 2018 Medicare Advantage Plans and stand-alone prescription drug plans. If you have a relationship with a licensed health insurance agent, Medicare Specialist or Medicare Consultant, they will more than likely start contacting you about your current plan. This is the time to discuss your concerns with your Medicare Specialist. You need to determine if all your prescription drugs are listed in the plan's 2018 formulary.  You also need to determine what your 2018 monthly costs will be for all your prescription medications. Ask yourself......."Have my out-of-pocket prescription drugs costs remained feasible on my current plan for 2018?" If so..... that's great! If not, it may be time to take a look at a new stand-alone-prescription drug plan. If you're on a Medicare Advantage Drug Plan, you will need to determine if your physicians are still in your plan's network and if your medical out-of-pocket costs are reasonable before you make any decisions. It is important to remember........ Medicare Specialists cannot take an enrollment application from you .......BEFORE October 15th! That is a Medicare Regulation!  If a Medicare licensed agent tries to take a signed application from you PRIOR to October 15th....... FIND A NEW AGENT! As a reminder........ NO ONE from Medicare will be knocking on your door or CALL you on the phone. Medicare will send you mail from the Social Security Administration ONLY! Any post cards or any letters with a return address from anywhere else on this Earth other than the Social Security Administration........ is not from MEDICARE!  It is most likely a solicitation from an Insurance Agent trying to get your business. Throw it out! Ok......let's take a look at the 2018 changes to Part D Prescription Drug Plans. Annual Deductible  The 2018 Maximum PDP Annual Deductible is $405.00. That's an increase of $5.00 from $400.00 in 2017. Starting January 1st of 2018....... if you are on a Medicare Advantage Prescription Drug Plan or Stand-Alone-Prescription Drug Plan...... that has a annual deductible, you will fit in one of two categories: 1. You will need to pay your annual deductible right away        prior to your plan's benefits kicking-in.  As of January 1, 2018, when you hand in a prescription for a listed drug on your plan's formulary, you will be expected to pay the full cost of that drug or the listed annual prescription deductible, whichever is less. For example, your stand-alone prescription drug plan has an annual prescription deductible of $405 on all tiers. You hand in your first prescription for lisinopril, which is listed as a Tier 1 on your plan's formulary. The listed      co-pay for a Tier 1 drug on your plan is $2.00. The total cost for a 30 day supply of lisinopril at your preferred pharmacy is $100.00. Since you have a $405.00 deductible, the cost for the 30 day supply of lisinopril  at $100.00 would be a lower out-of-pocket cost than the full $405.00 deductible. Therefore, you pay the $100.00 and deduct that amount from the $405.00 annual deductible, leaving you with a balance of $305.00. You will pay $100.00 for February, March and April for your lisinopril and in May you will pay the remaining balance of your deductible, which is $5.00. Then, your prescription drug benefits will kick in and you will also pay your $2.00 co-pay. Beginning in June, you will pay a $2.00 co-pay for your lisinopril for the remainder of the year.                                      OR 2. You will pay the annual deductible if and when you            "trigger" the deductible. As an example, You would trigger the annual deductible if you requested a prescription for a drug that was a Tier 3, Tier 4 or Tier 5 on your Medicare Advantage Drug Plan or Stand-Alone Prescription Drug Plan. If you requested a drug that was a Tier 1 or Tier 2 on that same plan, you would NOT "trigger" the annual deductible. Therefore, you would just pay the listed co-pay or co-insurance for that Tier 1 or Tier 2 prescription drug on your plan. So.....as we used lisinopril in the above example, in this case you would just pay your $2.00 co-pay for the 30 day supply of lisinopril starting right away in January. This is because lisinopril is listed as a Tier 1 drug on your plan's formulary. You wouldn't pay an annual deductible, since you haven't requested a prescription that was a Tier 3, Tier 4 or Tier 5 drug. You will continue to pay a $2.00 co-pay for your lisinopril for the remainder of 2018. The next portion of cost-sharing under prescription drug plans is called the Initial Coverage Period (ICP) During this portion of cost-sharing, the total amount spent during the Initial Coverage Period (ICP) is $3,750.00. The costs of covered drugs are shared - 25% by the beneficiary and 75% by the plan. If you do not have an annual deductible for prescription coverage, the maximum a beneficiary would spend out of pocket during the ICP is $937.50. The plan would pay the remaining balance, which is $2,812.50 ($3,750.00 - $2,812.50 = $937.50) You pay your co-pays and/or co-insurance, which is placed towards the $937.50. The plan pays the remaining balance of the Medicare negotiated price for the prescription, which is applied towards the $2,812.50. Once the total amount of your prescription drug costs (from your out of pocket costs and the plan's contributions) reach $3,750.00, you move into the next phase of cost-sharing. The next phase of Part D cost-sharing is called, The Coverage Gap, or commonly known as the "Donut Hole." During this phase, you will pay more for your prescription drugs. You will pay 35% for Brand name drugs and 44% for Generic drugs. Let's use Lisinopril again to look at the costs during the Donut Hole.  We stated a 30 day supply of Lisinopril from a preferred pharmacy is $100.00. Lisinopril is a generic drug, listed as a Tier 1 on your plan. In the Donut Hole, you are required to pay 44% of the Medicare negotiated price for Generics. In this example, you would pay $44.00 for a 30 day supply of Lisinopril in the Donut Hole. You are also paying a "Dispensing Fee," (about $1-$3 per drug) while in the Donut Hole. If you have a Brand prescription drug that is listed on a Tier 3, Tier 4 or Tier 5 on your plan, you will pay 35% of the Medicare negotiated price, while in the Donut Hole. Only True out-of-pocket (TrOOP) costs are counted toward the cost-sharing amount in the Donut Hole. TrOOP costs are - 1. The drug costs paid by the beneficiary 2. A 50% discount on Brand-Name drugs that is provided by the drug manufacturer. Payments made by the "plan" during the Donut Hole on Brand Name drugs DO NOT count toward TrOOP. If you DO have an annual deductible for your prescription drug coverage, the amount you pay out-of-pocket for your deductible is applied towards the ICP of $3,750.00. The maximum amount you would pay out-of-pocket during the Donut Hole portion of cost-sharing is $3,758.75 If the total cost-sharing amount reaches $3,758.75 in the Donut Hole phase, you will then move into the final phase of cost-sharing for 2018, which is called the "Catastrophic Stage." In the Catastrophic Stage, you will pay reduced co-pays and or co-insurance. You will pay either: A 5% co-insurance or a $3.35 co-pay for Generic drugs or a $8.35 co-pay for Brand drugs. You will pay whichever amount is greater. Let's use our example of Lisinopril one more time. With a total cost of Lisinopril being $100.00, a 5% co-insurance would be $5.00. With $5.00 being greater than $3.35 for Generic drugs, you would pay $5.00 for the 30 day supply of Lisinopril. You will remain in the "Catastrophic Phase" until January 1, 2019, when the slate is wiped clean and we start all over again.   I hope that answers your questions regarding changes to Prescription Drug Costs for 2018. If you have a question, and I can answer it in ONE paragraph or less, send me an email to - Support@TheMedicareNation.com I'll be happy to answer your question. If my answer requires more than one paragraph, or I need to research an answer....... you will need to hire me as a consultant to assist you. Go to this link and request a consultation from the "contact" tab. www.TheMedicareNation.com That's it for this week's show! I would love for you to rate & review Medicare Nation! Go to this link and tell me what you think!  https://goo.gl/sb3JXo   Have a happy, peaceful and prosperous week everyone!  

Hey Medicare Nation! I'm so happy to be here and tell you the latest, regarding Cigna-HealthSpring (Cigna) Medicare Advantage Prescription Drug Plans (MAPD) and Prescription Drug Plans (PDP). In January of 2016, CMS suspended Cigna from enrolling NEW Medicare Beneficiaries into their Medicare Advantage and stand-alone Prescription Drug Plans. The following States were affected by the suspension: Alabama, Arizona, Florida, Georgia, North Carolina, Pennsylvania, South Carolina and Tennesse. ON June 16, 2017, CMS released the suspension of marketing and enrollment sanctions on Cigna.....with a big BUT. On March 17, 2017, CMS received an attestation from Cigna, stating Cigna had corrected all  the violations that were listed in the CMS sanction notice. Quoted from the letter CMS sent to Cigna interim CEO & COO Mr. Shawn Moore - "CMS required Cigna to hire an independent auditor to conduct a validation audit provide CMS with the results of the audit. CMS used the information in the audit report to determine whether Cigna corrected the deficiencies that formed the basis for the sanction." Based on the results of the audit report, CMS determined that......"Cigna's deficiencies have been sufficiently corrected." Therefore, effective June 16, 2017, CMS is lifting the intermediate sanctions for Cigna's contracts and Cigna will return to normal marketing and enrollment status." Further down in the CMS document, on page 2, paragraph 1, line 3, it states...."In addition, during the independent validation audit, several findings were indentified, none of which prevent CMS from releasing Cigna from sanctions, but some of which merit additional monitoring and reporting. .......For up to one year, CMS will also conduct targeted monitoring in certain areas to ensure that Cigna continues to improve its operations.  What does that mean if you are currently a Medicare beneficiary on a Cigna-HealthSpring MAPD or PDP Plan? First of all, you are completely covered. Your benefits are intact and current. What you need to do now is become more "diligent" in reviewing your "explanation of benefits" (EOB) statement. Your EOB statement will contain information regarding prescription drugs, medical visits, diagnostics etc.  You should be ensuring the prescriptions listed on your EOB are the ones you received and that each doctor, diagnostic tests & procedures, hospitalizations etc. were actually done! Mistakes happen more than you know. Human errors and computer errors happen frequently. When you look at your EOB Statement every month you help eliminate these errors.  It is soooo important to review your EOB statement each month. If you find an error on your EOB statement, you have several options to rectify it. #1. Call Cigna Customer Support (800-668-3813)        Explain to customer support the "discrepency" you          found on your EOB statement. That may easily              correct the issue you found.  #2. Call your Medicare Consultant, Medicare                  Advisor or Agent.        Your Medicare Agent, who "sold" you this             policy, should be available to assist you with questions  or issues with your Cigna plan. #3. Contact Senior Medicare Patrol        Go to the Senior Medicare Patrol website to look up resources in your area.         Senior Medicare Patrol #4.  Contact your State Dept. of Aging          Every State has a Department of Aging or Department of Elder Affairs, which will assist you with many types of issues.          The "Healthy Aging" website has a list of each State's contact information for their Department of Aging or Elder Affairs.            Here's the link:           Healthy Aging List of State Agencies #5.   Contact Medicare          As a last resort, call Medicare directly. Government "downsizing" has caused delays in telephone correspondence, but it is still a reliable source.          Expect to be on hold from ten minutes to an hour, depending on the day and season.   Expect to see Cigna hit the airwaves and your mailboxes with advertisements regarding their Medicare Advantage and Prescription Drug plans. If you are not sure if you should remain on a Cigna Medicare Advantage Plan for 2018 and you have no one to speak to for assistance, call me! I am available for consulting and I do so on an hourly basis. I charge $150.00 an hour and I assure you, I am very honest in my time. If you have an interest in contacting me for consulting, send me an email to: Support@TheMedicareNation.com You can also visit my website for more information. www.CallSamm.com   I thank each of you for listening to Medicare Nation and I look forward to hearing from you with any questions you have regarding Medicare.   Until next time, have a happy, peaceful and prosperous week! Diane              

Hey Medicare Nation! Learn More About Medicare Here I receive many questions from clients and listeners about Medicare.  A question that is quite common is: "What vaccinations are covered under Medicare?" That's what this week's episode is all about.... vaccinations! There are currently three vaccinations that are covered under preventative and screening services under Medicare: 1. Flu Shot 2. Hepatitis Shot 3. Pneumococcal Vaccine   Flu Shot If you are enrolled in Medicare Part B, you can receive a Flu Shot from your doctor or other qualified health provider, who accepts Medicare assignment for administering the flu shot.  The cost for the Flu Shot under this scenario is $0 out-of-pocket for you. If your doctor or other healthcare provider does not accept Medicare assignment, your out-of-pocket cost be up to 100% of the cost of the Flu shot. Ensure your doctor or healthcare physician is contracted with Medicare before receiving treatment. For more information on the Flu, I'm sending you to this website: www.Flu.gov   Hepatitis B The Hepatitis B shot is available to individuals who are enrolled in Medicare Part B, have a doctor or other qualified health provider, who accepts Medicare assignment and you are at a "Medium" or "High" Risk to contract Hepatitis B. What indicates a Medium or High Risk? Well....there are many answers, but if you have certain diseases like hemophilia, ESRD (End Stage Renal Failure), Diabetes or other conditions that lower your resistance to infection are some good examples. If you have any questions regarding your eligibility for the Hepatitis B shot, ask your doctor. Since the Hepatitis B shot is covered under the Preventative and Screening Services of Medicare, there is $0 out-of-pocket cost to you. To learn more about Hepatitis B, I'm giving you the link to the Center for Disease Control and Prevention (CDC). Learn More About Hepatitis B   Pneumococcal Shot You are entitled to a Pneumococcal Shot if your doctor believes you need one, he or she is a qualified health provider, who accepts Medicare assignment and you are enrolled in Medicare Part B. There is also a second, different Pneumococcal shot that is administered one year after the first shot is given. Medicare Part B will cover this additional shot if your doctor says you need the two shots. You should always discuss your options and your concerns with your primary doctor. Here is the link to the CDC website on additional information about pneumococcal vaccinations: Learn More About Pneumococcal Vaccinations   Additional Vaccinations and Shots Available Other commercially administered vaccinations are available under Medicare Part "D" Tetanus, Diptheria and Pertussis (Whooping Cough) are examples of Part D coverage. A "Booster" shot, given to adults, adolescents and children is available as Tdap. Depending on what type of Prescription Drug Plan you are on, will depend on your out-of-pocket cost. You should contact your Medicare Insurance Carrier customer service department to request such information.   Shingles The Shingles Vaccine (Herpes Zoster) is also available under Part "D" of Medicare. The Shingles Vaccine out-of-pocket costs will vary by plan. You must contact your Medicare Plan Carrier's customer service department to determine your out-of-pocket cost for the Shingles Vaccine.  If you are not enrolled in Medicare Part D, you may have to pay up to 100% of the cost for the Shingles Vaccine. Here is the link to the CDC website for information on Shingles. Learn More about Shingles I also did an ENTIRE EPISODE ON SHINGLES! Go to Apple Podcasts and search in the Medicare Nation "Feed" directory. You'll see the episode is number 46, and was published on June 17, 2016. Listen to that episode! It is EXTREMELY educational. As the Medicare season has slowed down, I will be taking a break from the weekly publishing for the next few months. I'll post a new episode about every 3-4 weeks until September, when I'll pick right up and publish weekly shows again. Thank you soooo much for being a loyal Medicare Nation listener!  If you are enjoying Medicare Nation, give us a 5 Star Review on Apple Podcasts! The more people we can reach, the more people will learn more about Medicare. It' as simple as that! Thank you for listening to Medicare Nation! I'm so happy you are here! Share Medicare Nation with your family and friends, so they can learn more about Medicare and their benefits. Have a peaceful and prosperous week! Diane      

