My Part D USA

HOW MANY OF YOU LISTEN TO THE TALKING HEADS EVERY NIGHT? You have to first realize that RATINGS are their FIRST PRIORITY, not the facts.  Many of these people don’t even agree, and actually know they are starting controversy, but that is what creates BIG RATINGS!

There is no such thing as “OBAMA’S DEATH PANEL”! When you actually read the section of the bill, they are talking about DOCTOR-PATIENT CONSULTATIONS ABOUT END OF LIFE PLANNING, such as drawing up a living will or planning hospice treatment.  Please refer to my other blog about hospice care. YOU WILL FIND THIS BLOG IN THE CATEGORY SECTION ON THE LEFT HAND SIDE OF THIS PAGE, UNDER “OTHER TOPICS OF INTEREST”? It describes “advance care planning”, clearly stating on page (424, lines 21-23) that this means a consultation between the individual and a practitioner.  IT IS NOT ABOUT AN INDIVIDUAL AND THE GOVERNMENT.

Everyone needs a LIVING WILL!

If you do not have one, please ask your doctor.  If you leave these kinds of decisions up to your family, many times they do not have the heart to do what needs to be done.  We have all seen cases like this in the news and it gets blown totally out of proportion to the “real” situation.  Most of us would not want to be kept alive for years or even months on machines when there is no chance of recovery.

Just a little COMMON SENSE would do us all some good!  I’m sure many of you have had terminally ill members of your family and have gone through these gut-wrenching decisions.

Please remember that if it sounds ridiculous, it probably is ridiculous!

THOUGHT FOR THE DAY: ALL OF US COULD TAKE A LESSON FROM THE WEATHER.  IT PAYS NO ATTENTION TO CRITICISM.

A couple of BLOGS ago, scroll down, I wrote a bit about natural remedies and if Medicare would cover these expenses.  I also wanted to go over some nutritional issues that many people are finding helpful in wellness education.

The FIRST thing to remember as I went over before is that your doctor needs to know every supplement you take as some of them interfere with your medications and surgeries.

If you have never gone to www.Realage.com, please take the time to visit this website.  There is a section on “Staying Young” and gives you a Warranty Lesson on your health.  I have taken the liberty of sharing some of this great information with you.

FOODS TO FIGHT AGING

1.  FOLIC ACID – 800 micrograms a day will help your hearing for high-frequency sounds.

2. TURMERIC – an Indian spice for boosting memory and brain function.  You can check out mustards that contain this spice and also add it to soups, chicken and shrimp dishes.

3. GREEN TEA – flushes out toxins and boosts immunity.  It is advised to drink a very strong cup of green tea with the juice of 1/2 lemon before you eat anything in the morning.  This cleanses your liver and also helps with metabolism.

4. MAGNESIUM – helps lower blood pressure and reduce heart arrhythmia.  You can get magnesium from lima beans, avocado, whole grains, beets and raisins.  You should get 400 mgs a day.  1 cup of cooked lima beans has 100 mgs.

5. CHIA SEEDS – isn’t that funny?  You can get these seeds at your health food store.  They have the most antioxidant potency of any food.  It is a nutty tasting grain with Omega 3 fatty acids.  Take 2 daily doses of 2 tablespoons each.  You can sprinkle on your cereal, yogurt, salads or in muffin mixes or smoothies.

If you visit this website there are all kinds of info with recipes using foods that improve your health.  Good reading!

Dear Readers,

I get so many emails wanting to know how to get vaccines covered I thought I’d write about it for everyone to have this information.

If you have Medicare Part D, you can get the shingles vaccine.  Part D plans must cover all types of commercially available vaccines that are NOT covered by Part B, including the vaccine for shingles.  You need to contact the Customer Service number for your particular drug plan to ask them how to make a claim, and what they cover and the cost involved.

Medicare Part B (outpatient benefits) covers your seasonal flu shot from your clinic or doctor’s office, as well as vaccinations to prevent pneumonia and hepatitis B.  Part B also covers other immunizations if you have been exposed to a disease or condition, like tetanus or rabies shot.  Your doctor should know how to make this claim for you on your Medicare Supplement plan if necessary.

THOUGHT FOR THE DAY: Self-discipline is when your conscience tells you to do something, and you don’t talk back!

