Discovering The Mature Lifestyle
So what is Medicare anyway? Page 3
Medicare & Insurance
October 21, 2016
Long-term care insurance helps protect your assets Long-term care insurance is not meant to handle shortterm stays. It’s for someone with Alzheimer’s or a stroke, or someone too old to care for themselves on a daily basis. Sue Turner
Sue Turner is a long-term care insurance s pecialist i n E agan. Turner has a finance deg ree f rom t he U niversity o f Minnesota a nd first worked i n m utual funds. Her specialty for the last 20 years has been long-term care insurance. She has more than 1,000 clients and is part of a net work o f s pecialists acr oss t he country. (Submitted photo)
BY SUE WEBBER CONTRIBUTING WRITER In eras past, fa milies assumed t hey would ca re f or t heir agin g lo ved o nes a t home, often nursing them through a long illness prior to death. Now, t hough, lif estyles ha ve c hanged, most fa mily mem bers a re w orking a nd many p eople consider long ter m care insurance, so they don’t become a burden to their families. Sue Turner, a long-term care insurance specialist for 20 years at Turner Insurance Agency Inc., in Eagan, said most of her clients tend to buy LTC policies when they’re in their 50s or early 60s. “They t end t o b e p eople wi th ass ets,” she s aid. “ If y ou wa it un til y ou’re 60 o r 70, t he p remium will b e hig her. I f y ou wait to buy until you’re 65 and you have a slight health condition, you’ll pay $5,000 a month for four years of coverage.” Whether you’re single or married, you can purchase a policy of any size to cover nursing ho me, assist ed li ving facili ty o r home health care when and if needed. The client stipulates in the policy how long the coverage is t o last. “ Most c lients st ay a t home as long as possible,” she said. Premiums run between $100 and $400 a month, Turner s aid. “You pick t he dollar amount of coverage you want, and you pick y our o wn facili ty; y ou ca n g o a nywhere in t he U.S.,” she s aid. “ The premiums are a function of your age, your health and the benefits you pick within the plan.” Noting t hat t he b ill f or n ursing ho me care no w st ands a t a bout $85,000 a y ear, Turner s aid, “ Ninety-nine p ercent o f c li-
ents do n’t p urchase a p olicy t hat co vers $85,000 a y ear. They ca n usuall y co ver $1,000 t o $3,000 a mo nth o ut o f p ocket and t he p olicy co vers t he bala nce. Y ou don’t need to be insurance poor.” However, an inflation rider is the most important pa rt o f t he p olicy, she s aid. I t provides a n a utomatic a nnual inflation increase. F or exa mple, a p olicy pa ying $5,000 a mo nth f or ca re a utomatically goes up 3 p ercent. “It automatically compounds for you,” Turner said. “If you buy a policy when you’re 60, for example, and don’t need ca re until you’re 85, t he $5,000 a mo nth y ou sti pulated in t he p olicy p robably w on’t b e eno ugh, Turner said. Long-term care insurance is not meant to ha ndle sho rt-term st ays, she s aid. “ It’s for someone with Alzheimer’s or a stroke, or someone too old to care for themselves on a daily basis,” she said. Prospective clients have to be in g ood health w hen t hey p urchase t he p olicy Turner s aid. “ Most co mpanies wi ll s end someone to your home to look at the last five years of your medical records and perform a short cognitive test,” she said. Why do people buy it? Asset protection is one reason, according to Turner. Other reasons are that people want to ensure that they have good quality care when they need i t, a nd t hey do n’t wa nt t o b urden their children or grandchildren. Who sho uld no t b uy lo ng-term ca re insurance? S omeone w ho has no ass ets and couldn’t afford the monthly premium isn’t a candidate for the insurance, Turner said. “Some people buy it to protect their assets,” she said.
