The holidays are often filled with opportunities for togetherness, sharing, laughter and memories. But they can also bring stress, disappointment and sadness. A person living with Alzheimer’s may feel a special sense of loss during the holidays because of the changes he or she has experienced. At the same time, caregivers may feel overwhelmed maintaining traditions while providing care. Holiday Tip Sheet
All About Medicare Open Enrollment
Q: What happens during Medicare Open Enrollment?
A: Medicare holds an Open Enrollment period every Fall. This year it began on October 15th, and ends on December 7th. This is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the coming year to better meet their needs, like changing the cost of your plan, benefit coverages, and which providers or pharmacies are in your plan.
Original Medicare includes coverage for hospital and doctor care (Parts A and B) that is managed by the federal government. You generally have to pay a deductible before Medicare pays its share, and a portion of the cost for each service you use. You can also add a Medicare Drug Plan (Part D). Because of the out-of-pocket payments required by Original Medicare, you can choose a Medicare Advantage Plan (Part C), which is offered by private companies. These companies contract with Medicare to provide Part A and Part B benefits.
Medicare Advantage Plans include Health Maintenance Organizations HMOs) that limit you to the doctors and other providers in their network; Preferred Provider Organizations (PPOs), in which you pay less for providers that are in the Plan’s network; Private Fee-for-Service Plans, which are similar to Original Medicare; Special Needs Plans, which provide specialized health are for specific groups of people, like those who have Medicare and Medicaid, or have certain chronic conditions; and Medicare Medical Savings Account Plans, which combine a high deductible health plan with a bank account. In most Medicare Advantage Plans, you get services from a plan’s network of providers, so make sure the doctor you want is in the network, and the drugs you need are covered by the plan. Most Medicare Advantage Plans offer prescription drug coverage.
During Open Enrollment, you can: change from Original Medicare to a Medicare Advantage Plan; change from a Medicare Advantage Plan back to Original Medicare; switch from one Medicare Advantage Plan to another; switch from a Medicare Advantage Plan that doesn’t offer drug coverage to one that does; switch to a Medicare Advantage Plan doesn’t offer drug coverage; switch from one Medicare drug plan to another, or drop your Medicare prescription drug coverage completely.
All these options cause seniors great confusion about what to do during Open Enrollment. You can start by reviewing the material that your Medicare health or prescription drug plan sent you in October. Look for the “Evidence of Coverage” and “Annual Notice of Change” messages. If you are satisfied that your current plans will meet your needs for the coming year, and your plan is still being offered—they don’t need to do anything.
There is also a Medicare Advantage disenrollment period that runs from January 1st to February 14th. During this period, you can leave your Medicare Advantage plan and switch to Original Medicare. If you switch to Original Medicare, you’ll have until February 14 to also add a Medicare Prescription Drug Plan. During this period you can’t switch from Original Medicare to a Medicare Advantage Plan, or switch from one Medicare Advantage plan to another, or from one Medicare Advantage Plan to another.
Fortunately, there are trained Medicare experts in your community that you can use for free. The SHINE program (Serving the Health Information Needs of Everyone) has counselors all across Massachusetts who can offer a private health insurance counseling session to help guide you to the right Medicare Plan for you. Call 1-800-AGE-INFO and push “3” to set up your SHINE counseling session and get on the right plan.
pen Enrollment is here! Now through Dec. 7th. The process can be overwhelming, but SHINE can help.
Hear from Tracey Stewart – she appreciated the impartial Medicare counseling offered in a place she felt safe going to. The SHINE program provides free, unbiased, and trusted Medicare counseling. Contact your local council on aging or call HESSCO at 781-784-4944 to speak with a SHINE counselor.
Q: Do the elderly or ill have protections against utility shut-offs?
A: Yes. Households in Massachusetts in which all adult members are age 65 or older—whether there is a financial hardship or not—are protected against utility and phone shut-offs. “Utility” means your gas or electric service to your home, or your landline telephone. Cell phones are not protected from shut off, and heating oil is not covered by utility law. Most oil companies require you pay at delivery. Be sure to ask all these fuel companies if they offer a “senior citizen discount”
Every year from November 15 to March 15, gas and electric companies cannot shut off your service because you are unable to pay. This moratorium does not apply if service was shut off for non-payment before November 15.
When all adult members of the household are age 65 or older, your utility company cannot terminate service without first applying for written authorization from the Department of Public Utilities (DPU) and giving written notice to the Executive Office of Elder Affairs, and to everyone in your household. Make sure that everyone 65 or older in your household has given your utility companies written information about their age. The law also protects grandparent-headed households: as long as the only people under age-65 living in the household are minors (under age-18).
The DPU is unlikely to approve a shut-off, especially if you are trying to make a good faith repayment effort. But if you own your home, a utility might try to put a “lien” or “attachment” on your home, to collect what is owed when you home is sold. Interest on the bills will be charged.
If all the members of your household are not 65 or older, you have another option: to submit that someone in the household has been diagnosed as having a “serious” or “chronic” condition. Your illness or condition has to be verified by the diagnosis of a medical doctor, nurse practitioner, or physician’s assistant. The words “serious” and “chronic” are not defined in state law, so utility companies will usually go along with a doctor’s diagnosis. Attention Deficit Disorder, PTSD, asthma, anxiety or depression are examples of a serious illness or condition. All your doctor has to say is “you have a serious illness or chronic condition.” Your serious or chronic illness does not have to require uninterrupted utility service. If a shut-off threat is on very short notice, your utility company has to accept a phone call from a doctor—but a follow up written letter will be needed within 7 days of the call. The utility has to keep service on for 3 months once learn that a customer is “seriously ill.” If your illness is “chronic,” you can get six months protection. Ask your doctor’s office to fax their letter directly to the utility company, and to give you a receipt, because you may need proof to show your utility months later.