Hey Medicare Nation! March is colon cancer awareness month! Medicare offers different types of "preventative" tests and exams, which aid in diagnosing illnesses and diseases, such as colon cancer. Always speak with your primary care physician or specialist doctor, to discuss your medical history, family history regarding illness and diseases, as well as any signs & symptoms you may have. This will assist your physician in determining which type of "preventative" test or exam, is best for you. A special "Thank You," goes out to Phillip, from Kenosha, Wisconsin, who asks the question: "I don't like going through a colonoscopy. Are other options available and how often do I need one?" Let's look at Medicare's official website, to find out more about "preventative" Colo rectal cancer screenings. www.medicare.gov   How often is it covered? Medicare Part B covers several types of colo rectal cancer screening tests to help find precancerous growths or find cancer early, when treatment is most effective. One or more of these tests may be covered:   Screening barium enema:When this test is used instead of a flexible sigmoidoscopy or colonoscopy, Medicare covers it once every 48 months if you're 50 or over and once every 24 months if you're at high risk for colorectal cancer. Screening colonoscopy: Medicare covers this test once every 24 months if you're at high risk for colorectal cancer. If you aren't at high risk for colorectal cancer, Medicare covers this test once every 120 months (ten years), or… 48 months after a previous flexible sigmoidoscopy. Screening fecal occult blood test: Medicare covers this lab test once every 12 months if you're 50 or older. Multi-target stool DNA test: Medicare covers this at-home test once every 3 years for people who meet allof these conditions:   The Medicare Beneficiary is between 50–85. show no signs or symptoms of colorectal disease including, but not limited to, lower gastrointestinal pain, blood in stool, positive guaiac fecal occult blood test or fecal immunochemical test. They’re at average risk for developing colorectal cancer, meaning: They have no personal history of adenomatous polyps, colorectal cancer, inflammatory bowel disease, including Crohn’s Disease and ulcerative colitis. They have no family history of colorectal cancers or adenomatous polyps, familial adenomatous polyposis, or hereditary nonpolyposis colorectal cancer. Screening flexible sigmoidoscopy: Medicare covers this test once every 48 months for most people 50 or older. If you aren't at high risk, Medicare covers this test 120 months (ten years) after a previous screening colonoscopy.   Who's eligible? All people age 50 or older with Part B are covered. People of any age are eligible for a colonoscopy.   Your costs in Original Medicare For barium enemas, you pay 20% of the Medicare-approved amount for the doctor's services. In a hospital outpatient setting, you also pay a co-payment or co-insurance You pay nothing for a multi-target stool DNA test. You pay nothing for the screening colonoscopy or screening flexible sigmoidoscopy, if your doctor accepts assignment (contracted with Medicare or is an out-of-network physician who accepts assignment). If a screening colonoscopy or screening flexible sigmoidoscopy results in the biopsy or removal of a lesion or growth during the same visit, the procedure is considered diagnostic and you may have to pay co-insurance and/or a co-payment, but the Part B deductible doesn't apply. You pay nothing for the screening fecal occult blood test. This screening test is covered if you get a referral from your doctor, physician assistant, nurse practitioner, or clinical nurse specialist.    Early detection of cancer is critical to successful treatment and may prove to be life-saving! Get your preventative colorectal screening done as soon as your physician recommends it!   Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!  

Hey Medicare Nation! I receive many phone calls from clients, who say they were unable to schedule an appointment with a new doctor; even though they are on a Medicare Supplement Plan.  I made many phone calls, with my clients to physician offices, in order to fix these issues. What I found out didn't surprise me. Many of the staff at physician office's across the country are inadequately trained in the different types of Medicare Plans. I decided to educate you on how to make an appointment with a physician, lab, hospital, SNF or radiology center, if you have a Medicare Supplement Plan. Having a Medicare Supplement Plan allows you the freedom to see any physician or provider you want.....,as long as the provider "accepts assignment" with Medicare. Let's take an example. If you wanted to make an appointment with a new Cardiologist, 1. call the office you want to be seen in. 2. Tell the person, who is scheduling your appointment, that          Medicare is your Primary Insurance. 3. You may be asked if you have a "secondary insurance." If you are enrolled in a Medicare Supplement Plan, the answer is .... "Yes, I have a Medicare Supplement Plan." If you are enrolled in a Medicare Advantage Plan, the Medicare Advantage Plan is your "Primary Insurance." Most likely, you don't have another plan. When you visit the physician's office for the first time, show the receptionist your Medicare Supplement ID Card. You may be asked if you have your Medicare ID Card. Hopefully, you've made a copy of your Medicare ID Card and have left your original Medicare ID Card at home in a safe place. You shouldn't be carrying your Original Medicare ID Card! The staff will bill Medicare and the Medicare Supplement Plan for the amount you would have owed, if on Original Medicare. You should not receive any paperwork to submit to Medicare or a Medicare Insurance Carrier.  Prior to any physician visits or procedures, call and ask if you have any co-pay, co-insurance or deductible if you are enrolled in a Medicare Supplement Plan that is not designated by the letter "F." Medicare Supplement Plans are designated by Letters of the Alphabet and those "letter" plans can be offered by many different Insurance Companies.  Each "lettered" plan pays co-pays, co-insurance or deductibles, on your behalf, based on the plan you select.  After the physician's staff has your Medicare Supplement Plan info on file, they shouldn't require you to show them your card the next time you come in for an appointment. Hopefully, this has helped you understand what is going on in the real world, and it will make it a less frustrating place for you! Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!

Hey Medicare Nation! Many of you carry your Medicare ID card in your wallet or purse. If you are a Medicare Advantage beneficiary, you have a “separate” medical ID card from the insurance carrier. It is not necessary to carry your Medicare ID card, If you have a Medicare Advantage ID card. Who should carry their Medicare ID Card? If the official Medicare program is your “primary” insurance, you should be carrying your Medicare ID card. Now….. let me discuss with you how you can carry your Medicare ID card in a safer way. Currently, your Medicare ID Card has your Social Security number on it, with a letter at the end of your Social Security number.  If you have your social security number memorized, take these steps to help prevent “identity theft.” Make a copy of your Medicare ID Card Place your original Medicare ID Card in a safe place. Take a Black Permanent Marker and “black out” all of the numbers of your social security number( except the last four numbers and the letter), on the copy. Laminate the copy Put this copy of your Medicare ID card in your wallet or purse.   If you are on a Medicare Advantage Plan or a Supplement to Medicare Plan, you should be carrying the Medical ID card the insurance carrier provided you. If you have a stand-alone prescription drug plan, you will also have a separate card for your prescriptions. You will need to carry this card in your wallet or purse also.   How Do I Replace My Medicare ID Card if I Lost it or it Was Stolen? If you made a copy of your Medicare ID Card like I described above, you won’t have a problem. You can retrieve your Medicare ID Card from it’s safe place and make a new copy of the card. If you didn’t make a copy of your Medicare ID Card, you will need to ask the Social Security Administration for a replacement card. Follow these steps: You can ask for a Medicare Replacement Card : Online By phone At a local Social Security office location                                                            A.Online Go to ssa.gov You’ll see pretty pictures on the home page. On the left side is a picture, with the caption… “Learn What You Can Do Online.” “Click” on the that photo. When the next page opens, look down to about the 7th It will read….”If you get Social Security benefits or have Medicare you can….” “Click” on that line. Sign in or Register for a “My Social Security Account.” 5th line down should read….. “Get a Replacement Medicare Card” Select – “Replacement Documents” tab. Fill out the required information. If the site “accepts” your information, you are all set! You should receive your replacement Medicare Card in 30 – 60 days. If the site shows any kind of “error” or “red flags,” you will need to physically go down to a local Social Security location.             B. By Phone                      1. Call 800 - 633 - 4227                     C. Social Security Office                       1. Click on the "Social Security Location" tab and put in your                          zip code to find the nearest location to you.   Thanks so much for listening to Medicare Nation! I appreciate the time you took to listen. If you have a parent or grandparent, who is approaching Medicare age (65) or is already receiving Medicare benefits, help them “Subscribe” to Medicare Nation. Buy them a Smartphone! If you buy them an Apple phone…show them the “purple” podcast icon on the phone and how they access Medicare Nation. Once the Medicare Nation page loads….. click on “subscribe.” All current shows will load automatically once a week for them! If you buy them an Android phone, just go to Google Play and “Search” for the app – “Stitcher.” Download the Stitcher App. When you open Stitcher, they will need to sign up with an email address and password. Once the home page opens, show them how to “swipe” to the left, until they reach the “last page.” This is the “Search” page. In the “search” bar…. Type in “Medicare Nation.” Medicare Nation comes right up! “Click” on the Subscribe button…… they are set! Help your parents “search” for other types of podcasts they would have an interest in. You will be opening up a brand new world for them and they WILL thank you for it!

Hey Medicare Nation! I hope everyone is having an awesome week! Say goodbye to February! I know all of you Northerners are thrilled to see it go! Bring it on March! You know, I see many, many clients and one of the top questions I am asked is, "What does the letter on my Medicare ID card mean?" It happens so often, I figured I better dedicate an episode to just that! The Social Security Administration (SSA) assigns a letter and a number, (if you fit into a sub-group) when you apply for Social Security Benefits and/or Medicare. The letter (and number if it applies) is found on your Medicare ID Card, right after your social security number. As an example, if you have worked and contributed to FICA (Federal Insurance Contribution Act), and started receiving your Social Security benefits at age 64, and you enrolled in Medicare at age 65, the letter "A" will be designated to you. The "claim" number would look like this on your Medicare ID Card: 123-45-6789A Just as "Different Strokes for different Folks," the Social Security Administration assigns "claim" numbers for different situations. "Where Do I find the full list of Social Security claim letters?" You can go to the following locations to see a full list of claim letters: 1. www.ssa.gov 2. Title XVIII of the Social Security Act 3. For a Free List of the Codes Listed by the Social Security Administration on their website, go to my website - www.callsamm.com   Thanks for listening to Medicare Nation! Please SHOW someone how to "subscribe" to Medicare Nation, so they can learn about their Medicare benefits and what type of Medicare Plan they should be on!  

What is the Difference Between a Welcome to Medicare Visit  vs. an Annual Wellness Visit?  A "Welcome to Medicare" preventive visit: Is an introductory visit only within the first 12 months you have Medicare Part B. This visit includes a review of your medical and social history with your Primary Physician, as well as possibly including preventive services, including: Certain screenings, shots, and referrals for other care, if needed Height, weight, and blood pressure measurements A calculation of your body mass index A simple vision test A review of your potential risk for depression and your level of safety An offer to talk with you about creating "Advanced Directives" A written plan letting you know which screenings, shots, and other preventive services you need.  This visit is covered one time. You don’t need to have this visit as a "prerequisite," to be covered for yearly "Wellness" visits. Annual "Wellness" visits: If you've had Part B for longer than 12 months, you can get this visit to develop or update a personalized prevention help plan. This plan is designed to help prevent disease and disability based on your current health and risk factors. Your provider will ask you to fill out a questionnaire, called a “Health Risk Assessment,” as part of this visit. Answering these questions can help you and your provider develop a personalized prevention plan to help you stay healthy and get the most out of your visit. It can also include: A review of your medical and family history Developing or updating a list of current providers and prescriptions Height, weight, blood pressure, and other routine measurements Detection of any cognitive impairment Personalized health advice A list of risk factors and treatment options for you A screening schedule (like a checklist) for appropriate preventive services.  This visit is covered once every 12 months (11 full months must have passed since the last visit). Who's eligible? All people with Part B are covered. Your costs in Original Medicare You pay nothing for the “Welcome to Medicare” preventive visit or the yearly “Wellness” visit if your doctor or other qualified health care provider accepts assignment with Medicare  The Part B deductible doesn’t apply for annual wellness visits. However, you may have to pay coinsurance, and the Part B deductible may apply if: Your doctor or other health care provider performs additional tests or services during the same visit (ex: an EKG or draws blood). The additional tests or services aren't covered under the preventive benefits. An "Annual Exam" is where your Primary Care Physician will provide a "hands on" examination of you and you may have tests like an EKG or have blood drawn. Co-pays, coinsurance and deductibles will apply for Annual Exams.   Share Medicare Nation with someone! Teach your parents, your grandparents how to access this podcast! Buy them a smartphone. Show them how to access iTunes & Stitcher. The more they know, the less they will ask you for help. It's not easy being the "Sandwich Generation." So...... do yourself and your parents a favor and help them listen to Medicare Nation!   

Hey There Medicare Nation! Today, I'm speaking with a special guest. I'm speaking with my good friend James Van Prooyen. James recently retired from the military, where he spent twenty years in the Air Force. James didn't always want to serve in the Military. At first, James wanted to follow in his grandfather's footsteps and become an electrician. While James was a senior in High School, in Northern Michigan, he was introduced to a recruiting officer. James learned a great deal about being in the Military, and James wanted to serve - for four years!  Shortly approaching his fourth year in the Air Force, James thought about his future. He had a wonderful wife and a new baby. James loved working with his Air Force family, and he decided to enlist again for four more years. Those four years soon turned into twenty, and James found himself retiring and not knowing what to do next.  James kept very busy after retiring from the Air Force by helping his wife with her nutritional business and helping to take care of his daughter. James soon began networking and found himself part of the Tampa Bay Business Owners Association, and he soon learned he wanted to be an entrepreneur. James learned about Podcasting and new he wanted to have a Military Show. The Veteran's in Business Show was born! James wants the Veteran's in Business Show to be a conduit for veterans who already own a business, to guide and teach veterans who will be leaving the military in the coming year. Veteran's who want to start their own business, will learn from other veterans, who have done it before them. Resources for veteran's. James wants to make the transition easier for his brother and sister veterans. If you are a veteran business owner and would like to be interviewed on Jame's podcast..... send him an email to  TheMilitaryPodcastNetwork@gmail.com If you know of a veteran who would love to learn how to start their own business, tell them to listen to the Veteran's in Business Show with James Van Prooyen. Find the podcast here: veterans-in-business-show Contact James Van Prooyen: @JamesVanProoyen on Snap Chat - JamesVanProoyen LinkedIn - James Van Prooyen James - Thank You for your Service!   Tell a family or friend about Medicare Nation!  Help someone get on Medicare Nation with a Smart Phone!  The resources for people 64 and older is so valuable! I'm counting on my "Sandwich Generation" to help out and get their parents on the show! Help me to help you! Thanks for listenening!      