She str ongly sug gests t hat p eople interested in lo ng-term ca re in surance g et quotes f rom tw o o r t hree different companies. “I’m no t tied t o a ny o ne co mpany, s o I can compare companies,” she s aid. “You want t o mak e sur e y ou b uy f rom a n A rated co mpany. Y ou wa nt t o w ork wi th someone w ho kno ws a nd under stands long-term care insurance.” She em phasizes t hat unlik e he alth insurance, lo ng-term ca re is o ne b uy. “ You don’t switch a y ear or two from now,” she said. “ You wa nt t o g et i t r ight t he first time.” But co mpanies issuin g t he lo ng-term insurance ca re r eserve t he r ight t o ra ise rates, a nd t hey will g o u p, acco rding t o Turner. Without lo ng-term ca re in surance, people pay for their care out of pocket until t heir ass ets a re do wn t o $3,000. Then they g o o n w elfare. “ Some p eople do n’t want to run out of money to take care of themselves,” T urner sa id. “ A th ree-year policy gives you another three years.” Tuner has taught a number of classes on long-term care insurance. The next class is scheduled for 6:30 p .m. Wednesday, Nov. 20, through Eagan Community Education Department. Call 651-423-7920 for information or to register. In addition to learning the terminology and information about assets, quality care, and ho w p lans differ f rom on e c ompany to another, and alternatives to LTC insurance, a t t he c lass Turner will co ver MN Partnership Pla n, sha red p lans a nd e ven plans that return your premiums if care is not needed.
Page 2 Our Life โข Friday, October 21, 2016
nรรยยฃย รnAeรถ รยจ Qรฆรถ A !neย[Aรn ยทยAยฃร 2ยnรnรร ยยจรร ยจ| |รnn ยnยยท รยจ }ยฃe A ยทยAยฃ รยจ }ร รถยจรฆร ยฃnneร Aยฃe Qรฆeยnรยฝ ยฃ ยจรenร รยจ รAยn AeรณAยฃรAยn ยจ| รถยจรฆร รnรยจรฆร[nรb รถยจรฆรยย ยฃnne รยจ ยยฃยจรด รยn รยยยร รรฆnรรยยจยฃร รยจ Aรยยฝ 9ยรยร ยnAยรยยทAรรยฃnรรยneย[Aรnยฝ[ยจยรรดยจรยรยnnร รยจ eยจรดยฃยยจAe A รดยจรยรยnnร รดยรย รรฆnรรยยจยฃร รยจ ยnยยท รถยจรฆ รยยจยทยฝ nรn Aรn ยรฆรร A |nรด รยยยฃยร รถยจรฆรยย }ยฃe ยจยฃ รยn รดยจรยรยnnรa
ยจรด ยรฆ[ย รดยยย ยทAรถร
ยจnร รยn ยทยAยฃ ยAรณn nรตรรA Qnยฃn}รรร
รรร ยยยทยจรรAยฃร รยจ ยยฃยจรด ยยจรด ยรฆ[ย รถยจรฆร !neย[Aรn ยทยAยฃ รดยยย [ยจรรยฝ n รรฆรn รยจ [ยn[ย ย| รยn ยทยAยฃรร ยทรnยยรฆยb eneรฆ[รยQยn Aยฃe [ยจยทAรถรร[ยจยยฃรรฆรAยฃ[n Aรn รดยรยยยฃ รถยจรฆร Qรฆeยnรยฝ
"ยจร Aยย !neย[Aรn ยทยAยฃร Aรn [รnAรne nรรฆAยยฝ 0ยจยn ยจ||nร รรAรณnย [ยจรณnรAยnb ยรถย eยร[ยจรฆยฃรร Aยฃe nรณnยฃ enยฃรAย [ยจรณnรAยnยฝ รย AQยจรฆร รยnรn Aยฃe ยจรยnร ยทnรยร รถยจรฆ [Aยฃ ยnร รดยรย รถยจรฆร ยทยAยฃยฝ