For phone land lines, the same “over 65” protections apply, as well as the “serious” illness protections. For phone service, only a doctor or clinician in a doctor’s office can certify illnesses. The same phone call from a doctor rule applies if a shut-off is imminent, with a follow up written illness letter within 7 days. A doctor’s letter can be renewed two times, totaling 90-days protection.
The phone company won’t shut-off service if the customer asks for “personal emergency protection,” demonstrates that he or she cannot pay the bill, and that phone service is necessary to protect the health or safety of a member of the household. An elder with an emergency alert button around his or her neck, for example, could ask for personal emergency protection. If the phone company denies the protection, the customer can appeal to the Department of Telecommunications and Energy (DTE). Ask your gas, electric or phone company to send you an elderly household protection form, or a serious illness/chronic condition, or personal emergency protection form.
Even with these shut-off protections, you are still responsible for paying off your bill, and you will be charged interest for late payments.
If you are facing a utility shut-off, contact the Attorney General’s Consumer Hotline at (617) 727-8400. To read more on your shut off rights, go to: http://www.masslegalhelp.org/special-protections-against-shut-offs
Eldercare Q&A – October, 2017 – Learning About Lung Health
Q:What are the major lung conditions elders should know about?
A: Diseases of the lung are almost as common as breathing air. Lung problems that are common among older people include: chronic obstructive pulmonary disease (COPD), pneumonia, lung cancer, and asthma. Q&A column Oct 2017 Lung Health
In the wake of Hurricanes Harvey and Irma, we could all use a reminder on how to be prepared for an emergency. This video produced by Massachusetts Emergency Management Agency provides helpful information and resources.
Q:Are there any strategies for preventing or slowing cognitive decline?
A: Most studies are cautious about answering this question. One recent report by the Lancet Commission on Dementia Prevention and Care concluded that one-third of dementia cases could potentially be prevented through better management of lifestyle factors, such as smoking, hypertension, depression, and hearing loss over the course of a lifetime. QA ElderCare September 2017 Can We Prevent Cognitive Decline (2)
Eldercare Q&A July, 2017
The Care And Treatment Of Sciatic Pain
Q: Is sciatic nerve pain something I just have to put up with?
A: No, sciatic pain does not have to be a chronic condition. The medical condition called “sciatica” is a major cause of work absenteeism and a major financial burden to both employers and our health care system. Q&A July 2017 The Care & Treatment of Sciatic Pain
Who would have thought that we’d be talking about extreme heat this week, when we were all wrapped up in blankets last week?! Temperatures could hit 90 degrees tomorrow, so please take a moment to review these important reminders about staying safe in extreme heat.
The Impact of Retirement on Your Health
Q: Does retirement have a positive or negative impact on health?
A: Retirement can have good and bad impacts on health. One study by the National Bureau of Economic Research concluded that complete retirement leads to a 5-16% increase in difficulties associated with mobility and daily activities, a 5-6% increase in illness conditions, and 6-9% decline in mental health. But these negative health effects are reduced if the retiree is married, has social supports, continues to engage in physical activity after retirement, or continues to work part-time after retiring. The negative health effects of retirement may be larger if a person has been forced to retirement.
The National Institute on Aging says that health problems have a big influence on the decision to retire early—but less research has been done on how retirement affects your health after you retire. According to the Harvard Health Blog, retirement for some people is a chance to relax away from the daily grind—but for others, retirement can be a period of declining health and increasing limitations. One study ranked retirement 10th on the list of life’s most stressful events. (Losing a spouse was #1.)
U.S Health and Retirement Study data shows that retirees were 40% more likely to have had a heart attack or stroke than those still working. The increase was greater during the first year after retirement, and leveled off after that. Another study from England concluded that retirement significantly increased the risk of being diagnosed with a chronic condition. In particular, retirement raised the risk of a severe cardiovascular disease and cancer.
But there are other studies which link retirement with improvement in health, or a neutral effect on health. One study found that retirement did not change the risk of major chronic diseases, and brought about a substantial reduction in mental and physical fatigue and depressive symptoms among people with chronic diseases.
So the impact of retirement on health may depend on the individual. The Harvard Health Blog suggests that “moving from work to no work comes with a boatload of other changes.” If you loved your work, retirement can bring some emptiness of purpose. If you had a stressful job, retirement brings relief. Either way, researchers offered these tips for a rewarding retirement:
- Don’t ‘retire’ from daily contact with friends and colleagues:
- Maintain Activities like sports or traveling, to keep a purposeful daily life
- Be creative: keep your brain healthy by painting, gardening, or helping other people
- Keep learning: explore new subjects you’ve always been interested in.
Understanding what large group studies say about retirement is interesting, but studies can’t predict how retirement will affect your life. People who retire because of health problems may not enjoy retirement as much as someone who retires feeling healthy. But it makes sense to view retirement as a process, not as a single event, that will bring good changes and bad—just like the earlier stages in your life.