Hey Weight Loss Nation! This week I’m discussing Medical Marijuana! 2017 has issued in with additional States Legalizing Marijuana for Medicinal purposes. I am speaking with Dr. Rachna Patel, The Medical Marijuana Expert this week on Medicare Nation. Dr. Rachna Patel completed her undergraduate studies at Northwestern University in Illinois and her Medical studies at Touro University in Vallejo, CA. Dr. Patel is a licensed practitioner in the State of California and is in impeccable standing with the State of California Medical Board. She has been practicing in the area of Medical Marijuana (cannabis) since 2012, and she has treated countless patients! Dr. Patel is known for her “bedside manner” with her patients and does things differently than other Medical Marijuana doctors. Dr. Patel sees her patients “in person” and not by phone or virtually. Dr. Patel spends a thorough amount of time with patients to ensure she is guiding them step-by-step through the Medical Marijuana process. Dr. Patel may “recommend” medical marijuana for conditions and diagnoses such as, but not limited to: Chronic Pain (nerve, muscular) Auto-Immune Conditions Anxiety Insomnia Cancer Eating Disorders Dr. Patel may “not” recommend medical marijuana for conditions and diagnoses such as, but not limited to: Spinal Stenosis Severe “Shingles” Case Bi-Polar Disorder History of Heart Attack/Stroke   Medical Marijuana is “Googled” daily by tens-of-thousands of people. According to ProCon.org , Colorado residents show the most interest in “searching” information on Medical Marijuana.  This may be due to the fact that Colorado was the first State to legalize “recreational use” of marijuana. According to the website ProCon.org, as of March of 2016, there are over 1,250,000.00 people using marijuana medicinally. As more States legalize the use of Medical Marijuana, those numbers will steadily rise. The following 21 States have passes legislation for the use of Medicinal Marijuana: Montana, North Dakota, Minnesota, Michigan, Ohio, Pennsylvania, New York, Vermont, New Hampshire, Rhode Island, Connecticut, New Jersey, Delaware, Hawaii. The following Nine States have passed legislation for the recreational use of marijuana: Washington, Oregon, California, Nevada, Alaska, Colorado, Maine, Massachusetts, D.C.  That’s 30 States Total that have legalized Medicinal Marijuana. Here are a few links to learn more about Medical Marijuana: www.weedmaps.com http://medicalmarijuana.procon.org/ Would you like to contact Dr. Rachna Patel to learn more about Medical Marijuana and/or her practice?   Here are links for Dr. Patel. Website – www.Dr.RachnaPatel.com Facebook page: www.facebook.com/DoctorRachnaPatel YouTube                                                                                                        https://www.youtube.com/channel/UCNtN7JXpNKHAYA7ZdWzpi1A How to Choose a Medical Marijuana Doctor that You Can Trust 28 Legal Medical Marijuana States and DC: Laws, Fees, and Possession Limits   Thank you for listening to Weight Loss Nation! Share this show with anyone you know who has a medical condition that Medical Marijuana may help! Thanks again for listening!    

Hey Medicare Nation! This week I’m discussing Medical Marijuana! 2017 has issued in with additional States Legalizing Marijuana for Medicinal purposes. I am speaking with Dr. Rachna Patel, The Medical Marijuana Expert this week on Medicare Nation. Dr. Rachna Patel completed her undergraduate studies at Northwestern University in Illinois and her Medical studies at Touro University in Vallejo, CA. Dr. Patel is a licensed practitioner in the State of California and is in impeccable standing with the State of California Medical Board. She has been practicing in the area of Medical Marijuana (cannabis) since 2012, and she has treated countless patients! Dr. Patel is known for her “bedside manner” with her patients and does things differently than other Medical Marijuana doctors. Dr. Patel sees her patients “in person” and not by phone or virtually. Dr. Patel spends a thorough amount of time with patients to ensure she is guiding them step-by-step through the Medical Marijuana process. Dr. Patel may “recommend” medical marijuana for conditions and diagnoses such as, but not limited to: Chronic Pain (nerve, muscular) Auto-Immune Conditions Anxiety Insomnia Cancer Dr. Patel may “not” recommend medical marijuana for conditions and diagnoses such as, but not limited to: Spinal Stenosis Severe “Shingles” Case Bi-Polar Disorder History of Heart Attack/Stroke   Medical Marijuana is “Googled” daily by tens-of-thousands of people. According to ProCon.org , Colorado residents show the most interest in “searching” information on Medical Marijuana.  This may be due to the fact that Colorado was the first State to legalize “recreational use” of marijuana, and has set a "standard" for other States to follow. According to the website ProCon.org, as of March of 2016, there are over 1,250,000.00 people using marijuana medicinally. As more States legalize the use of Medical Marijuana, those numbers will steadily rise. The following 21 States have passed legislation for the use of Medicinal Marijuana: Montana, North Dakota, Minnesota, Michigan, Ohio, Pennsylvania, New York, Vermont, New Hampshire, Rhode Island, Connecticut, New Jersey, Delaware, Hawaii. The following Nine States have passed legislation for the recreational use of marijuana: Washington, Oregon, California, Nevada, Alaska, Colorado, Maine, Massachusetts, D.C.  That’s 30 States Total that have legalized Medicinal Marijuana. Here are a few links to learn more about Medical Marijuana: www.weedmaps.com http://medicalmarijuana.procon.org/ Would you like to contact Dr. Rachna Patel to learn more about Medical Marijuana and/or her practice? Here are links for Dr. Patel. Website – www.Dr.RachnaPatel.com Facebook page: www.facebook.com/DoctorRachnaPatel YouTube                                                                                                       https://www.youtube.com/channel/UCNtN7JXpNKHAYA7ZdWzpi1A     How to Choose a Medical Marijuana Doctor that You Can Trust 28 Legal Medical Marijuana States and DC: Laws, Fees, and Possession Limits   Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!    

Hey Medicare Nation! How many of you have just found out your Doctor is leaving the Medicare Advantage Network you're in? I'm certain there are "Thousands of you." That is the #1 complaint I receive from clients, is that their "Doctor" is leaving or has left their Medicare Advantage Plan (MAPD) Network. Medicare has regulations about how a Medicare Advantage Organization (MAO) can "terminate" a Doctor contracted in their network and in reverse, there are regulations on how a Doctor can leave a MAO. There are also regulations on how a MAO publishes it's "Provider Directory" for their network. Chapter 4, Section 110.1.1 of the Medicare Managed Care Manual, titled, Provider Network Standards, lists in part....  "MAO's are required to establish and maintain provider networks that: ...... Are accurately reflected in up-to-date directories. Plans are responsible for verifying and regularly updating their network directories to ensure that providers included in the directories are available to their enrollees (ie, listed providers accept new patients who are enrolled in the plan).   In section 110.2.2 labeled Provider Directory Updates, it states in part: ....MAO's must include information regarding all contracted network providers in directories at the time of enrollment. Directories must include information about the number, mix, and distribution of all network providers. MAO's may have separate directories for each geographic area they serve (e.g. metropolitan areas, surrounding county areas), provided that all directories together cover the entire service area. Provider Directories must be updated anytime the MAO becomes aware of changes. They have 30 days to update the changes or be non-compliant. When there is a change to the provider network (a provider is terminated or the provider is leaving the network), The MAO "must make a good faith effort to provide a written notice of a termination of a contracted provider at least 30 calendar days before the termination effective date to all enrollees who are patients seen on a regular basis by the provider whose contract is terminating." In regards to termination of "Primary Care Physicians," all enrollees who are patients of that primary care professional must be notified."   So.....what's being done about all the inaccuracies to provider directories?   CMS conducted it's first review of 54 Medicare Advantage Organizations (MAO's) online provider directories, between February and August of 2016. The finding......45% of provider directory locations listed in these online directories were inaccurate! About one-third of all MAO's with 5,832 providers were reviewed in total. Twenty-One MAO's received warning letters from CMS around January 6th, and they have 30 days to fix the errors or face possible fines or sanctions, which could include suspending marketing and enrollment of medicare beneficiaries. Here are the Medicare Advantage Plans that received warning letters from CMS to immediately fix the errors in their provider directories. Blue Cross & Blue Shield of Rhode Island - RI Rhode IslandBlue Cross Blue Shield of Michigan - FL MI, MO WI Catholic Health Partners - IA,KY, MI, OH CIGNA  - IL, IA Community Health Plan of Washington - WA Emblem Health Inc. - CT, NY, RI Fallon Community Health - MA Gateway Health Plan, LP - OH, PA, WV Health Partners Plans, Inc. - PA Highmark Health - PA Humana Inc. - WI Indiana University Health - IA Magellan Health Inc. - NY Moda, Inc. AK, ID, MT, NM, OR, WA Molina Healthcare, Inc. - UT Piedmont Community Health Plan - VA Premera - WA Samaritan Health Services - OR SCAN Health Plan - CA UnitedHealth Group, Inc. - CO Wellcare Health Plans - IL   Now.... if you are a member of one of these MAO plans that received a "warning letter," you may qualify for a "Special Enrollment Period," from Medicare. What should you do?........ 1. Call Medicare - 800-633-4227 2. Tell the Medicare employee that you are a member of the ________ Medicare Advantage Plan, that received a "Warning Letter" from CMS for non-compliance of their provider directory. 3. State (if it's true!) that you were not notified by your physician or the MAO of the termination of your doctor, and your directory wasn't updated. 4. VERY IMPORTANT  TO STATE.....     Tell the Medicare employee you RELY on the directory to locate an in-network provider, and by the Medicare Advantage Plan & the Doctor NOT informing you that he/she was LEAVING the network, it caused a SIGNIFICANT access to care barrier for you!  Because now...... You can't see your doctor who has taken such good care of you..... due to the error. 5. Ask for a Special Election Period, so that you can choose a Medicare Advantage Plan where your Doctor is in-network. 6. If they grant you the Special Election Period, tell the Medicare employee which Medicare Advantage Plan you want to be on. 7. If they say "NO,"  Thank the Medicare Representative for their help and say goodbye.   What do you do now???? See if you qualify for a different Special Election Period. Listen to my earlier episode on SEP's. Listen to Last Friday's episode on 5 STAR Plans. Listen to the episode on the Medicare Advantage Disenrollment Period. It also includes information on Special Need Plans. If NONE of these ideas offer you the opportunity to change your Medicare Advantage Plan to a better option, than you will have to remain on the Medicare Advantage Plan you are on until the Annual Enrollment Period to change plans. Do your Due Dilligence Nation! Don't enroll in another Medicare Advantage Plan.... just because the doctor who is leaving the network is on that one! Make sure the plan will fit your Medical, financial and prescription needs for 2017! Share Medicare Nation with someone! Teach your parents, your grandparents how to access this podcast! Buy them a smartphone. The more they know, the less they will ask you for help. It's not easy being the "Sandwich Generation." So...... do yourself and your parents a favor and help them listen to Medicare Nation!   

Hey Medicare Nation! Medicare has announced the 2017 "5 Star Plans." What are 5 Star Plans? Medicare rates all health and prescription drug plans each year, based on a plan's quality and performance. Medicare Star ratings will help you understand the job a plan is doing. There are 2 main types of Star Ratings: 1. Overall Star Rating that combines all of the plan's scores. 2. A Summary Star Rating that focuses on a plan's medical or prescription drug services. A few areas Medicare reviews for these Star Ratings include: 1. How plan members rate their plan's services and care. 2. How well a plan's network of doctors detect illnesses and keep members healthy. 3. How well a plan helps it's members use recommended and safe prescription medications. A plan can receive a 1 to 5 Star Rating. 5 Stars is Excellent 4 Stars is above average 3 Stars is average 2. Stars is below average and 1 Star is poor. You can only switch to a 5 Star Rating Medicare Advantage Plan or a 5 Star Stand-alone Prescription Drug Plan, that is available in your area. You can only switch to a 5 Star Medicare Advantage Plan, Medicare Cost Plan or Medicare Prescription Drug Plan once from December 8th to November 30th of the next year. Once you use your election to enroll in a 5 Star Plan, you cannot use it again. If a Medicare Advantage Plan or a Stand-Alone Prescription Drug Plan has received a 5 Star Rating from Medicare, it doesnot mean you automatically go out and enroll in the 5 Star Plan. That 5 Star Plan may not fit your unique needs! The option is available..... if you need it! Some people enroll in a Medicare Advantage Plan during the Annual Enrollment Period, and only switched plans because they received an incentive from the new plan. Ex: Your neighbor "Phil" tells you he is on the greatest Medicare Advantage Plan. He receives $30 in "Bandaids" from his plan every month. He tells you to "switch" plans so you can get $30 worth of over-the-counter supplies every month. Phil hands you his "Agent's" card. You call Phil's "Agent," who gladly comes out and enrolls you into the same exact plan that Phil has. The plan goes into effect January 1st. You call your Primary Doctor on February 6th for an appointment because you think you have the flu.  The secretary advises you that Dr. Jones does not accept the new plan your on. What? You didn't check to see if your Primary Doctor accepts the new plan? Phil's "Agent" didn't check to see if your Primary Doctor was in the new plan's network? Sorry......you should have done your due diligence. Now you will have to "remain" on this plan until the next Annual Enrollment Period. You are "locked-in," until October 15th.  Maybe you were better off on the plan you originally were on. In this example, you may have another option! You find out in January, that XYZ Medicare Advantage Plan has a 5 Star Rating in your area. You can look up the XYZ Plans and determine if one of their plans accepts your Primary Doctor in their network. Check the co-pays, co-insurance and deductibles on the new plan. Check that all your prescription drugs are in the new 5 Star Plan's formulary. If you like what you found out about the 5 Star Rating Plan that is available in your area, you are allowed to "switch" one time from the Medicare Advantage Plan you are stuck on, to the 5 Star Rating Plan available in your area.  Once you make the election to switch to the 5 Star Plan, you cannot enroll into another plan - whether it has 5 Stars or not.  Only a criteria that fits a Special Election Period will be allowed. Look on the www.Medicare.gov website for the list of Special Election Period examples. The 14 Medicare advantage Plans that received "5 Star Ratings" for 2017 are:      Company Name                           Service Area 1. KS Plan Administrators, LLC -     4 Counties TX 2. Kaiser Found. HP, INC                 31 Counties CA 3. Kaiser Found. HP of CO               17 Counties CO 4. Kaiser Found. of the Mid-            D.C. &         Atlantic States                              11 Counties MD                                                             9 Counties VA 5. Tufts Assoc. HMO                       10 Counties MA 6. BCBS of MA HMO Blue                11 Counties MA 7. Group Health Plan (MN)            87 Counties MN                                                           8 Counties WI 8. Aultcare Health Ins. Corp          12 Counties OH 9. Physicians Health Choice TX     19 Counties TX 10. Gundersen Health Plan            1 County IA,                                                                 8 Counties WI 11. Optimum Healthcare Inc.        25 Counties FL 12. Kaiser Found. HP of NW          9 Counties OR                                                            4 Counties WA 13. Sierra Health & Life Ins.         1 County CO,                   1 County KS, 2 Counties MA, 3 Counties MD.             1 County MI, 2 Counties NJ, 2 Counties PA,               2 Counties TX, 1 County in VA   If you live in the service area of the above 5 Star Rated Plans, you should go onto the Medicare.gov website and compare the 5 Star Plan to the Plan you are currently on. Make sure your doctors are in the network. Make sure ALL your prescription drugs are covered in the formulary. Look at the co-pays, co-insurance and any deductibles. Make sure the "5 Star Plan," is worth "switching" too! Just because it was given a 5 Star Rating from Medicare, doesn't mean the plan will automatically be the best choice for your unique needs. Do your Due Diligence!  You can check the Medicare.gov site for any 5 Star Prescription Drug Plans in your service area and Medicare Advantage Plans that are health plans only and do not offer prescription drug coverage on that particular plan. You can also listen to episode MN061. I give you information on the Medicare Advantage Disenrollment period and information on Special Need Plans. You don't have to be "stuck" on a Medicare Advantage Plan that doesnot suit your needs. This is the time of year to make changes. Make sure you switch to a better plan this time! Questions?? Send them to Support@TheMedicareNation.com Thanks for listening to Medicare Nation. If you like the information that is provided, give us a 5 Star Review on iTunes! The more reviews we get, the more exposure iTunes will give Medicare Nation, and that means more people will be able to find the show. https://itunes.apple.com/us/podcast/medicare-nation/id1031060767?mt=2 Have a happy, peaceful & prosperous week!                         