:ยยย ยรถ ยneร Qn [ยจรณnรneร 2Aยn A รรฆย[ย ยยฃรณnยฃรยจรรถ ยจ| รถยจรฆร ยneย[ยยฃnรยฝ รรร A ยยจยจe ยenA รยจ ยAยn รรฆรn รถยจรฆร |รฆรรฆรn !neย[Aรn ยทยAยฃ [ยจรณnรร รยnยยฝ 4ยฃenรรรAยฃeยยฃย ยยจรด รยn ยทยAยฃรร ยทรnร[รยยทรยยจยฃ [ยจรณnรAยn รดยจรยร รดยยย ยnยยท รถยจรฆ Qรฆeยnร |ยจร ยneย[ยยฃnร รถยจรฆ ยAรถ ยฃnneยฝ
2 <$4/ .402$"0 "0:/
<ยจรฆ [Aยฃ ยยจ รยจ Aยฃ nรณnยฃร ยจร รAยย รยจ Aยฃ nรตยทnรรยฝ ยจยยรฆยฃยรรถ ยnnรยยฃยร ยยจรรne Qรถ A ยnAยรย ยยฃรรฆรAยฃ[n [ยจยยทAยฃรถ Aยฃe [ยจยยรฆยฃยรรถ nรณnยฃรร Aรn รถยจรฆร รย[ยnรร รยจ |รnn Aeรณย[n |รยจย A รnยยAQยn รยจรฆร[nยฝ <ยจรฆ [Aยฃ Aยรยจ [Aยย A !neย[Aรn nรตยทnรร รถยจรฆ รรรฆรรยฝ 2ยยร [Aยฃ Qn A |Aยยยรถ ยnยQnรb Qรยจยnร ยจร !neย[Aรn ยยฃรรฆรAยฃ[n รAยnร รnยทรnรnยฃรAรยรณn
5 4/ "" 2 ('#* %. **(""* (
")* .%# 2%. & 2.%4 .4.8 & "" 4/ .%# *#* 2% '*#* /5$ 8/ 6!* .4.8 & 2% '2#. 39 6-. . *#* 2% '*#* %$8 2.%4 .8*
Our Life • Friday, October 21, 2016 Page 3
So, what is Medicare? Medicare is he alth in surance for people 65 or older, people under 65 wi th cer tain dis abilities, and people of any age with EndStage Renal Dis ease (p ermanent kidney fa ilure r equiring dial ysis or a kidney transplant). You a re eligib le f or M edicare on t he first day of t he month in which you turn 65. If your birthday is o n t he 1st, t hen y ou a re eligible o n t he 1st o f t he p rior month. You ca n enr oll f or M edicare 90 days prior to turning 65. You are enrolling in M edicare Part B (Medical Services). Your Part A, which covers in-patient hospital services, begin s a utomatically on the 1st of the month in which you turn 65. When y ou a re first eligible for Medicare, you have a s evenmonth p eriod t o sign u p. This seven-month pe riod be gins three mo nths b efore y our 65t h birthday, includes the month you turn 65, a nd ends t hree mo nths after you turn 65. You can sign up for Medicare
as s oon as y ou b ecome eligib le, regardless o f w hat mo nth i t is. But e ach y ear, y ou ha ve t he o ption of ma king change s to you r Medicare A dvantage a nd p rescription drug plan (or Medicare Part D) during open enrollment. The o pen enr ollment p eriod this year runs from Oct. 15 to Dec. 7, 2016. You can select coverage f or t he first time t hen, o r make c hanges in y our c urrent coverage. I f you ma ke change s during o pen enr ollment, ne w coverage b egins J an. 1, 2017. New costs a nd b enefits changes also begin if you keep your existing Medicare health or prescription drug coverage and your plan makes changes. During th e o pen e nrollment period, y ou ca n swi tch f rom original M edicare t o M edicare Advantage, or vice versa. You can also s witch f rom on e M edicare Advantage p lan t o a nother, o r from one Medicare Part D (p rescription dr ug) p lan t o a nother, or dr op y our M edicare P art D coverage altogether.