I am not yet on Medicare, but every time I go into a pharmacy I check to see what kind of programs they have for Medicare beneficiaries.  Yesterday at CVS I saw a plan where they have over 400 generic drugs for $9.99 for a 90 day supply.  I know that Walgreens, Wal-Mart, Costco, Sam’s Club and many other places have these plans as well. You may ask, “but why should I do this when my co-pay is cheaper than that?”  Even though your co-pay is $4, your drug plan dings you $20, $30 or $40 dollars or more because it is the RETAIL PRICES that count toward your donut hole amount of $2,700.  This pushes you closer and closer into the donut hole.  DON’T BUY YOUR GENERICS ON YOUR DRUG PLAN!  SAVE YOUR $2,700 FOR BRANDS YOU MUST HAVE THAT ARE MORE EXPENSIVE.

I also asked the pharmacist if they made claims on your Part D drug plans when you had this program and he told me absolutely NOT!  The reason I asked them that is I have recieved many emails from readers telling me their pharmacist said it was against the law if they didn’t file a claim.  This is a downright LIE! They just get a higher re-embursement if they file a claim.  If your pharmacist tells you this, give him/her my number and I’ll report them to Medicare or you can do so yourself at 800-633-4227.

Many of you are now in the “DREADED DONUT HOLE”.  Please know that if you begin 2010 by using these generic programs instead of using your Part D plan on your generics you will stay OUT of the donut hole months longer next year!

ONE MORE THING: Read your monthly drug plan statements like it was your bank statement.  See what claims have been charged to you to push you further and further towards the donut hole.  Many people report duplicate claims.

YOU MUST SHOP AROUND! Even on my own meds, I found huge differences in prices from one pharmacy to the next on the same exact medication.  One medications was $127.00 at one pharmacy and $67.00 at another pharmacy.  Don’t just pay them, tell them you can get it cheaper down the street.  Shop around and find the best price either locally or online.  When you are in the DREADED DONUT HOLE, YOU CAN’T BE FAITHFUL AND USE YOUR PART D PLAN, YOU MUST GET YOUR MEDICATIONS ANYWHERE YOU CAN FIND THEM CHEAPER NOT USING YOUR DRUG PLAN!  YOUR PART D DRUG PLAN IS NOT FAITHFUL TO YOU!

If you know you will get to the 95% coverage, then you must use your drug plan through the donut hole….but if you fall in, never to get out for the year….just act like you don’t even have a Drug Plan, except you must continue to pay the premiums or be penalized.

I know I sound like a broken record, but I’m still getting so much email on this subject!  Hope this helps.

THOUGHT FOR THE DAY:  Your Integrity Will Affect Your Destiny; Don’t Leave Home Without It!

Since I get so many questions by email everyday I thought I would share some of them with you, just in case!

QUESTION: Does Medicare pay for any kind of herbal or natural treatments instead of just prescription medication?

ANSWER: No, Medicare does not consider herbs true medications and will not cover these expenses.  I understand why you would want to know this because I have been in my local health food store and know how much the supplements many doctors recommend cost, such as Omega 3 fish oil, and antioxidant herbal additions to your treatment.

My advise to you if you want to use herbal supplements in addition to or instead of standard prescription medications is to find a Doctor in your area who deals with both ways of treatment.  Many herbs can interfere with your prescriptions, so you need to disclose everything you take to EVERY doctor you see.

There are recent studies that the herb Astragalus has been used in combination with other drugs to treat cancer and can boost the power of some types of chemotherapy.  Ginseng is another herb that can boost energy in cancer patients, and Glutamine can help with your digestive tract and the damage chemo does to your body.  Chronic inflammation is known to fuel the growth of tumors and Omega 3 fatty acids in fish oil and flaxseed are potent anit-inflammatories that slow tumor growth.

Omega 3’s also help your heart and joints, so even though taking fish oil does not sounds very appetizing, they have caplets or flavored oil that goes down easily.

No matter what kind of treatment you choose, make sure that everything you take works well together and check with your doctor, or find one that has an open mind about both natural remedies and prescription drugs!

QUESTION: Ms. Blake, last year my husband, who was on SS disability turned 65.  During the enrollment period for a supplelment where he could NOT be turned down because of medical reasons, a Medicare Advantage rep talked us into going with (a certain MAPD).  It was all so confusing to us and what he said SOUNDED GOOD, but now that my husband is past that enrollment period, we know the truth and he would not be able to pass a medical exam for a Medigap/Medicare Supplement.  Is there any hope for us? Also, he is in the “dreaded donut hole”.