Hello Medicare Nation! Happy New Year to everyone. I hope everyone had a wonderful holiday season. The Annual Enrollment Period is over. I hope each of you did your due diligence in deciding which plan will fit you best for 2017. I have many episodes available for you to learn all about Medicare Advantage Plans, Original Medicare and Part D of Medicare. If you determine the Medicare Advantage Plan you are on is not suitable for you or a loved one in 2017, you may have other options available to you. Right now, you are in the Medicare Advantage Disenrollment Period. It started on December 8th and will end on February 14th of 2017. Here is how you "dis-enroll" from a Medicare Advantage Plan during this time period. 1. Call Medicare 800-633-4227 2. Advise the Medicare Representative that you would like to "dis-enroll" from your current Medicare Advantage Plan and go back onto Original Medicare. 3. You can enroll in a stand-alone Part D prescription drug plan. 4. You can also enroll in a Supplement to Original Medicare plan, that will assist you in paying your out of pocket costs for Part A & Part B.  Each Supplement to Original Medicare Plan (Plan A, Plan B, Plan C, Plan D, Plan F, Plan G, Plan J, Plan K, Plan L and Plan N.) cover different out of pocket Medicare costs. Research each one prior to enrolling in the Supplement plan to determine the plan that will fit your health & financial needs for 2017. If you find it difficult to figure out if Original Medicare and enrolling in a Part D and/or a Supplement to Original Medicare Plan is right for you, contact me at either -  Support@TheMedicareNation.com OR Go to my website..... www.CallSamm.com and tell me in the "Contact Me" how I can assist you.   SPECIAL NEED PLANS Are you a Diabetic? Do you have COPD? Do you have Cardiovascular Disease? If you answered "yes" to any of these questions, you may be eligible to enroll in a special needs plan. A special needs plan is a Medicare Advantage Plan. If you are diagnosed with any of the conditions I listed above, you may use a special election to change to a special needs plan one time during the year. How do you determine if you have Special Need Plans in your area? Go to www.medicare.gov and click on the "find health and drug plans." The database will take you through several screens and you should select "special needs plan," when you advise Medicare what type of plan you are on. The database will provide you with the special need plans in your area. You can also look under special election periods, to determine if you have a qualified reason to change. If you like Medicare Nation, please give us a 5 Star Review on iTunes! https://goo.gl/uAhvLe When you leave us a great review, iTunes gives Medicare Nation more exposure. More exposure means individuals who need advise about Medicare will find the show! I appreciate you listening to Medicare Nation! Have a happy, healthy & prosperous week!    

Welcome, Medicare Nation! I’m excited about our guest and our important topic today. We’re discussing the confusion surrounding advanced directives. Have you ever thought about what would happen if you can’t speak for yourself and are in an emergency health situation? Who will express your wishes, and will the health care professionals understand? Dr. Ferdinando (Fred) Mirarchi is the ER Director of University of Pittsburgh Medical Center-Hamot. He has a solution!  Tell us about health care directives and the issues that commonly arise when people come to the ER. There are three types of directives: living will, DNR (Do Not Resuscitate order), and POLST (Physicians’ Order for Life Sustaining Treatment). All three of these have safety issues surrounding them, and all three bring questions. When are they to be followed? None of us know when an emergency situation may arise, so when do we carry these documents with us? Even medical professionals don’t understand these orders, but no one really wants to raise the safety concerns. What happens when someone comes to the ER with no accompanying family and no papers? It’s not just an ER situation, but anywhere in the hospital, for any medical procedure. “You, the patient, are asked if you have a Living Will, then you are subjected to whatever their understanding is as to what that means.” About 78% of the time, physicians assume that a Living Will equals a DNR, but in 64% of cases, a DNR is strictly an end of life order and does not apply to critical care emergencies. Medical professionals assume if you have any advanced directive that you’re an end of life care patient and don’t want care. Many don’t understand the difference between being critically ill and being in an “end of life” situation. If you have advanced directive documents, should you bring them with you to any scheduled procedure, like a colonoscopy? Most physicians would say YES, but I say NO. Keep your document in a safe place so that it doesn’t compromise your care and treatment. Pull it out when you need it, but then you face a retrieval issue. Will the proper medical professional have access to your papers when they need it? We have a process that can insure that those documents are retrieved when needed. Most ER doctors are forced to look at a paper and make an interpretation, based on THEIR understanding, which might not be right for you. Can you explain the difference in a Living Will and a DNR? A Living Will is a legal document, not a medical document. It is for use in situations when someone can’t speak for themselves, develops a terminal condition, or is in a persistent vegetative state. A DNR is specifically for when someone is found with no pulse or breathing, and no CPR is desired. There is a common misunderstanding that a DNR means no medical treatment at all, when it most often applies to end of life care. When someone has a Living Will and the medical professional assumes it’s a DNR, then it can affect care and treatment of any medical emergency. “It’s a coin toss with a 50% chance of being treated or not being treated.” You’ve developed a solution to help people explain their wishes about receiving treatment. Can you explain? At the Institute of Health Care Directives, we have created ID cards containing detailed information to be understood by any medical professional in any hospital. It gives patients a voice to guide their care and treatment. Your ID card has info and directives linked with a QR code that accesses a video recording of your wishes. The recorded video is in a database and can be pulled up on any smart phone for any medical situation you may encounter. Will this ID card work in any medical office, hospital, or ER? Yes, and it’s in clear and understandable medical language so that any professional will know what to do. Can you explain how to find out more and what the service includes? Visit our website: www.institutehcd.com or email us: info@institutehcd.com. You can even call us at 814-490-6584. Dr. Mirarchi is offering a 10% discount to the first 100 MN callers on either of the available packages. The Basic package is for healthy, young people, and the VIP package is for those with multiple medical problems. The VIP package gives you access to an on-call doctor 24/7/365. You can ask any question or any medical professional treating you can call for information about your condition. Our solution is a much clearer and simpler process and has received great response from physicians. The goal is to plan for when you are critically ill and (separately) for when you’re at the end of life. There is a study coming out in 3-6 months on a 15 state trial, and the preliminary results are amazing. This is truly a game-changer in the health care industry. Here is the news story video of the 57y.o. man who was mistakenly noted as "DNR" in his hospital file           whistle blower 9 Investigative news http://www.wsoctv.com/news/9-investigates/whistleblower-9/whistleblower-9-do-not-resuscitate-bracelet-mistakenly-put-on-hospitalized-mans-wrist/446014450    Here is a Parody Video on "Advanced Directives" https://youtu.be/S6XKv7MOuts Good Practice (A parody of Green Day's " Good Riddance") By Michael Barton Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! 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            

Welcome Medicare Nation! I just had my annual eye exam and what a surprise I got!  I was diagnosed with Narrow Angle Glaucoma!  How could I be diagnosed with Glaucoma being just 54 years old?   Not only was I diagnosed, but I had to have immediate laser surgery to correct it. I don't want any of you to be diagnosed with Narrow Angle Glaucoma, so I'm going to discuss glaucoma with you to help you understand this disease. There are several types of glaucoma. The two main types I will be discussing today are open-angle and narrow angle glaucoma. These types of glaucoma are marked by an increase of pressure inside the eye.   Open-Angle Glaucoma Open-angle glaucoma, (also called  Chronic Glaucoma), is the most common form of glaucoma, accounting for at least 90% of all glaucoma cases: In open-angle glaucoma, the angle in your eye where the iris meets the cornea is as wide and open as it should be, but the eye’s drainage canals become clogged over time, causing an increase in internal eye pressure and subsequent damage to the optic nerve can occur. It is a lifelong condition and needs to be monitored. It is the most common type of glaucoma, affecting about 3 million Americans, many of whom do not know they have the disease, because you will not have signs or symptoms until it is too late. You are at increased risk of glaucoma if your parents or siblings have the disease, if you are African-American or Latino, and possibly if you are diabetic or have cardiovascular disease. The risk of glaucoma also increases with age.   The 2nd type of Glaucoma is called - Narrow Angle Glaucoma Narrow Angle Glaucoma, also called acute glaucoma, is a less common form of glaucoma – less than 5% of the general population develops Narrow Angle Glaucoma. Far sighted people are more common to have narrow angle glaucoma, since their Front Chamber of their eye is smaller than normal. The Iris can “bow” forward, thinning the angle that drains fluid from the eye. Fluid builds up and so does the pressure inside the eye. This happens when the drainage canals get blocked.  Such as When you put a drainage stopper in the sink or something clogs the drain. With angle-closure glaucoma, the iris (which is the colored portion of your eye – your brown eyes, your blue eyes etc.) is not as wide and open as it should be. The outer edge of the iris can bunch up over the drainage canals, when the pupil enlarges too much or too quickly. This can happen when entering a dark room. Unlike open-angle glaucoma, narrow angle glaucoma is a result of the angle between the iris and cornea closing quickly.   What are some Symptoms of Angle-Closure Glaucoma? Hazy or blurred vision The appearance of rainbow-colored circles around bright lights Severe eye and head pain Nausea or vomiting (accompanying severe eye pain) Sudden sight loss  Treatment Treatment for Glaucoma an involve eye drops, laser or conventional surgery. Everyone is unique and may require different treatment. Eye drops A number of medications are currently in use to treat glaucoma. Your doctor may prescribe a combination of medications or change your prescription over time to reduce side effects or provide a more effective treatment. The medications are intended to reduce elevated pressure in your eye and prevent damage to the optic nerve. Eye drops used in managing glaucoma decrease eye pressure by helping the eye’s fluid to drain better and/or decreasing the amount of fluid made by the eye. Combination drugs are available for patients who require more than one type of medication.  2 Types of Laser Surgeries Are: Micropulse Laser Trabeculoplasty (MLT) is a common procedure for the treatment of primary open-angle glaucoma  MLT provides pressure-lowering effects. It is unique in that it uses a specific diode laser to deliver laser energy in short microbursts. MLT is a relatively new laser procedure. Laser Peripheral Iridotomy (LPI) For the treatment of narrow angles and narrow-angle glaucoma. Narrow-angle glaucoma (also known as acute angle glaucoma).           LPI makes a small hole in the iris, allowing it to fall back from the fluid channel and helping the fluid drain. In general, surgery for narrow angle glaucoma is successful and long lasting. Regular checkups are still important though, because a chronic form of glaucoma could still occur.   Conventional Surgery MIGS  stands for minimally invasive glaucoma surgery. The goal of all glaucoma surgery is to lower eye pressure to prevent or reduce damage to the optic nerve. Standard glaucoma surgeries are major surgeries. While they are very often effective at lowering eye pressure and preventing progression of glaucoma, they have a long list of potential complications. The MIGS group of operations have been developed in recent years to reduce some of the complications of most standard glaucoma surgeries. MIGS procedures work by using microscopic-sized equipment (tiny, tiny tubes & shunts) and tiny incisions. While they reduce the incidence of complications, some degree of effectiveness is also traded for the increased safety.   Get Your Annual Exam so your Optometrist can detect any issues with your eyes early!   A Comprehensive Glaucoma Exam Regular glaucoma check-ups include two routine eye tests: tonometry and ophthalmoscopy. Tonometry measures the pressure within your eye. During tonometry, eye drops are used to numb the eye. Then a doctor or technician uses a device called a tonometer to measure the inner pressure of the eye. Eye pressure is unique to each person. Ophthalmoscopy  This diagnostic procedure helps the doctor examine your optic nerve for glaucoma damage. Eye drops are used to dilate the pupil, so that the doctor can see through your eye to examine the shape and color of the optic nerve. If the pressure within your eye is not within the normal range or if the optic nerve looks unusual, your doctor may ask you to have one or two more glaucoma exams: perimetry and gonioscopy.   Perimetry  Perimetry is a visual field test that produces a map of your complete field of vision. This test will help a doctor determine whether your vision has been affected by glaucoma. During this test, you will be asked to look straight ahead and then indicate when a moving light passes your peripheral (or side) vision. This helps draw a "map" of your vision.   Gonioscopy This diagnostic exam helps determine whether the angle where the iris meets the cornea is open and wide or narrow and closed. During the exam, eye drops are used to numb the eye. A hand-held contact lens is gently placed on the eye. This contact lens has a mirror that shows the doctor if the angle between the iris and cornea is closed and blocked (a possible sign of angle-closure or acute glaucoma) or wide and open (a possible sign of open-angle, chronic glaucoma). Pachymetry  Pachymetry is a simple, painless test to measure the thickness of your cornea – (the clear window at the front of the eye over the pupil). Diagnosing glaucoma is not always easy, and careful evaluation of the optic nerve is needed for diagnosis and treatment. Always get a second opinion of any diagnosis of open angle or narrow angle glaucoma.   Resources: http://www.glaucoma.org/glaucoma/video-narrow-angle-glaucoma.php   www.glaucoma.org www.worldglaucoma.org   Do you have a Medicare Question? Send it to Support@TheMedicareNation.com Tell a friend or family member to SUBSCRIBE to Medicare Nation. They’ll get a new episode on their laptop, tablet, or phone every Friday so they won’t miss an episode Find all our shows on the Medicare Nation website – www.TheMedicareNation.com Finally, Medicare nation will be having its ONE YEAR Anniversary in a few weeks. I”d love for you to help me celebrate this past year of guests, topics and questions from listeners….by telling me what you’ve enjoyed most about Medicare Nation. Go to my website www.callsamm.com And “Click” on the contact tab. You’ll see a blue button that says “ Start Recording." You’ll be able to leave a short message of what you’ve enjoyed over the past year on medicare Nation. If you’d like me to announce your celebration message, leave me your first name & city & tell me you want  to be ON Medicare Nation.  