Questions to co nsider mig ht include: • C onvenience: W here is the d octor’s office located and what are the hours? Do they use electronic h ealth r ecords? Is th e pharmacy y ou us e in t he p lan’s network? • C ost: H ow m uch a re t he premiums? How do y ou pay for hospital stays or doctor visits? • Coverage: How well does the plan cover the services you need?
Medicare’s four parts:
Part A (hosp ital in surance) helps cover: • Inpatient care in hospitals • Skilled nursing facility care • Hospice care • Home health care Part B (medical in surance) helps cover: • S ervices f rom do ctors a nd other health care providers • Outpatient care • Home health care • Durable medical equipment
• Some preventive services Part C (Medicare Advantage): • Includes all benefits and services co vered under P art A a nd Part B • U sually inc ludes M edicare prescription drug coverage (Part D) as part of the plan • R un b y M edicare-approved private insurance companies Part D (Medicare prescription drug coverage): • Helps cover the cost o f prescription drugs • R un b y M edicare-approved private insurance companies • M ay hel p lo wer y our p rescription dr ug costs a nd hel p protect aga inst hig her costs in the future. The e asiest wa y t o enr oll in Medicare is t o g o t o w ww.socialsecurity.gov/medicareonly Source: M edicare & Y ou 2016, t he o fficial U.S. go vernment M edicare h andbook published by the U.S. Department of Health and Human Services Centers for Medicare
and Medicaid Services.
Medicare expert suggests questions for seniors to consider BY SUE WEBBER CONTRIBUTING WRITER Sara W agner, a M edicare exp ert a t Health P artners in B loomington, s aid t he thing she he ars most f rom s enior ci tizens who are just signing up for Medicare is that it’s “really confusing.” “It’s no t s omething a nyone ca n p repare for,” said Wagner, who has a master’s degree in gerontology and has been at Health Partners for 15 years. “People are lo oking for help, resources and ‘ what do es t his me an? ’” Wagner s aid. “They’re starting from square one.” There a re cer tain t hings p eople mig ht want to co nsider as t hey sho p f or he alth care coverage, Wagner said. • C an I k eep my do ctor? “Not all p lans have the same network,” Wagner said. • Do I need a referral to see a specialist? • CMS (C enters for Medicare and Medicaid S ervices) has a five-star, in-depth
rating syst em in place f or p lans, a quality assura nce score ca re a vailable a t medica re. gov. “ In M innesota, w e’re f ortunate to have good quality p lans, b ut you sho uld lo ok Sara Wagner is a Medicare at t he pl an’s st ar expert at Health Partners in rating,” W agner Bloomington. said. “ It’s p retty rigorous. It speaks to t he q uality a nd s atisfaction o f members’ experiences, not just what you pay in monthly premiums.” • What can you afford to pay each moth? • What do y ou pay out of pocket if y ou travel to see a do ctor outside the plan network? • Is there a fitness benefit? “We find a lot of p eople w ho a re interested in t he fitness
benefit,” Wagner said. • Is there a dental plan included? “Sometimes we forget about teeth,” Wagner s aid. “Some plans include dental plans, and some don’t. You have to know what you’re buying.” All p lans ha ve a n emer gency p lan t hat will cover you when you travel, according to Wagner. However, some have a ca p on extended benefits, she s aid. “Most plans have some sort of travel benefit,” she said. • I s t here a co rresponding p rescription drug plan? “We often find that people like everything with one carrier,” Wagner said. She no tes t hat most he alth in surance carriers in Minnesota offer classes or information sessions, or opportunities for people to educate themselves before they enroll in Medicare. “They want to help people make the transition,” Wagner said. Seniors ca n g et inf ormation f rom a ny independent insurance agent, a broker that represents all p lans, f rom S enior L inkage
Line or at the medicare.gov website. Telemedicine no w is o ffered b y s ome plans as a n alternate to a face-t o-face visit with the doctor. “A lot of physicians participate in that,” Wagner said. As for Health Partners, she s aid, “We’re really proud of our Virtuwell online clinic. It’s available 24/7, and it treats 50 common conditions, including bladder infections, flu and sinus infections.” To us e the program, patients fill out an online f orm a nd a nswer s ome q uestions that a do ctor would be likely to ask. C ertified n urse p ractitioners mak e a diagnosis, create a p ersonalized tr eatment p lan a nd send a prescription if needed. Wagner suggests that people who are approaching Medicare start looking at options a year in ad vance, “to get an idea of what’s out there.” “Don’t be afraid to ask q uestions,” Wagner s aid. “ You r eally do n’t ha ve t o do t his alone.”
