Choosing the right health insurance plan can be overwhelming. It may be tempting to just keep the plan you currently have rather than look at spreadsheets and dense, hard-to-decipher descriptions of coverage options.
That’s a mistake. Whether you’re over 65 and inundated with advertising about Medicare open enrollment options or getting your insurance through the Marketplace or working for a company whose annual open enrollment is taking place this fall, it’s imperative that we review our current plan and see what our options are for 2021.
Here are some things to keep in mind regardless of where you get your health insurance:
Medicare Open Enrollment started October 15 and you can’t watch TV these days without seeing commercial after commercial about different Medicare insurance options. During Medicare Open Enrollment you can:
A few tips:
Health Insurance Marketplace and Employer Health Plans
Bottom line: Be sure you understand your options, get your questions answered, and know your preferences (cost, access, convenience, willingness to accept risk, etc.) before you make a decision. Contact me if I can help answer questions or conduct an analysis for you.
Medicare is complicated. There are a lot of “parts” as well as rules, enrollment periods, etc. I’ve started making 1-2 minute videos to explain different aspects of Medicare including what is open enrollment, what isn’t covered by Medicare, Parts A, B, and D, what is IRMAA, and more. I'll be adding to this "Medicare collection" periodically so subscribe to my YouTube channel to stay up to date.
Thank you Betsy Phillips, Realtor, Baird & Warner, for having me on your "Let's Chat" series to talk about patient advocacy!
Medicare's annual open enrollment period starts this month and that means there are A LOT of commercials urging people to switch plans. Here are some of my thoughts after seeing yet another one of those commercials...
I was recently on a podcast, hosted by Claudia Cometa of Peace Advocacy Group, with 3 other fabulous patient advocates. Listen to learn more about what patient advocates do. I talk specifically about how to talk to your aging parents about health and safety concerns and what has surprised me most about my work as a patient advocate.
Since the beginning of the pandemic, I’ve received many calls and heard many stories about how difficult the visitor restrictions continue to be for hospitalized patients, residents of senior living communities, and family members. As the pandemic continues, more and more organizations and individuals have been voicing concern about the isolation of seniors in assisted living and skilled nursing facilities, as well as the lack of advocacy for hospitalized patients. While exceptions for end-of-life or compassionate care visits have been available throughout (for patients without COVID), they often require families to make painful, difficult choices about who can say goodbye in person. Rules for all of the above scenarios have changed, loosened and also vary based on geographic area and facility. Be sure to check the most recent policy of the health care facility or community in question.
Please use the information below to understand the issues as well as to advocate to visit your loved ones.
The Beryl Institute recently released Patient and Family Recommendations for Addressing Visitation Policies during COVID-19. This policy statement emphasizes the importance of allowing a “care partner” to be in the hospital or any healthcare setting with patients. Anyone who has been in the hospital or had a loved one in the hospital knows how critical it is to have someone there with you: it’s usually difficult to understand and remember what the doctors are saying and ask meaningful questions when you are in a health crisis. Care partners also provide important information to health care providers that patients, due to physical illness, cognitive issues or just being overwhelmed, tired, or scared, may not remember to share on their own. While these recommendations include that “All patients must have the option to have a care partner present in the healthcare setting,” they also set out guidelines and responsibilities for care partners to keep healthcare personnel safe. The photo below shows some of the recommendations:
Please see my previous post about having an “In Case Of Emergency Kit” prepared - this will make it easier for your care partner!
Long term care settings:
The Centers for Medicare & Medicaid Services (CMS), has issued guidelines to states regarding visitation of residents of long term care facilities. They note:
While CMS guidance has focused on protecting nursing home residents from COVID-19, we recognize that
physical separation from family and other loved ones has taken a physical and emotional toll on residents.
Residents may feel socially isolated, leading to increased risk for depression, anxiety, and other expressions
of distress. Residents living with cognitive impairment or other disabilities may find visitor restrictions and other
ongoing changes related to COVID-19 confusing or upsetting. CMS understands that nursing home residents
derive value from the physical, emotional, and spiritual support they receive through visitation from family and friends.
The guidelines address indoor and outdoor visits as well as compassionate care visits and visitor testing. See the photo below for some of the guidelines for indoor visits. Check the guidelines from your state and the long term care facility you wish to visit for more specifics.
Bottom Line: There should be ways to allow family members to advocate for and visit their loved ones, combat social isolation, and also prevent the spread of Covid-19. Hopefully, the recent progress in developing guidelines for visitors will help people get the care and companionship they need.
I want to thank Jeffrey Wallk, The Value Enablement Group LLC, and Elizabeth Finlayson, The Non-Profit Coach, for featuring me on their Ask the Experts webcast. I shared information about my business as well as examples of how I’ve worked with clients, how I can help in different situations, and more.
I often hear from clients that they feel dismissed by their doctors — that their doctor doesn’t care about them. Watch this quick video to learn how I helped a client turn this situation around.
How many of you have had a Telehealth appointment - either audio or video - since the COVID-19 pandemic started? I recently gave a presentation via Zoom to a group of about 25 older adults. I used the polling feature to ask if they’ve tried Telehealth and if they liked it. 80% reported that they had used it and thought it was great (the other 20% had not used it yet). Honestly, I was surprised at how many had used it AND liked it. This month’s blog provides some tips to make your Telehealth appointment successful.
Telehealth may transform how healthcare is delivered in the future. It cannot replace every type of clinical visit, but in many cases, it can be just as good as being there in-person — just without the hassle of having to get to a doctor’s office. If the HIPAA rules and insurance reimbursement changes stay in effect even after the COVID-19 Public Health Emergency ends, we’ll all need to get familiar and comfortable with these type of provider appointments.
It’s important to know that Telehealth was always subject to strict HIPAA privacy and confidentiality rules. Any platform used for Telehealth had to be HIPAA-compliant. These HIPAA rules have been relaxed since the Public Health Emergency was put in place; this means that providers and patients are using any form of communication that works, including FaceTime, Google Hangouts, whatever.
Medicare has made some important changes to Telehealth. Currently, any provider who is eligible to bill for Medicare may provide and be reimbursed for services delivered as Telehealth. That includes doctors, nurses, mental health professionals, physical therapists, and more. They can bill patients for usual cost-sharing (co-pays, co-insurance) but they have the option to waive or reduce those fees. Also, the requirement that a patient had to see the provider in the past 3 years in order to have a Telehealth appointment is waived.
Here are some tips to make Telehealth easier and more effective:
Write something about yourself. No need to be fancy, just an overview.