The NOTICE ACT On August 6, 2016, The Notice of Observation Treatment and Implication for Care Eligibility Act, went into effect. (Sec. 2) This bill amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services(Medicre) to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning to receive (Observation Services) which: explains the individual's status as an outpatient and not as an inpatient and the reasons why; explains the implications of that status on services furnished (including those furnished as an inpatient), in particular the implications for cost-sharing requirements and subsequent coverage eligibility for services furnished by a skilled nursing facility; includes appropriate additional information; is written and formatted using plain language and made available in appropriate languages; and is signed by the individual or a person acting on the individual's behalf (representative) to acknowledge receipt of the notification, or if the individual or representative refuses to sign, the written notification is signed by the hospital staff who presented it.    Here is the link to the Federal Register, which explains in more detail Procedures Applicable to Beneficiaries Receiving Observation Services: https://www.gpo.gov/fdsys/pkg/FR-2016-04-27/pdf/2016-09120.pdf   Medicare Advantage Plans  “A beneficiary enrolled in a Medicare Advantage or other Medicare health plan would receive the required notice under the existing rules that apply to hospitals and CAHs under a provider agreement governed by the provisions of section 1866(a)(1)(Y) of the Act.”   If you are enrolled in a Medicare Advantage Plan, you are covered under the provisions of your plan. READ your plan’s Evidence of Coverage (EOC) to determine what your out-of-pocket expenses will be in this situation.   I am urging each of you to be Pro Active with your own Health Care! If you or a loved one goes to the Emergency Room or a Critical Access Hospital, be prepared to speak up! Speak to the Physician in the ER who is treating you. Ask the physician specifically…..”Am I being ADMITTED to the hospital as an INPATIENT?” If the answer is “Yes,” you will be covered under Medicare Part A benefits.  If the answer is…. “No…..you are UNDER OBSERVATION. OR……”No……you are receiving OUTPATIENT SERVICES.”  You WILL more than likely be responsible for co-payments, co-insurance or maybe ALL charges! Call your Primary Physician or Specialist. Tell the office or Answering Service that you or your Family member is in so and so Emergency Room, so and so hospital and you want your Doctor to either: Come to the hospital and examine you to determine if you should be admitted to the hospital as an inpatient                                            OR Have your doctor speak to the Emergency Room physician who is treating you, in order to determine if you will be admitted or able to be discharged from the Emergency Room.   You Should NOT have to be in an Emergency Room for up to 23 and a quarter hours UNDER OBSERVATION! Your Primary Doctor is the “Quarterback of your health team!” Your Primary Doctor is in charge of your health care! That is what they get paid to do all that extra paperwork for! Put them to work for you!   Do you have a Medicare Question? Send it to Support@TheMedicareNation.com Tell a friend or family member to SUBSCRIBE to Medicare Nation. They’ll get a new episode on their laptop, tablet, or phone every Friday so they won’t miss an episode Don’t know how to subscribe? Visit my short video to show you how to do it – step by step. Find all our shows on the Medicare Nation website – www.TheMedicareNation.com Finally, Medicare nation will be having its ONE YEAR Anniversary in a few weeks. I”d love for you to help me celebrate this past year of guests, topics and questions from listeners….by telling me what you’ve enjoyed most about Medicare Nation. Go to my website www.callsamm.com And “Click” on the contact tab. You’ll see a button that says “ Record Your Message Here.” Click on it and start talking! No equipment required! You’ll be able to leave a short message of what you’ve enjoyed over the past year on Medicare Nation. If you’d like me to announce your celebration message, leave me your first name & city & tell me “I want to be ON Medicare Nation.”     Thank you for being part of Medicare Nation’s Anniversary!

Welcome Medicare Nation! Today, I will be discussing Advance Beneficiary Notices. An Advance Beneficiary Notice (ABN), also known as a waiver of liability is a notice you should receive when a provider or supplier offers you a service or item they believe Medicare will not cover. ABNs only apply if you have Original Medicare, are on a Medicare Supplement Plan. ABNs do not apply if you are in a Medicare Advantage private health plan. If you receive an ABN and you're on a Medicare Advantage Plan, ask to speak to the office manager. Providers must give you an ABN when the service or item could be covered by Medicare, but the provider expects that Medicare will not find the care to be medically necessary and will, therefore, deny coverage. The ABN must list the reason why the provider doubts Medicare will cover care. For example, an ABN might say, “Medicare only pays for this test once every ten years.” That would be the case for a colonoscopy, since Medicare pays for a low-risk colonoscopy once every ten years. You should not be receiving an ABN for services or items that are never covered by Medicare, such as hearing aids.  In order to receive an official decision from Medicare, you must: 1. First receive the care or receive the item                                                       2. You must sign the ABN form, agreeing to pay for it yourself if Medicare rejects       coverage. Also, you must select Option 1 on the ABN form in order for the doctor or supplier to bill Medicare! Selecting this option requires your provider to bill Medicare after providing you with the service or item. If you don't select Option 1 on the ABN, you have no chance, nada, zilch chance of Medicare coverage because your doctor is not required to submit the claim. You will receive a Medicare Summary Notice (MSN) from Medicare. The Medicare Summary Notice will show if Medicare has denied payment for a service or item.   If Medicare denies your claim, you should file an appeal. Just because you filled out an ABN does not prevent you from filing an appeal. Medicare has specific rules about an ABN and how it should look. If these rules are not followed, there is a good chance you may not be responsible for the cost of the care. Remember, first you will have to file an appeal to prove your case. Here are a few reasons you would not be responsible for the charges on an ABN Is difficult to read or hard to understand. Is given by the provider (except a lab) to every single patient with no reason to believe the claims may be denied by Medicare. The ABN does not list the actual service provided  The ABN is signed after the date the service was provided. The ABN is handed to you during an emergency or is handed to you just prior to receiving a service (ex:You're on the xray table & they hand you an ABN) An ABN was not given to you when it should have.  You can file an appeal by going to your Medicare Supplement website and search for Appeal Form, call your Medicare Supplement Health Insurance Carrier or you can call Medicare at 800-633-4227 and ask them to mail you an appeal form. Thanks for listening to Medicare Nation! I appreciate you taking your time to listen to the show! Send me your questions to Support@TheMedicareNation.com I might read your question on the air! Like our Facebook page! Go to https://www.facebook.com/MedicareNation  

Welcome, Medicare Nation! Today I want to explain a brand new bill being introduced in the US House and Senate. It’s the BENES Act (Beneficiary Enrollment Notification and Eligibility Simplification Act). This bill impacts people eligible for Medicare, specifically those who are nearing the age 65 enrollment period for Part B. The bill was introduced by Rep. Raul Ruiz (Dem.-CA) and Rep. Patrick Mann (Rep.-PA) in the House and by Sen. Bob Casey (Dem.-PA) and Sen. Chuck Schumer (Dem.-NY) in the Senate. I hope I can clear up any confusion for you! Let’s look at the current PROBLEM, which boils down to a LACK OF INFORMATION: The current system lets CERTAIN people know when to enroll in Medicare. If you are receiving SSI(disability) or SS benefits, then you will receive a letter as your 65th birthday approaches, advising you of your enrollment period and Medicare effective date. What about those NOT receiving those benefits? THAT is the problem! If you don’t receive current SSI or SS benefits, then the government has no “trigger” to alert you that it’s time to enroll as you approach age 65. If you don’t enroll during your initial enrollment period (three months prior to, including, and following your BIRTHDAY MONTH—for a total of seven months), then significant late penalties can apply. These can raise the premium you pay by as much as 30%! In 2014, ONE MILLION people paid a late penalty. The average monthly premium is $105 and the average late penalty adds an average of 30% to your monthly premium—EVERY MONTH!  Remember the following: If you have worked for 10 years (40 quarters paid into FICA), then you have paid the minimum to qualify for Medicare Part A, premium-free. Part A is the “accommodations” part of Medicare, meaning it covers overnight stays in medical care facilities. Part B covers outpatient services, which includes everything you might need in health care, excluding overnight stays. Under current law, the government will NOT send you any notification of your approaching enrollment period, and then they will assess you a substantial late penalty if you don’t enroll when you should. “It’s all about the mighty dollar, folks!” Let’s look at what the BENES Act will do to correct the PROBLEM: The Act will make it possible for those turning 65 (10,000 Americans EVERY DAY!) to avoid mistakes and will give uniform information about the Part B enrollment process. Each individual will receive a “clear and detailed” notice of Part B enrollment rules that will help them make informed decisions. The government will send a notification when you are 64, letting you know that your initial enrollment period (that 7-month window around your birthday) is approaching. I’m excited about the possibilities of this new law, but it has to get passed first. Congress will reconvene on September 6 after their summer break, and if you want to stay informed about the progress of the BENES Act, then see our resources section. Here’s a listener question from Teresa in Philadelphia: How do I enroll in Medicare? Well, Teresa, there are some options. If you are turning 65 and not currently receiving SSI or SS benefits, then you need to visit www.ssa.gov, go under Menu—Benefits—Medicare, and then scroll down to “Apply for Medicare only.” Click on “Start a New Application” and follow the directions. It should take about 10 minutes! Do it prior to your 65th birthday. My caution is that your personal information must have been updated with the Social Security Administration or there will be delays. If you have moved to a new address, changed your marital status or name, then you will have to go to the local SS office to enroll. You can call 800-772-1213 to enroll over the phone, but it is a LONG process. If you are over 65 and still working and are covered by your employer’s credible insurance plan, and NOT under Part B---then you will have to go to the local office and have two forms with you: the Employer Attestation Form (to prove there have been no gaps in insurance coverage since your 65th birthday) and the Application to enroll in Part B. Find these forms at www.ssa.gov or email me at support@the medicarenation.com and request copies. Thanks for the question, Teresa, and I hope this helps you! Resources: www.medicare.gov  and    www.callsamm.gov can give you information NOW about Medicare enrollment. www.congress.gov  (Keep up with the BENES Act progress—reference House Bill 5772.) www.medicarerights.org   (For great information and resources!)   Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! 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  

Welcome, Medicare Nation! Today’s topic is Diabetes Prevention, based on the expansion of a pilot program instituted by the CMS (Centers for Medicare/ Medicaid Services). I’ll be explaining the program’s components and the results. Join me! What you’ll hear in this episode: Statistics about diabetes: There are currently more than 30 million Americans with Type 2 diabetes. There are TWO deaths every FIVE minutes from diabetes! There are 86 million Americans at a high risk of developing diabetes. One out of three adults have “pre-diabetes,” which means they have higher than normal (normal is

Welcome, Medicare Nation! Today’s episode is a Q & A in which I answer questions from two listeners. If you have a question for me about Medicare, then email me: support@themedicarenation.com.  Let’s jump right in! From Mike, in Pleasanton, CA: If my doctor drops out of my HMO network, can I change to a Medicare Advantage plan that the doctor currently takes? Here’s the thing, Mike: when you enroll in Medicare Advantage, you are in a “locked-in” period unless you have a “special election.” A special election can occur for a number of reasons: if you moved to a different county with new plans, or if CMS (Center for Medicare Services) decided to terminate a Medicare Advantage policy and you need to find a new one. Another situation for special election would be if you are still working, at age 65 or over, and are covered under your employer’s plan and aren’t on Part B. If you need to drop your employer’s coverage and enroll in Part B, then a special election would exist. Unfortunately, doctors can drop out of an HMO or PPO anytime, although they do have to give 60 days’ notice.  Mike, you will have to change doctors unless this occurs between October 15 and December 7, which is the open enrollment period, or unless you have a special election period. Your situation would not be considered for special election. It’s unfortunate, but it is very common and happens to many people each year. The doctors do this because of money, but keep in mind that if you follow a doctor to another plan, then the same thing can occur again. I hope this helps. Visit www.callsamm.com or www.medicare.gov for more information.   From Sharon, in Austin, TX: How much will I have to pay to be in the hospital for 7 days? Well, Sharon, the answer depends upon your plan. If you have original Medicare, Part A, then you have what I like to call  “accommodations insurance.” This means overnight stays are covered, with a deductible of $1288 for any stay of 1-60 days. All services and procedures in the hospital would then be covered for you. From days 61-90, you would pay $322/day for the same coverage. Of any stay of more than 90 consecutive days, you can draw on your lifetime reserve of 60 days at a cost of $644/day. Keep in mind, though, that those extra 60 days are a “lifetime piggy bank” of days, and you can’t get them back once you use them. The old adage, "You use them - You lose them," applies here. If you have a Medicare Advantage plan, then they are all different. An HMO will have a smaller network, and your co-pay will range from $0-$250/day. A PPO network is larger, therefore, your co-pay for an inpatient hospital stay will range from $0-$425/day. You would need to contact your Medicare Advantage Carrier to determine the exact amount of what your inpatient hospital co-pay will be. There are also Medicare Supplements (MediGap) plans, such as the F plan, G plan, and N plan. For these plans, you pay your monthly premium, but then have $0 out-of-pocket "medically necessary" inpatient hospital stays. Other Medicare Supplement (MediGap) Plans have a Part A deductible. Again, you need to contact your Medicare Plan customer service representative to determine your exact cost. Sorry, I can’t be more specific since I don’t know your plan, Sharon, but I hope this information is helpful for you. Thanks for the question!   Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! 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