Page 4 Our Life • Friday, October 21, 2016
/ /0 "20 Ý¨ ÝÏö £nô 2 2n[£¨¨ö £ nAÏ£ eÓ½ Ïn ö¨æb ¨Ï Ó¨n¨£n ö¨æ £¨ôb ÓÝÏæ£ ôÝ nAÏ£ ¨ÓÓÅ :n £nne AÏnA ÏnÓen£ÝÓ ô¨ [æÏÏn£Ýö ônAÏ nAÏ£ AeÓ ¨Ï Aón £nónÏ ô¨Ï£ nAÏ£ AeÓ QæÝ Aón e||[æÝö nAÏ£b nõ·n[Aö £ £¨Óö ÓÝæAÝ¨£Ób Ý¨ nóAæAÝn Ýn AÝnÓÝ £ eÝA Ýn[£¨¨ö |Ï¨ nÝ¨£n½ nÝ¨£n ô ·nÏ|¨Ï [¨·Ïn
n£Óón nAÏ£ [¨£ÓæÝAÝ¨£Ó / ¨| [AÏn Ý¨ A [AnÏÓ½ -nAÓn [A AÓ Ó¨¨£ AÓ ·¨ÓÓQn Ý¨ Ó[neæn ö¨æÏ nóAæAÝ¨£ Ý¨ nóAæAÝn Ýn AÝ nÓÝ £nAÏö £óÓQn nAÏ£ Ae Ýn[ £¨¨ö½ A£eeAÝnÓ Ónn[Ýne ô Qn AÓne Ý¨ nóAæAÝn Ýn AÝnÓÝ £nAÏö
2n nAÏ£ ¨·æÝnÏ Ó |æö AæÝ¨AÝ[½
æÓÝ Ó· Ý £½
£óÓQn nAÏ£ Ae Ýn[£¨¨ö½ A£n A nAÏ£ Ae ÝAÝ AæÝ¨AÝ[Aö AeA·ÝÓ Ý¨ ö¨æÏ ÓæÏ Ï¨æ£e£Ó A£e n||n[ÝÓ ö¨æÏ Ó·n[}[ |nÓÝön½ A£n A nAÏ£ Ae ÝAÝ Ó Ó¨ ·nAÓA£Ý Ý¨ ônAÏ ÝAÝ Ý ónÓ A £nô nA££ Ý¨ Ýn ·ÏAÓn É[æÓ
Ý¨nÏ ÓAÝÓ|A[Ý¨£½Ê <¨æ [A£ nAÏ A£e Ónn |¨Ï ö¨æÏÓn| ôÝ ÝÓ ¨||nÏ½ 2An AeóA£ÝAn ¨| Ýn Ïnn en ¨£ÓÝÏAÝ¨£Ó ¨||nÏne ÝÓ ônn½ A nÝ¨£n Ý¨eAö |¨Ï A £¨ ¨QAÝ¨£ A··¨£Ýn£Ý½
Ý Ó een£ £Óen I nAÏ£ Ó nAÓö½
nAÏ£ ÝnÓÝN ¨||nÏne
$[Ý¨QnÏ ä¯äsb äü¯Ø | ö¨æÏ nóAæAÝ¨£ Ó¨ôÓ nAÏ£ ·Ï¨ón n£Ý ôÝ Ýn £nô £ÓÝÏæ n£ÝÓb ö¨æ Aö [¨¨Ón Ý¨ ÏnÝA£ Ýn A£e Ïn [nón küü $ ¨£n £ÓÝÏæn£Ý ¨Ï ksüü $
:n AÏn A ·Ï¨óenÏ |¨Ï æA£Ab 0b - b A£e A£ö ¨ÝnÏ £ÓæÏA£[nÓz
A [¨·nÝn ÓnÝ½ <¨æ ô AÓ¨ Ïn[nón / |n Ýn £v$|}[n !A£Ýn £A£[n |¨Ï Ýn |n ¨| Ýn nAÏ£ AeÓ A£e A önAÏ Óæ··ö ¨| QAÝÝnÏnÓ½
:2 / ¯ß¯ü ½ ôö ¤Ø
-<!$42 ¯äsü~ ôö ~~
4/"09 ¯ß×~~ "[¨nÝ ón½ 0½
$$" /- 0 ¯üüäØ 4£ónÏÓÝö ón ":
/$09 ¯×üü :½ ôö ßØ
$$!"2$" s¯üü -n££ ón½ 0½
/!"2$" üs ßÏe 0Ý½
NnAÏ£ 2nÓÝÓ AÏn ón£ |¨Ï Ýn ·æÏ·¨Ón ¨| Ónn[Ý¨£ A£e AeæÓÝn£Ý ¨| nAÏ£ £ÓÝÏæn£ÝAÝ¨£½ /nÓæÝÓ Aö óAÏö ÏnAÝne Ý¨ eæÏAÝ¨£ A£e ÓnónÏÝö ¨| ·AÏn£Ý½ AÏö enÝn[Ý¨£ Ó ·¨ÏÝA£Ý½
9""Ù:" " "$! --$"2!"20 9 tĜȋĜȂ̰©ȶźƶƣ ƶĂĜú "/¯üäü
Our Life • Friday, October 21, 2016 Page 5
Health issue? There’s an ‘-ology’ for that We all kno w that people are living lo nger a nd en joying la te lif e more t oday. N aturally, t here a re many reasons for our increased longevity, inc luding b etter diet a nd a more active lifestyle. Medical ad vancement is als o a prime co ntributor. W e’re b lessed with good health care. But it comes at a cost (a nd I do n’t j ust me an stratospheric he alth in surance p remiums.) Besides b eing exp ensive, g etting care from our health care