In addition to assisting clients with analysis of their best health insurance and Medicare options, we try to keep our readers informed of Medicare changes and important news in the healthcare field, including insurance and coverage options.

We do not sell insurance, but offer our clients an analysis of options based on our expertise and experience day in and day out in the healthcare system. We provide analysis, troubleshooting and advocacy.

As you are probably aware, a large number of changes to our healthcare system were passed in 2010. Do you know about the provisions of this law? Do you know about those that are already in effect and how they might impact you? While there are uncertainties about future changes and challenges to these laws, there is some important information for you to know about today.

We will use the term Affordable Care Act (ACA) to refer to The Patient Protection and Affordable Care Act, H.R. 3590, P.L.111-148 and the Health Care and Education Reconciliation Act, H.R. 4872, P.L. 111-152, signed by President Obama on March 30, 2010 (which amended #1). These acts made many changes, ranging from the eventual abolishing of pre-existing condition clauses in insurance to requiring individual coverage for those not covered under various programs.

Some of the first changes that have taken effect are in the Medicare program. Starting in 2011, the "doughnut hole" in the Medicare D prescription drug program will be phased out. This year, individuals who reach the doughnut hole will receive a 50% discount on covered brand name drugs while in the gap. Additionally, sections 4103 & 4104 updated the preventative care benefits under Medicare, so that now an annual wellness visit is covered at 100% along with screenings for colon, breast and prostate cancer.

As part of the requirement for all individuals to have coverage by 2014, certain programs have been implemented to phase in coverage for different groups traditionally at a disadvantage in securing coverage. One such program, which began last year, is the Pre-Existing Condition Insurance Program (PCIP). Sec. 1101. Immediate access to insurance for people with a preexisting condition: Provides up to $5 billion for this program, which terminates when the American Health Benefit Exchanges are operational in 2014. Also establishes a transition to the Exchanges for eligible individuals.

To be eligible for this program the individual must: 1. Be a citizen or lawful resident. 2. Have been uninsured for at least the last 6 months. 3. Show proof of the pre-existing condition (such as letter from doctor, insurance denial because of it, or insurance coverage turned down with rider excluding the condition. There is an online application and there are no financial qualifications. There are no waiting periods (if you sign up by the 15th of the month, coverage will begin at the beginning of the coming month). Recipients have three plan options: a standard plan, an extended plan and a Health Savings Account plan. The rates are very competitive and were actually reduced in July of 2011. For more information, please visit www.pcip.gov.

Come back to visit us for more information and continued updates on healthcare reform, Medicare changes and information on Florida Medicaid and eldercare resources. You can sign up for our newsletter for monthly updates delivered right to your inbox!

CONTACT US TODAY for a Medicare Analysis appointment or consultation on your healthcare and eldercare options.

Aging Wisely's Director of Communications, Shannon Martin, has recently served as an expert guest on the Boomer Nation! radio show, offering advice to caregivers of seniors. The first show focused on preparing for caregiving and aging. Shannon pointed out that one of the important things we can all do to prepare for aging (or an emergency/accident) and the possibility that someone may have to make decisions on our behalf, is to execute necessary legal documents.

Why is advance planning so important?

These documents better enable your loved ones to step in and help you at a time when you cannot speak for yourself or need help managing your affairs. You can exercise control over who you want making those decisions...and hopefully have conversations with them about your preferences. This is a gift to your loved ones, as they may face a lot of headaches and more costly options if you are not properly prepared.

What documents do I need?

In general, the documents to consider when talking about planning are the durable power of attorney (for managing financial and practical affairs), the healthcare surrogate or healthcare power of attorney (sometimes integrated with the first), and a living will (specifically covering certain end of life care). You should consult with your attorney about the necessary documents, as well as additional estate planning documents such as a will and trust that may be needed for your situation. An experienced attorney can guide you through drafting documents to best meet your needs and understanding your options.

What else should I consider in helping someone to make decisions on my behalf?