Welcome, Medicare Nation! I’m excited about our guest and our important topic today. We’re discussing the confusion surrounding advanced directives. Have you ever thought about what would happen if you can’t speak for yourself and are in an emergency health situation? Who will express your wishes, and will the health care professionals understand? Dr. Ferdinando (Fred) Mirarchi is the ER Director of University of Pittsburgh Medical Center-Hamot. He has a solution! Join us to learn more! Tell us about health care directives and the issues that commonly arise when people come to the ER. There are three types of directives: living will, DNR (Do Not Resuscitate order), and POLST (Physicians’ Order for Life Sustaining Treatment). All three of these have safety issues surrounding them, and all three bring questions. When are they to be followed? None of us know when an emergency situation may arise, so when do we carry these documents with us? Even medical professionals don’t understand these orders, but no one really wants to raise the safety concerns. What happens when someone comes to the ER with no accompanying family and no papers? It’s not just an ER situation, but anywhere in the hospital, for any medical procedure. “You, the patient, are asked if you have a Living Will, then you are subjected to whatever their understanding is as to what that means.” About 78% of the time, physicians assume that a Living Will equals a DNR, but in 64% of cases, a DNR is strictly an end of life order and does not apply to critical care emergencies. Medical professionals assume if you have any advanced directive that you’re an end of life care patient and don’t want care. Many don’t understand the difference between being critically ill and being in an “end of life” situation. If you have advanced directive documents, should you bring them with you to any scheduled procedure, like a colonoscopy? Most physicians would say YES, but I say NO. Keep your document in a safe place so that it doesn’t compromise your care and treatment. Pull it out when you need it, but then you face a retrieval issue. Will the proper medical professional have access to your papers when they need it? We have a process that can insure that those documents are retrieved when needed. Most ER doctors are forced to look at a paper and make an interpretation, based on THEIR understanding, which might not be right for you. Can you explain the difference in a Living Will and a DNR? A Living Will is a legal document, not a medical document. It is for use in situations when someone can’t speak for themselves, develops a terminal condition, or is in a persistent vegetative state. A DNR is specifically for when someone is found with no pulse or breathing, and no CPR is desired. There is a common misunderstanding that a DNR means no medical treatment at all, when it most often applies to end of life care. When someone has a Living Will and the medical professional assumes it’s a DNR, then it can affect care and treatment of any medical emergency. “It’s a coin toss with a 50% chance of being treated or not being treated.” You’ve developed a solution to help people explain their wishes about receiving treatment. Can you explain? At the Institute of Health Care Directives, we have created ID cards containing detailed information to be understood by any medical professional in any hospital. It gives patients a voice to guide their care and treatment. Your ID card has info and directives linked with a QR code that accesses a video recording of your wishes. The recorded video is in a database and can be pulled up on any smart phone for any medical situation you may encounter. Will this ID card work in any medical office, hospital, or ER? Yes, and it’s in clear and understandable medical language so that any professional will know what to do. Can you explain how to find out more and what the service includes? Visit our website: www.institutehcd.com or email us: info@institutehcd.com. You can even call us at 814-490-6584. Dr. Mirarchi is offering a 10% discount to the first 100 MN callers on either of the available packages. The Basic package is for healthy, young people, and the VIP package is for those with multiple medical problems. The VIP package gives you access to an on-call doctor 24/7/365. You can ask any question or any medical professional treating you can call for information about your condition. Our solution is a much clearer and simpler process and has received great response from physicians. The goal is to plan for when you are critically ill and (separately) for when you’re at the end of life. There is a study coming out in 3-6 months on a 15 state trial, and the preliminary results are amazing. This is truly a game-changer in the health care industry. Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! 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    

Welcome, Medicare Nation! My guest today is Dr. Steven Loomis, an optometrist in Littleton, CO. Dr. Loomis is also the president of the American Optometric Association. Did you know that June is Cataract Awareness Month? It’s important to know what cataracts are, how they develop, and how to treat them. Dr. Loomis is here to discuss those topics and others related to general eye health. Join us! Many people don’t understand the difference between an optometrist and ophthalmologist. Can you explain?  Think of an optometrist “like a family doctor for your eyes.” These are medical doctors with four years of undergraduate education and four years of specialization. They deal with eye issues such as blurred vision, diabetes, and glaucoma. Optometrists actually diagnosed 240,000 cases of diabetes in 2014! An ophthalmologist is an eye surgeon who works in conjunction with a patient’s optometrist. We know we need comprehensive eye exams, but how often should we get them, and what is included in that exam? An annual exam is recommended unless there is a condition that warrants more frequent care. Specific tests are included, such as visual acuity, auto refraction, an image of the inside of the eye, visual field, blood pressure, and a check of the pupils. The doctor will also ask questions about medical family history.  What exactly does “20/20 vision” mean? Vision is based on the Snellen Acuity Chart, which was invented by Dr. Snellen over 100 years ago. It is the basic eye chart we are all familiar with that has a series of letters or shapes of certain sizes. The “20 foot” standard has been established, meaning that you see what you should see at a distance of 20 feet. A vision of 20/30 or 20/40 means that you see at 20 ft. what the normal eye sees at 30 or 40 ft. Some people see better than normal, like 20/15. It’s interesting how they measure the 20 feet distance, when most exam rooms are not 20 ft. long. The chart might be 12 ft. away from the patient on the wall, and a mirror is placed 8 ft. behind the patient, to make up the 20 ft. distance. As we age, does 20/20 vision decrease? Yes, unfortunately. It’s completely normal because our eyes age as do other parts of our bodies. As your lens ages, cataracts may form and the retina and cornea lose some functionality. What are “floaters,” and can they clear up? Floaters are very common. They can be seen during an eye exam with dilated eyes. What happens is that the vitreous fluid in the eye, which should be firm, solid, and gelatinous, begins to liquefy as we age. This more liquid substance has fibers in it that appear in our vision as floaters. The good news is that they can clear up; they can shrink, sink, and then we THINK they are gone. If floaters increase or change, then see your optometrist to be checked. What is glaucoma? In short, it occurs when the pressure inside the eye damages the optic nerve. Risk factors include family history, racial characteristics, age, and medications. The first symptom is often vision loss.  If glaucoma is indicated, what is the treatment? Medications can control the pressure. Usually eye drops are prescribed once daily and can safely manage the disease. What are cataracts and how are they treated? Cataracts are very, very common and usually show up around age 60. The lens becomes not as clear as it used to be as it loses its clarity and transparency. Exposure to UV rays can cause them, as well as steroids, diabetes, radiation treatments, eye trauma, and eye surgery. The #1 cause? Too many birthdays! There is no treatment needed for early cataracts, but they can worsen to cause hazy vision and nighttime glare. Surgery is the only cure, where the natural lens is removed and an artificial lens is implanted. The good news is that your lens prescription can be incorporated into the artificial lens so your vision is improved on multiple layers. (Tune in to hear a fascinating account of cataract surgery details! Did you know it only takes 5-8 minutes to complete?) How do Medicare benefits factor into cataract surgery? Medicare will pay for a monofocal artificial lens, but the patient can pay for an upgraded lens if desired. Medicare, depending on your plan, will pay a portion of glasses or contacts needed for after surgery. Final words from Dr. Loomis: Keep up with your annual eye exams and discuss options with your doctor when issues arise. Visit www.aoa.org for more information and for their “doctor locator” tool. Question from Eileen in PA: Does Medicare cover eyeglasses? The answer is no, except for what is needed after cataract surgery, and then a portion may be covered under your plan.   Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! 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      

Welcome, Medicare Nation! I’ve had a busy two weeks and have just returned from a conference in Miami for the National Osteoporosis Foundation. I have been flooded with emails, so today’s episode will be a Q&A session in which I address as many of those questions as possible. Join me! From Steve in Texas: “I’m turning 65 in July and your program has been helpful to me. Can I change Part D prescription options over time without having to pass insurability determinations?” The options can be confusing. You can change Part D plans during the annual enrollment period, from October 15-December 7. You can change plans every year, if needed. You should review your plans yearly, based on your prescription needs and usage.   From Dottie: “I have a Medicare Advantage Plan with Blue Cross. When I get the benefits summary, do the fees reflect those set by Medicare or do the doctors make these up?” Every Medicare insurance carrier negotiates with each doctor and facility so they have a contract for how much the doctor gets paid for services. The summary shows what the doctor usually charges, what your plan covers, and what your co-pay amount is. What you see is what the doctor normally charges, but NOT what you will pay. The negotiated rate will be applied by your plan and you pay your co-pay or co-insurance.   From Dottie, the 2nd part of her question: “If I want to change to another Medicare Advantage Plan, can I keep my same doctor even if he isn’t in the network?” Remember, Medicare Advantage is all about being in a network. It’s a “pay as you go” plan because you only pay for what you need. If your doctor is not in network, you have to decide what’s more important. Do you have to stay with that doctor or do you value the plan’s benefits more? You may need to change plans or pay out of pocket. This depends upon if your plan is an HMO or a PPO. A PPO has an out of network option but you will pay a higher co-pay. An HMO in Medicare Advantage doesn’t allow any out of network options. I hope these questions and answers have been helpful to you. If need be, we’ll add another show each week just to cover your questions. So, keep those coming!  Email me: support@themedicarenation.com. Remember, you can visit www.medicare.gov for more information.  Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! 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  

Welcome, Medicare Nation! Can you believe the month of June is here? The year is rolling right along, and you may not be aware that June is Aphasia Awareness Month. If you’re not familiar with aphasia, you should know that it’s an acquired disorder that affects a person’s ability to speak and to process language, but it does not affect intelligence. Let’s learn more about this disorder. Here are a few basic facts about aphasia: Often, aphasia is the result of brain injury, brain tumor, neurological disease, or stroke. (25-40% of stroke survivors will have aphasia.) About 2 million Americans are affected by aphasia, with 180,000 acquiring it yearly. Aphasia can affect any age, race, ethnicity, and gender. Those over age 60 have the highest aphasia rates, with those over age 40 being the second highest. The rate of occurrence is the same for all other age groups. Aphasia can’t be cured but can be treated and improved with speech and occupational therapy, and these are covered by Medicare, depending on the plan. Some helpful therapies can be done via an app or on a computer. Many of these costs can be reimbursed, depending on your Medicare plan. Aphasia is self-diagnosable because the signs are noticeable, and may include social isolation, repeated actions/words, and jumbled/slurred speech. There are several types of aphasia: Global aphasia is the most severe form. It leaves the person unable to speak more than a few words and they can’t understand spoken words or read. Broca’s aphasia has characteristics of reduced speech output, limited vocabulary, but the person can understand language and read. Mixed Non-fluent aphasia makes it hard to speak and limits comprehension. The person cannot read or write beyond the elementary school level. Wernicke’s aphasia leaves the person fluent, where they can grasp the overall meaning of a sentence, but may not comprehend individual word meanings. Primary progressive aphasia is a rare neurological syndrome in which brain tissue degenerates. To find out more about aphasia, visit the website for the National Aphasia Association: www.aphasia.org. You may contact them via email: naa@aphasia.org or find them on Facebook: Aphasia Recovery Connect. Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! 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    

Diane Daniels is a successful entrepreneur and Medicare Advisor. She left the insurance industry to become a renowned authority on Medicare when she was unable to assist a seventy-year-old woman enroll in a Medicare plan that fit her lifestyle. Six months later, Diane started her own business and has never looked back at corporate. She is the Host of Medicare Nation and The Weight Loss Nation. Medicare Nation will feature interviews with experts in health, insurance, policy and more. We’ll explore specific challenges and situations, which we’ll help listeners understand how Medicare relates to each one. In addition, we’ll share helpful links and resources. Weight Loss Nation is a lifestyle oriented competition where participants get 24 hour, 7 day a week support in making their dreams of a healthy lifestyle a reality! JJ Flizanes is an Empowerment Strategist. She is the Director of Invisible Fitness, an Amazon best-selling author of Fit 2 Love: How to Get Physically, Emotionally, and Spiritually Fit to Attract the Love of Your Life, and author of Knack Absolute Abs: Routines for a Fit and Firm Core. She was named Best Personal Trainer in Los Angeles for 2007 by Elite Traveler Magazine.   JJ vividly reminds us that the word ‘fitness’ is not just about the state of one’s physical body, but also the factors which determine a person’s overall well being. And, for JJ, the key components in all these areas are ‘invisible’ — balanced support structures of nutrition, emotional centeredness and health. A favorite of journalists and the media for her depth of knowledge and vibrant personality, JJ, a contributing expert for Get Active Magazine, has also been featured in many national magazines, including Shape, Fitness, Muscle and Fitness HERS, Elegant Bride, and Women’s Health as well as appeared on NBC, CBS, Fox 11 and KTLA. She is also a video expert for About.com and regular contributor for The Daily Love. JJ launched her professional career in 1996 as the Foundations Director for the New York Sports Club, where she designed curriculum and in-house certification for new and previously uncertified fitness trainers. She has also been certified by the American Council on Exercise (ACE), International Sports Science Association (ISSA), National Academy of Sports Medicine (NASM)and the Resistance Training Specialist Program (RTS). With a focus on biomechanics, JJ has lectured for The Learning Annex and as a featured speaker for New York Times Bestselling Author of The Millionaire Mind, T. Harv Ecker’s Peak Potentials seminars, as well as corporate clients, including Pacific Gas and Electric, Hanson Engineering, and Jostens, Inc. She is the Wellness Expert for KFC International, the Health and Fitness Expert for the National Association of Entrepreneur Moms, and a Fitness Expert for Nourishing Wellness Medical Center.  She has been working in the health and wellness industry for 15 years, as a fitness trainer with a knack for helping her clients become more self-aware and self-empowered through her ability to quickly identify and pinpoint problem areas, and then create simple solutions involving exercise, nutrition and mindset changes. She is the Host of the new iTunes Podcast Show Fit 2 Love: Physical, Emotional and Spiritual Fitness for the Happy Life You Deserve which is six day a week video and audio show. What sets JJ apart from her Celebrity Fitness counterparts is the holistic approach to getting results. Over the last fourteen years she has studied, used and applied Positive Psychology, Neuro-Linguistic  Programming (NLP), Eye Movement Desensitization and Reprocessing (EMDR), Emotional Freedom Technique (EFT), Law of Attraction, Quantum Physics, Non Violent Communication, Imago Therapy, and Hypnotherapy. JJ Flizanes has proven that she’s not only an expert in matters of the body and fitness—she’s an insightful and provocative author who delivers a timely message about matters of the heart.