system can be frustrating, complicated, confusing a nd exha usting. F or st arters, selecting a su pplementary he alth insurance p lan is lik e na vigating a maddenin g maze o f co nvoluted corridors. Then, t here are t he myriad rules to follow, hurdles to clear, hoops t o j ump t hrough a nd f orms to fill out. As it turns out, our health care system is held together with red tape. It’s eno ugh t o mak e y ou s eek medical treatment. But most co nfusing to me is t he
Guest column ... by Bob Ramsey mushrooming f ragmentation a nd specialization o f medical ca re. P rimary c are do ctors ha ve b ecome mostly b rokers, s orting o ut patient a ilments a nd r eferring t hem to the appropriate sp ecialists. I was amazed recently to find an en tire department o f “ha nd do ctors” in our local hospital. I wouldn’t be surprised if t here a re no w do ctors f or the right hand and others specializing in left hand c are. We no lo nger have a single family doctor; we have a whole posse of healers in our corner. Coping wi th all t hese sp ecialists raises s erious q uestions. W ho do you call first? Who prescribed what for w hat? And w ho g ets t he final
word? We can only hope they know what e ach o ther is do ing a nd do n’t get in a turf war over our bodies. There tr uly is a n “ ologist” f or every ailment, injury or dis ease today — and my wife and I have seen them all — s o ma ny in fac t, t hat it p rompted her t o p en t his li ttle tongue-in-cheek verse - adjacent. With all t hese do ctors o n o ur case, we should live a long time. After all , o ur c linic ca n ba rely a fford to let us die; w e’re su pporting t oo many of their physicians. Although w e kid a nd co mplain about t oday’s “ care b y co mmittee,” we are the beneficiaries of this modern approach to medical tr eatment. Keeping us he althy has definitely become a t eam sp ort. S o t hanks, team! Bob Ra msey i s a l ifelong ed ucator, freelance w riter a nd a dvocate f or “vital a ging.” H e c an be r eached a t 952-922-9558 o r b y e-m ail a t jo email@example.com
Ode to “Ologies” “Your body is complicated,” Said my doctor to me. “Your blood count is low, So go to HEMATOLOGY!”