Help your loved ones by talking to them about your wishes. You may even wish to draft a letter or document with details about your wishes and feelings on such matters as end of life care. While not a legally binding document, this can provide tremendous guidance and comfort to a loved one. You may suggest that they seek out professional help, such as maintaining a relationship with your current financial advisor or seeking a care assessment from a professional geriatric care manager.

Think through the practical matters and try to determine the best way to set things up to ensure your family members can assist you when needed. Talk to your attorney about any family conflicts or concerns you have so that he/she can make suggestions and help you plan properly.

To read more about these documents and the rules governing them in the state of Florida:

Florida Power of Attorney Statute (Florida Ch. 709)

Healthcare Advance Directives (Florida Ch. 765)

Chapter 709 has been significantly ammended via Senate Bill 670 (effective October 1, 2011). You may wish to review these changes with your attorney. Though Power of Attorneys executed prior to the law will be effective if valid under the current law of the time, many of the provisions will apply to use of all Power of Attorneys. For providers who are in the position of accepting these documents, there are some very important changes to understand to ensure you are in compliance with the law.

Contact us for help, including eldercare advice, referrals to professional advisors, and care management assessements.

Listen to our Director of Communication, Shannon Martin, on Boomer Nation Radio Show discussing how to prepare for caregiving and to age wisely:

[audio:http://www.agingwisely.com/wp-content/audio/BoomerNation-8-7-11.mp3]

Tips for Individuals and Caregivers

Make the most of your medical appointments by being prepared. Even if your doctor gives you time and attention, appointments are brief by nature and it can be overwhelming to ensure you cover the pertinent information and absorb what you are being told. Here are some Aging Wisely tips for being a good medical advocate for you or someone you love at those doctor's appointments:

• Prepare some notes regarding: any recent symptoms or concerns (try to jot down information when you are experiencing issues, i.e. what it feels like, when it happens, what occurs, frequency and when you first noticed it).

• Prepare a list of top questions. Be realistic about what can be covered and if you have more extensive needs, you may want to forewarn the office staff when making the appointment that you have several questions or concerns so they can plan accordingly.

• Feel free to take notes. Tell the doctor (especially if you are the “third party”, not the patient), “I am going to take some notes so that I understand everything you are telling me and can make sure not to forget any of your instructions”. As patient advocates for many years, we can tell you that physicians are understanding and appreciative because they want patients (or those that are assisting the patient) to follow through properly.

• In those notes, indicate any follow up or instructions given so you have a checklist to follow. If anything is not clear, ask for clarification.

• Consider using an organizing system to manage medical records, history and tracking. An electronic/online system offers many advantages in consistency and access (read more in our post about personal health record systems). Aging Wisely uses a system called Caregiver’s Touch for our clients to ensure care continuity, which can be quickly accessed by caregivers online and via a mobile app.

Some other important considerations to ensure the best medical care and continuity for elders or anyone experiencing chronic illness or managing health issues:

• As a patient potentially facing a serious diagnosis, going through major testing or managing multiple or major conditions, always consider having an advocate along with you. It can be very emotional and having someone to focus on the practicalities and to be a sounding board is invaluable. As a family member, it might even help to have someone else along as you may also be too emotional upon hearing a diagnosis or prognosis to manage the questions and advocacy role.

• Review with your attorney to ensure you have the up-to-date legal documents that will allow a trusted person to handle your needs should you no longer be able (Healthcare Surrogate, Living Will and a Durable Power of Attorney for financial/practical matters).

• If you wish for your loved one to be able to get test results and other information to assist you in managing your care, ask the provider what paperwork you need to complete (most now have this built in to patient paperwork with an area you can sign allowing someone to have access and ensuring the office complies with patient privacy laws).

• Learn more about how professional patient advocates can help you and your family. If you are a caregiver at a distance from aging parents/loved ones, get peace of mind by hiring one of our professional geriatric care managers/patient advocates to attend appointments, advocate and communicate to family members.

CONTACT US TODAY to learn more about eldercare advice, patient advocacy and other ways we can help you in Aging Wisely.