Welcome Medicare Nation! Hot Topic – The Comprehensive Care For Joint Replacement Model (CJR Model) Hip Replacements & Knee Replacements are the MOST COMMON Inpatient Surgery for Medicare Beneficiaries. In 2014 over 400K procedures were done, which cost Medicare over 7 Billion $ for the Hospitalization for these procedures ALONE. Hip & Knee Replacement Surgeries can require long recovery time & long Rehab periods. I KNOW!  I’m not even on Medicare yet, and I’ve had TWO Arthroscopic Knee Surgeries, and each surgery took me about a good 6 MONTHS to recover.   This is the SCARY PART!   The Quality & Care you receive VARIES from one Hospital to the next! Complications like – Infections received at the hospital …….OR Implant Failures Can be 3X Higher Performed at Some Hospitals More Than Other Hospitals. To me……that is just NEGLIGENCE!  When you go into a hospital……you expect to receive the best care, a clean environment and YOU SHOULD NOT  CONTRACT  ANY INFECTION OR DISEASE from the Hospital you’re being treated at!  That’s what you Expect from a Hospital…..NOTHING LESS. But……it is apparently going on RIGHT NOW Nation! And it takes a CMS LAW or MODEL PROGAM to prevent it from happening in EVERY Hospital? Aye,,yi,,,yi.   WHY IS THIS HAPPENING TO YOU? In episode 34 on Medicare Nation, you listened to Melissa’s Story. Melissa’s story is about the struggles she had with her mother, who suffered a broken hip and the FRAGMENTED care her mom received while in the hospital and the struggles she had in moving her mom to a skilled care facility and then setting up home care physical therapy for her mom. That is why all this is happening Nation! There is a LACK OF COMMUNICATION, between Hospital Staff, other Doctor’s, Skilled Nursing Facilities and Home Care Physical Therapy. NO ONE is talking to anyone else! The LINKS in the CHAIN of Patient Care is BROKEN, and YOU are paying for it!  This FRAGMENTATION of Care is causing LONGER RECOVERY TIMES, HIGHER HOSPITAL RE-ADMISSIONS & HIGHER OUT OF POCKET COSTS FOR YOU & FOR MEDICARE. The Comp Care Joint Replace Model Addresses the LOW QUaLITY CARE & Higher Costs that come from this FRAGMENTED CARE, by – PROMOTING CO-ORDINATED PATIENT CENTERED CARE! Imagine that Nation!  Putting the Patient 1st! What a New Concept!   HOW  WILL  THE  CJR  MODEL  WORK? Started  April 1,  2016 The hospital in which the hip or knee replacement and/or other major  leg procedure takes place, will be accountable for the costs and quality of related care  from the time of the surgery through 90 days after hospital discharge—what is called an   “episode” of care. Depending on the hospital’s quality and cost performance during the  episode, the hospital will either  Earn a financial reward     OR,  beginning with the second performance year, be required to repay Medicare for a portion of the spending.  This payment structure gives hospitals an incentive to work with  physicians,  home health agencies,  skilled nursing facilities,  and other providers to make sure beneficiaries receive the coordinated care they need  The goal is reducing avoidable hospitalizations and complications.  Hospitals in the model will be provided access to additional tools – such as spending and utilization data and sharing of best practices -- to improve the effectiveness of care coordination. The model also gives providers additional flexibilities that are not otherwise available under Medicare so they can better manage the care of patients, including patients who are at home. By “bundling” payments for an episode of care, hospitals, physicians, and other providers have an incentive to work together to deliver more effective and efficient care. The CJR model is being tested in 67 geographic areas throughout the country, and nearly ALL hospitals in those geographic areas are required to participate. The CJR model supports Health & Human  Service’s  efforts to transform the health care system towards one focused on better quality care, smarter spending, and healthier people through care transformation and payment reform. WHAT  AREAS  ARE  PARTICIPATING  IN  THE  CCJR  MODEL Over 800 Hospitals across the US are participating, in 67 Geographical Locations. Areas were determined based on statistical population data, with populations of over 50K residents. Here are a Few selected Areas: Florida – Broward, Collier County, Gainsville, Hernando, Hillsborough, Indian River County, Lake County, Martin, Miami-Dade, Orange County, Osceola, Palm County, Pensicola area, Pinellas, Pasco, Santa Rosa County, Seminole County and St. Lucia County   California – Alemeda County, Contra Costa County, Los Angeles County, Marin County, Orange County, San Francisco County, San Mateo, Stanislaus County,    The rest are on the CMS.gov site. Search “CJR Model Geographical Areas,” To find out if a Hospital or County where you reside is participating. OR You can go to my website, www.callsamm.com  and I’ll put up a PDF of the Counties participating in the CJR Model program for you to request.     You can also download a copy of the Federal Register, which is a daily journal of the US Government.  The FINAL Rule for the CCJR Model is there in LONG Form https://goo.gl/hN44cm Federal Register/ Vol. 80, No. 226 / Tuesday, November 24, 2015 / Rules and Regulations  www.callsamm.com - has all of this information available for you.   Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! 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            

Welcome, Medicare Nation! March is National Kidney Disease Awareness Month, so I’ve invited Dr. Jeffrey Berns on Medicare Nation. Dr. Berns is the president of the National Kidney Foundation and a professor of medicine and pediatrics at the Perelman School of Medicine at the University of Pennsylvania and the Associate Chief of the Renal Electrolyte and Hypertension Division. He is also the director of the Nephrology Fellowship Training Program and the Associate Dean for Graduate Medical Education. Dr. Berns is a busy and dedicated physician, and I’m grateful he is taking the time to inform us about kidney disease today! Give the listeners an idea of the prevalence of kidney disease in the US. One in three people are at risk for kidney disease, while one in nine already has some level of kidney disease. Chronic kidney disease is measured in stage 3, 4, and 5. Stage 5 is the level at which dialysis or a transplant is required. Throughout your lifetime, it’s important to avoid exposure to things that can damage the kidneys, and that includes many prescription medications. Is it correct to say that kidney disease if most often a “silent” disease? It is similar to high blood pressure, which is also an important risk factor for kidney disease. Kidney disease is asymptomatic until permanent damage is done. Some tests can reveal the disease to a doctor, but patients don’t often have symptoms until it’s late in the game. What is the difference between a nephrologist and an urologist? A nephrologist is a physician with specialized training in medical diseases of the kidney, while a urologist is trained in surgical diseases of the kidney and urinary tract. What are signs and symptoms that would indicate late stage kidney disease?   Protein in the urine in large amounts Swelling of the feet, hands, legs, and face High blood pressure Fatigue Difficulty concentrating Sexual dysfunction Loss of appetite Metallic taste in the mouth   When should people see their doctor about kidney disease? We all have to be aware of the risk. Most older people are at increased risk, and minorities are at a higher risk. If kidney disease is in the family history, then the risk is higher. Diabetes increases the risk, but many cases of mild kidney disease can be managed quite well by a primary care physician. Wouldn’t it be a good idea to check blood levels for patients at yearly checkups? That would be the perfect time and opportunity for routinely-done tests. Your doctor can monitor you for any change over time, and you can ask your doctor if you have signs of chronic kidney disease. The National Kidney Foundation has partnered with MACC (Medicare Advantage Care Coordination) Task Force, aligned with 35 leading patient-care providers for patients with multiple disorders. Tell us more about MACC. Many patients with kidney disease also have other issues. MACC allows for their care to be more cohesive and patient-centered instead of fragmented care coordination. What can listeners do to improve care coordination? Make sure each of your doctors are communicating with each other. Most providers have electronic patient records that every doctor can see. Patients should remind each of their physicians to send their medical records to their primary physician. Your Primary physician is in charge of coordinating your care. Provide your Primary physician with a list of your other providers names and phone numbers. Carry a list of up-to-date medications to every doctor. How is Care Coordination utilized with different types of Medicare Plans ? Original Medicare provides the most freedom in seeking physicians with no referrals. Lack of communication between physicians causes fragmented care, with no care coordination. Medicare Advantage Plans include networks of physicians, with required referrals to see specialists. This allows continuity and greater communication in care coordination. Medicare Advantage Plans are continually trying to improve payment models and care coordination. Here are several steps individuals should follow to improve care coordination: Know your risk factors. Talk to your primary care doctor and have screening tests. Carry a list of medications with you. Keep a list of numbers and names of care providers. Make sure your plan has care coordination tools.   Learn more about Kidney Disease, find helpful resources and support on the National Kidney Foundation's website Visit www.kidney.org for more information. To learn more about the Medicare Advantage Care Coordination Task Force : Visit www.medicarechoices.org 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

Welcome, Medicare Nation! It’s March, which is a huge month for awareness. Last week’s show highlighted colon cancer awareness, this week we are discussing MS awareness, and next week’s topic is chronic kidney disease.  What is MS? MS is multiple sclerosis, which is a disabling disease of the central nervous system. It occurs when there is a disruption of the electrical circuit between the brain and the rest of the body. Nerves have a myelin sheath that covers and protects them; when the sheath is damaged and the electrical impulses are disrupted, then multiple sclerosis is the diagnosis. What are signs and symptoms of MS? Fatigue that interferes with your ability to function Numbness/tingling in face and extremities Muscle weakness Dizziness/vertigo Pain, significant and chronic Vision problems How is MS diagnosed? It’s a difficult disorder to diagnose, and can be found using blood tests and MRI’s. Doctors can test the electrical impulses in the brain, and they also pay attention to family history. Medicare covers these diagnostic tests to some degree, so CHECK YOUR PLAN! See your doctor if you experience any symptoms. Over 400,000 people in the US have been diagnosed, with more than 200 newly diagnosed cases each week! Most patients are between 20-50 years old. There is no cure for MS; all doctors can do is to try to slow the progression of the disease. For more information, visit www.nationalmssociety.org or call 1-800-344-4867 to contact the National MS Society.   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    

Welcome, Medicare Nation! Today’s guest is Lee Silverstein, who is a colon cancer survivor. Lee is here to discuss the risks, prevalence, and treatments for this disease. Colorectal cancer is the most commonly diagnosed but also the most preventable through proper screening. The American Cancer Society estimates that 95,000 people will be newly diagnosed with colon cancer in 2016. Over their lifetimes, 1 in 21 men and 1 in 23 women will be diagnosed! Colon cancer is clearly not “the old man’s disease” that many of us have been led to believe. Let’s hear Lee’s amazing story! Why has colon cancer become so widespread for people under age 40? “Over the last few years, the rates for diagnosis have remained steady, with a huge increase in the number of cases in people under age 40. It is scary, alarming, and unexplainable by doctors. I recently attended a conference on colon cancer and met a newly diagnosed 23-year-old. The common risk factors are being overweight, a lack of physical activity, a diet rich in red meat, heavy smoking and alcohol use. Keep in mind that you can have NONE of these risk factors and still be diagnosed with the disease, like what happened to me.”   Would you mind telling our Medicare Nation listeners your personal story? “Not at all—I would love to share my story. I had NO risk factors and had just turned 50, living a very health-conscious life. I exercised regularly and was eating smart. I had a colonoscopy in March 2011, and the doctor couldn’t get the scope where he needed it to go. I wasn’t alarmed, but received a call from the doctor two days later saying I had a tumor in my transverse colon. This colonoscopy saved my life!”   Would you share what your treatment was? “I had colon cancer and needed to have the tumor removed; the surgeon was confident that he could remove it all. My cancer was classified as Stage 2, which meant it was borderline as to whether there were benefits to undergoing chemotherapy. I got three opinions and determined that the benefits of chemo did NOT outweigh the risk. My follow-up exam included a CT scan and bloodwork, which showed a small spot on my liver. A biopsy was ordered and showed that my colon cancer had spread to my liver, even though it was a small spot and slow-growing. Surgery was recommended and chemotherapy. I went to Sloan-Kettering, which was the hospital I had been treated at as a child when I had a rare kidney cancer. The liver surgeon there was confident that I would be fine. Surgery was scheduled for January 2013 and I finished chemo treatments in August. In 2014, two small spots on my lungs were discovered. The doctor suspected that it was colon cancer that had metastasized to my lungs. He wanted to treat it with SBRT, a cyberknife-type targeted radiation procedure. In normal radiation, low doses are given over a wide area over a long period of time, with damage to the surrounding tissue. In this procedure, pinpointed high doses are given over a short time. I had the treatment with no side effects, and was even able to continue training for a race. The one spot disappeared and the other shrunk significantly. I’m not cancer-free, but I am stable. The goal of colon cancer treatment is to make it a chronic manageable disease.”   Can you tell Medicare Nation listeners about the Colon Cancer Alliance? “I found this organization when I was first diagnosed. They are the largest patient support non-profit organization for colon cancer, based in Washington, DC. They do research and provide online support.”   Medicare  provides several levels of preventive care and testing for colon cancer: Barium enema is allowed every 24 or 48 months, depending on the risk. Colonoscopy is allowed every 120 or 48 months, depending on the risk. Fecal blood tests are allowed every 12 months. Flexible sigmoidoscopy is allowed every 48 months for people over 50. Multitargeted DNA test is allowed every 3 years for people aged 50-85. This is a new test with many stipulations. Plans, coverage, and co-payments differ. Some procedures are free, but related surgical procedures (like to remove polyps) are NOT free. Tell our listeners about your podcast. “I started The Colon Cancer Podcast about a year ago. I interview survivors, caregivers, and medical professionals. We share stories of struggle, hope, and survival in the face of colorectal cancer.”   Tell us about the “Undie Run.” “These are 5K events sponsored by the Colon Cancer Alliance. We run around in our underwear! Events are held 2-3 times each month, in different cities around the country from February through October. The events are to raise funds and raise awareness of the disease.” Resources: www.ccalliance.org 877-422-2030 Find the Facebook group: Blue Hope Nation Special Bonus! Stay tuned to the entire show where Diane Daniels answers listener questions after the interview! 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  

Welcome, Medicare Nation! My guest today is Dr. Andrea Singer, who is a professor of  Obstetrics and Gynecology at Georgetown University Medical Center. Dr. Singer is the Director of Women’s Primary Care and the Director of the Bone Densitometry program. She is a trustee and clinical director for the National Osteoporosis Foundation and a national lecturer on the subject. Dr. Singer has published extensively on many women’s issues and is active in the education of medical students and residents at Georgetown University Medical Center. Dr. Singer is here to teach us about osteoporosis and how it affects our lives and health. Can you define osteoporosis for Medicare Nation listeners? “Yes—I value this opportunity and hope it can be a call to action for your listeners. Osteoporosis is a disease of the bones in which too much bone is lost or the body simply makes too little bone. The bones become weak and can break from minor falls or simple actions, even like bumping into furniture or sneezing!” How prevalent is osteoporosis in the US? “It’s a very common disease and I’ll give you some statistics: 50% of people age 50 or older (54 million of the 99 million) have either osteoporosis or low bone mass. The number jumps to 65% of people age 65 or older who are at risk for broken bones.” Do these numbers apply to both genders, or just to women? “They apply to both genders, even though it’s commonly thought of as a woman’s disease. Interestingly, men have a harder time recovering after a broken bone incident. Of the population age 50 or older, 1 in 2 women and 1 in 4 men will break a bone due to osteoporosis in their remaining years.” What are the risk factors for osteoporosis? “Risk factors can be broken into two categories: non-modifiable and modifiable factors. Non-modifiable risk factors are those that you can’t control, like age, gender, family history, low body weight/frame, and previous bone fractures. Modifiable risk factors include lack of calcium/vitamin D, inactive lifestyle, smoking, and too much alcohol. Regarding previous fractures, those of the spine, hip, wrist, shoulder, and pelvis are classic osteoporosis fractures. Also, certain medications for other disorders can increase bone loss. If you have these risk factors, you should speak to your health care provider and ask about being evaluated for osteoporosis.” How is osteoporosis diagnosed? “Doctors will look at risk factors and do physical exams and lab tests, but the only real way to find osteoporosis is to do a bone density test. The lower the bone density, the greater the risk will be. The DXA scan is the bone density test, and is covered under the Welcome to Medicare package for women. Men are not covered for this test unless they fall into one of the following categories: on long-term steroid therapy, diagnosed with hyperparathyroidism, already on osteoporosis therapy, or has a vertebral abnormality or deformity found on an x-ray. The National Osteoporosis Foundation recommends that men be screened at age 70, but the bone density test isn’t covered unless one of the four criteria is met.” Why are there not many people being screened for osteoporosis? “Osteoporosis is under diagnosed, under recognized, and under treated. It’s thought of as ‘my grandmother’s disease,’ and many people don’t recognize the risk factors. In addition, there are fewer health providers doing DXA scans. For many, they lack the realization that broken bones over age 50 is a strong indicator of osteoporosis. We need to raise awareness so that people who are candidates for osteoporosis will get tested. I hope that this discussion empowers people to take charge of their bone health, be proactive and advocate for yourself to your doctor.” How is the medical community treating osteoporosis? “People need to get adequate calcium and vitamin D, either through diet or supplements. Weight-bearing, muscle-strengthening exercise can help stimulate the bones to remodel themselves and reduces the risk for falls. Fall prevention is a big part of treatment, and there are medications that can slow the bone breakdown or build new bone.” What are the options for osteoporosis medications? “Prescription pills can be taken daily, weekly, or monthly. These are covered under Medicare Part D. Injections can be given daily, once yearly, or 4x/year; these are covered under Medicare Part B or Part A, depending on where they are administered. The important point is that there is a medication to fit everyone who is at risk.” Where can Medicare Nation listeners go for more information and resources? Visit the website of the National Osteoporosis Foundation: www.nof.org. You can also find the Foundation on Twitter: @osteoporosisnof or on Facebook. There is also a new app available on iTunes or Google Play: Food4Bones. Check out these valuable resources for more information!   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  