ANSWER: I am happy to tell you that because you were misled and you are within the 12 months of joining an MAPD, you can change back to a Medicare Supplement with no health questions and a stand alone Part D plan. You need to call Medicare directly and tell them about your situation and that you were confused about the benefits provided by the MAPD and the way the salesperson explained it to you was not clear.  They can enroll you back into the ORIGINAL MEDICARE SYSTEM. When that is done you can call us here at My Part D USA or someone else you can trust locally that will help you and KNOW HOW to deal with this process.  Also, if your income is low enough you can go to your local SS office and tell them you want to apply for MEDICARE PART D LIMITED INCOME SUBSIDY.  SS will send you a letter telling you if you qualified or not.  If you did, you MUST send a copy of that letter to your Part D plan provider, so they will know not to bill you for a premium, that you will have NO DONUT HOLE and all your drugs will be between 4 to 8 dollars for a 30 day supply.  If you cannot qualify for this, please contact the actual manufacturer of your husbands most expensive drugs, many times their income levels are higher to qualify for help and you can get discounts that way.  You can also shop around, not using your drug plan during the donut hole! There are also FREE DISCOUNT CARDS, you can download, as I have talked about on the blog before, just look in the category section.  Remember to read my other blogs about ways to MAXIMZE your drug plan beginning next January to NEVER buy your generics using your drug plan so you can save your c0-pays for the more expensive brand name drugs.  This will also keep you OUT of the donut hole longer each year.

THOUGHT FOR THE DAY:  If you laugh a lot, when you get older your wrinkles will be in the right places!

As I was sitting in my doctor’s office yesterday I picked up a WEBMD magazine.  You can go to their website at www.WebMD.com.  I found an article about how one of the best things for our hearts is LAUGHTER!  Not that we can all go and throw our Lipitor down the toilet, but just think about these few ideas:

1. Every day your heart beats about 100,000 times, sending 2,000 gallons of blood surging through your body.  All this blood feeds our organs and tissues, so we better take care of it by eating healthy, taking at least 3,000mg’s of Omega 3’s per day and doing some kind of exercise that gets our heart rate up.

2. A good belly laugh can send 20% more blood flowing through your entire body!  Now who knew that?  One study found that when people watched a funny movie their blood flow increased.  That is why laughter is the perfect antidote to stress.  When you laugh, the lining of your blood vessel walls relaxes and expands and this excersises your heart muscle making it stronger.  So, find ways to make yourself laugh every day…..read jokes online, watch a funny movie or stand-up comedian.  There are too many stressful things to watch on TV.  One of these is your local news and all the arguing talking heads.  Who wants to spend their evening listening to people argue?  Many people do and this contributes to YOUR STRESS! Watch old re-runs of Andy Griffith instead of Hannity or listening to all the horrible news stories, over and over again, that you can’t do anything about anyway.

I read one study about how the media causes stress in the elderly. Many times all they have to entertain themselves is the BOOB TUBE or TV and the more news stories and talking heads they watched the more afraid, stressed, worried about the future and plain out paranoid they became.  Stress causes your immune system not to function properly which can cause sickness of many kinds.  It increases your blood pressure.  Choose what you watch as carefully as you choose other components of your health care.

3. A man’s heart weighs about 10 ounces, while a woman’s heart weights about 8 ounces.  Not only is a woman’s heart smaller than a man’s, but the signs that its in trouble are a lot less obvious.  Women have different symptoms of  a heart attack than men, such as nausea, indigestion and shoulder aches, rather than the hallmark chest pain.

I KNOW THERE ARE LOTS OF MEDICATIONS PEOPLE TAKE FOR HEART PROBLEMS THAT CANNOT BE REPLACED BY LAUGHTER, OMEGA 3′S OR ANYTHING ELSE, SO PLEASE, EVEN IF YOU ARE IN THE “DREADED DONUT HOLE” THIS TIME OF YEAR, DO NOT STOP TAKING YOUR NEEDED MEDICATIONS.  IF YOU FIND THAT YOU ABSOLUTELY CANNOT AFFORD TO BUY THEM ANYMORE, PLEASE CALL YOUR LOCAL SOCIAL SECURITY OFFICE AND TELL THEM YOU NEED TO APPLY FOR MEDICARE PART D LIMITED INCOME SUBSIDY PROGRAM.  IF YOU QUALIFY YOU WILL NOT HAVE A DONUT HOLE!  DO THIS TODAY.  IF YOU HAVE ANY QUESTIONS ABOUT DOING THIS, PLEASE WRITE ME AND I’LL GET BACK TO YOU ASAP! YOU MAY EVEN CONTACT THE DRUG MANUFACTURER.  MANY TIMES THEIR INCOME LIMITS ARE HIGHER AND YOU CAN GET HUGE DISCOUNTS DIRECTLY FROM THEM.

Thought for the Day: Some Doctors Say That Cheerful People Resist Disease Better Than Grumpy Ones.  The Surly Bird Catches The Germ.