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      

For Episode 39, I'm very excited to bring back Diane Daniels. You may remember her from episode 25 where she gave us the low-down on the present state of Medicare. Diane is a renowned authority on Medicare and is the founder of the service, Senior Advisors for Medicare & Medicaid.  She is also the Author of The Medicare Survival Guide and the Host of the weekly podcast – Medicare Nation. Heads up boomers! This is important information that will affect you. In this interview Diane talks about: Why and how to drop your Medicare Advantage Plan. If you are dissatisfied with your Medicare Advantage Plan, from January 1st to February 14th 2016 you can drop your Medicare Advantage Plan and go back on your regular Medicare Plan. Why the cost of your premium for Medicare Part B may be higher. How delaying your Social Security Benefits may cause you to pay higher rates in Medicare Part – B. Who really pays for people on Medicare and Medicaid? The changes to Medicare Part D, your prescription drug plan, and why it will cost you more. The irons that Diane has in the fire for 2016 and beyond. Click Here to contact Diane Daniels Click Here to buy The Medicare Survival Guide – 2015 Edition by Diane Daniels Click Here to go to the Seniors Advisors for Medicare & Medicaid Website Click Here to go to Senior Advisors for Medicare & Medicaid Facebook Page Click Here to go to Diane's Medicare Nation podcast Click Here to go to the Government Medicare Website Click Here to join The Essential Boomer Private Facebook Group.

Healthcare has never been a more important topic than now. Costs, options and more become more robust, specific and – how can one person possibly know about it all? The answer, of course, is Diane Daniels, the host of the Medicare Nation podcast. Join Curtis and Art as they collect answers, options, and the details … Continue reading A Chat with Healthcare Expert Diane Daniels from TheMedicareNation.Com →

  Welcome!  My guest today is Dr. Steven Loomis, who is an optometrist in Colorado.  He has been a member of the American Optometric Association Board of Trustees since 2007 and is the newly elected president of the AOA since 2015.  He has served on numerous other professional boards and received many awards.   During this Medicare enrollment season, there are many questions about eyeglasses, hearing aids, and dental care, which are not part of regular Medicare benefits.  You may be wondering what to do.  Dr. Loomis is here to answer some relevant questions: How did you decide to become an optometrist?  “I had decided to be a pediatrician when I realized I might not want to be with children ALL DAY LONG.  A friend suggested optometry, so I considered it.”  Dr. Loomis has found the perfect niche over the past 30 years, and he is confident that he made the right decision.   Can you clarify the difference between optometrist and ophthalmologist?  An optometrist treats most eye diseases and injuries to the eye, along with providing exams for glasses and contacts. Optometrists provide 70% of primary eye care to patients. An ophthalmologist is an eye surgeon who works closely with an optometrist to treat patients.  They even sub-specialize in specific eye care fields.   Are most optometrists Medicare providers?  Yes, all that I know of are.  We have been full Medicare participants since 1986.   What will Medicare cover for vision care?  Medicare will cover any eye disease or injury, inflammation, glaucoma, but does not cover routine well vision exams.  Those diagnosed eye diseases have their regular exams covered to monitor their problems.  Medicare Advantage Plans DO cover preventative eye care services, but you MUST know and understand your plan.   Can you explain diabetic retinopathy?  The retina is sensory tissue in the back of your eye that transmits pictures to the brain.  Diabetes attacks the tiny blood vessels in the eye, but a special photo must be taken to view the vessels.  Diabetics and pre-diabetics must have yearly exams to monitor the condition.   Why should a Medicare Nation listener get an annual eye exam if they aren’t having a problem?  The two leading causes of blindness are diabetic retinopathy and glaucoma.  Glaucoma is a condition in which pressure inside the eye damages nerve fibers. Macular degeneration is another eye disease. These eye diseases are asymptomatic, which means that they can exist without initial symptoms until vision is severely affected.   How would a senior make the most of their Medicare dollars?  They must understand their plan; participants in Parts A & B are eligible, but the amounts vary from state to state.  Usually, patients have to pay about 20% of approved amounts.  If they have met their deductibles, then now is a good time to get it done.  For example, the Part B deductible is only $147, so must people have already met that by the time the 4th quarter rolls around.   How else can uncorrected eye problems or undiagnosed eye problems affect seniors’ quality of life?  Most seniors want to maintain their vision for reading, watching TV, and other daily activities.  Also, falls are a big problem that can devastate a senior, and a significant number of falls occur because of poor vision.   Links and Resources:   www.aoa.org   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  

In Episode 25, Diane Daniels, Founder of Senior Advisors for Medicare & Medicaid and the Medicare Nation podcast, talks about what we boomers need to know about the present state of Medicare and the big changes that are happening soon. Heads up boomers! This will affect all of us. CLICK HERE to go to the show notes for this episode.

Welcome Medicare Nation!  I have to tell you that today’s show is packed with tons of great information.  The topic of today's show is making end of life decisions and having an advanced care plan for yourself.   Today’s guest is Dr. Stanley Terman (founder of Caring Advocates for Advanced Care Planning),a board certified Psychiatrist in Carlsbad, CA, and a published author on today’s topic.  Dr. Terman has spent the last 15 years focused on reducing the pain of terminally ill patients.   People’s greatest fear is losing control and it means that other people have to make decisions for you.  It becomes difficult for people to be in a situation where they have to make decisions about your life, based on your wishes, not on your finances.  This instills much fear within all of us as we are aging.   Advanced care planning has been painted as “death panels”in the media and has fostered the idea that decisions about your care will be made with bias.  If you learn what your choices are now, you can plan and then not have to worry about it later in life.  There is a freedom that comes when you have made these decisions for yourself, and it allows you to continue enjoying your life.     The majority of people in certain groups do not prepare enough for advance care directives: Religious people  African Americans   Living Wills tend to be more controversial, we understand that some are reluctant to adopt them.  Doctor Terman created a Natural Dying Living Will, which is an extremely flexible document.   You are required to fill out a form of this nature in order to document your wishes.  You don’t need to consult an attorney and you don’t need to spend any money.  You can fill out a living will for free.  The Natural Dying Living Will isn’t free, but it gives you  many options and it is flexible.  The document needs to be strong enough to compel Physicians to follow your specific wishes.  The Natural Dying Living Will accomplishes  this with several layers of protections built in, and it has proven effective to get the attention of the physician.  Once you have filled out all of the paper work,  Dr. Terman recommends making a video where you summarize your wishes in a video directive.   **You need a Durable Power of Attorney in order to give someone the authority to make the Physicians follow your Living Will.   This will ensure you have the 4 P’s   1.  Peaceful 2.  Prompt 3.  Private 4.  Passing   Caring Advocates provides a laminated business card with a scannable bar code.  When scanned, it immediately pops up the video of your final wishes, and the necessary documents for your living will.  There’s concern about finding documents or getting documents out of safe keeping, in order to submit them to the Doctor   When attending a counseling appointment with a Doctor, bring your end of life documents with you to the session. Then your session becomes getting your Doctor’s opinion on the decisions you have made.  Some services like Palliative Sedation are choices you may make, but a Doctor might not support it.  Better to find this out ahead of time.  Having a discussion about this type of treatment and even Respite Sedation are beneficial.  You need to give your Doctor the tools to help sustain life, and these tools can accomplish that.   Once you have this paperwork taken care of, including the Durable Power of Attorney, there are clauses that would allow for the changing of Physicians and even for changing the treatment plan.  So this way of handling your paperwork is comprehensive and it can last through the ages, and the changes that can occur.     Plan now, to die later, to live longer.     You don’t want to miss Doctor Terman’s offer to assess your existing Living Will for the 3 main scenarios that will likely cause your death.  It’s an unbeatable offer!  Listen to the show for all the details!     Resources Mentioned in the show:   www.caringadvocates.org   The Natural Dying Living Will   Doctor Terman’s Books:   A Lethal Choice - The Best Way To Say Goodbye Peaceful Transitions - An Ironclad Strategy to Die When and How You Want Peaceful Transitions - Plan Now, Die Later My Way Cards - Natural Dying Living Will Cards     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       

A great episode to get a taste of the ever-evolving world of Medicare, for you, your colleagues, and your family. Diane Daniels is host of the Medicare Nation podcast and owner of Senior Advisors for Medicare & Medicaid (SAMM) in the Tampa, Florida area. We discuss the world of Medicare, including Medicare basics, fraud, and additional coverage. We also learn about Diane’s background, growing up in Brooklyn, New York.

In this week’s episode of Medicare Nation, Diane Daniels interviews Max Richtman, the president of the National Committee to Preserve Social Security and Medicare (NCPSSM). In this episode, Diane and Max discuss Medicare’s 50th anniversary, the role of the NCPSSM, the Supreme Court’s challenge to the Affordable Care Act and HR 3308 - Seniors Have Eyes, Ears, and Teeth Bill.   Main Questions Asked: Tell us what the National Committee to Preserve Social Security and Medicare does? How do you view the importance of the Supreme Court’s challenge to the Affordable Care Act and Medicare’s 50th anniversary? What is your take on Medicare’s financial condition? How can we balance the two schools of political thought when it comes to Medicare? Key Lessons Learned: 55 million people depend on Medicare for their healthcare. Billions of dollars are lost each year to fraud, healthcare’s rising costs, and increasing numbers of Americans retiring from the workforce. NCPSSM Former Congressman James Roosevelt, who was the eldest son of FDR, founded The National Committee. The NCPSSM is dedicated to protecting the Social Security and Medicare programs and is the second largest senior citizen lobbying association in the USA, with about 3.5 million members and supporters. The recent focus has been to improve, enhance, and expand the Social Security and Medicare programs. Supreme Court’s Challenge to the Affordable Care Act $716 billion was saved out of the Medicare program and the Affordable Care Act. These savings came from reducing payments to providers such as Medicare advantage programs and reimbursements to hospitals. Under the Affordable Care Act, Medicare beneficiaries enjoy preventative care with no out-of-pocket costs. This includes cancer screenings, colonoscopies, mammograms, and diabetes testing. The Medicare program is now solvent until the year 2030. Medicare’s Financial Condition In light of the Obamacare program, the solvency of the Medicare program was expanded for an additional 13 years. As the Affordable Care Act takes hold and reduces health care costs, it will have an impact on Medicare as well. Max is looking forward to additional years being added to the program by virtue of the restraint on costs that will be received due to the Affordable Care Act. Besides reducing reimbursement rates to providers, it has changed the focus on healthcare payments to be tied to value and not volume. Doctors and their staff have to be current and understand what is needed to reduce cost as so much money is depleted through fraud, waste, and abuse. Diane’s Advice Look at your Medicare statement every month to ensure it is correct with regards to providers and procedures. If you notice a discrepancy, then call your Medicare Plan immediately and report it. Remember, the patient can play the largest role in finding discrepancies and overcharges. This has a significant impact in reducing waste and fraud. Politics and Medicare There is a significant divide among politicians in how Medicare should function in the future. We hear from the campaign trail that it is fiscally responsible to reform Medicare, but we also hear expansion of Medicare is the best option. We need to ask ‘what does reform mean?’ To some, ‘reform’ is another’s idea of ending the Medicare program. The reason we have a Medicare program in the first place is because insurers didn’t want to insure seniors as it was deemed too expensive. The value of a voucher will not keep up with the increased cost and inflation in healthcare. It will become less valuable over time and less able to provide coverage. Using vouchers is a way to rescind Medicare law and go back to a time when people were on their own and a lot more seniors were living in poverty. HR 3308 Seniors Have Eyes, Ears, and Teeth Act Congressman Alan Grayson from Florida recently introduced the Eyes, Ears, and Teeth bill. The NCPSSM wrote a letter endorsing the bill that will, for the first time, add coverage under Medicare for vision, hearing, and dental. Medicare and Hearing One third of people in the 65–74 age group experience hearing loss. Half of people over the age of 75 have hearing loss issues. Congresswoman Debbie Dingle introduced The Medicare Hearing Aid Coverage Act of 2015 that will take a portion of that coverage and add Medicare coverage for hearing testing and hearing aids There is a lot of opposition from the medical industry as providers don’t want to deal with the Medicare regulations even though there would be a massive increase in volume. Dr. Franklin Lin from Johns Hopkins has developed groundbreaking research that makes a link between hearing loss and dementia and Alzheimer’s. Having Medicare cover hearing loss and come up with the financial resources to provide that coverage would pale in comparison to the cost of treating Alzheimer’s patients. Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here) www.CallSamm.com Episode Resources NCPSSM 1–800–966–1935 Congressman Allan Grayson presents to the House of Representatives HR 3308 – Seniors Have Eyes, Ears and Teeth Bill Congresswoman Debbie Dingell presents to the House of Representatives HR 1653 - The Medicare Hearing Aid Coverage Act of 2015 Medicare Federal Trade Commission Click To Tweet - Spread the news! Are you aware of The Eyes, Ears and Teeth Bill? Find out what it means for you. @NCPSSM @medicarenation http://tinyurl.com/ow3ea9l What is Medicare’s current financial condition? Find out w/ @NCPSSM @medicarenation http://tinyurl.com/ow3ea9l