And being a woman, I occasionally see — Of course, that would be — GYNOCOLOGY! My aches and pains persist Then my heart rate dropped Through my anatomy, down. So of course, I’m sent It’s a pacemaker for me. To RHEUMATOLOGY! So the good doctor sent me To CARDIOLOGY! Now that didn’t help, So what next should it be? What are these spots on my The doctor said, “Now go skin? To NEUROLOGY!” They do n’t lo ok no rmal to me! Since I’m getting old, So the next place I go is — My kidneys agree, To DERMATOLOGY! That I should be sent — To UROLOGY!! Printed words on the page, Are harder to see. Enough of these “ologies,” And t here’s a sp ecialty f or I think all would agree, that. I’ll probably be sent — It’s OPTHALMOLOGY! To PSYCHIATRY!! J. R.
Choose your medications wisely BY SUE WEBBER CONTRIBUTING WRITER Prescription drug coverage is a big part of any health insurance plan. And it’s wise to do some research before choosing prescription drug coverage. “Go t o t he p harmacist wi th a complete listin g o f y our medications,” s aid S teve L angemo, w ho was a retail pharmacist for 20 years and now has been general manager of Merwin LTC Pha rmacy in N ew Brighton for the last 18 years. “A p harmacist ca n c heck t o b e sure t here a re no in teractions b etween t he medica tions,” L angemo said. “ Some p eople do uble u p o n medications without realizing it. Also, from a cost standpoint, there might be alternatives that are less expensive.” Merwin’s L TC Pha rmacy in N ew Brighton is a c losed-door p harmacy, which means it is not open to the public. The p harmacy de als ex clusively
with residents in skilled nursing facilities, according to Langemo. Long-term care (LTC) pharmacies generally s erve t he residents of nursing ho mes, assist ed-care facili ties, extended-care facilities, and/or retirement homes. Drug plans may vary in what drugs they co ver, a nd s ome ma y ha ve sp ecial rules that you must follow before a dr ug is co vered, acco rding t o t he Medicare website.
A f ormulary is a list o f t he dr ugs that a M edicare drug plan covers, according t o t he M edicare w ebsite. I t includes how much you pay for e ach drug. If the plan uses tiers, the formulary lists w hich drugs are in e ach tier. Formularies include both generic and brand-name dr ugs. E ach dr ug p lan has its own formulary, so you should check t o mak e sur e y our dr ugs a re covered.
Medicare dr ug p lans ma y r equire
“prior authorization,” the website said. “This means that before the Medicare drug plan will co ver certain prescriptions, y our do ctor m ust co ntact t he plan f or a pproval,” t he w ebsite s aid. “Your doctor may need to provide additional inf ormation a bout w hy s aid. “Your doctor may need to provide additional inf ormation a bout w hy t he drug is medicall y necess ary f or y ou before y ou ca n fill t he p rescription. Plans ma y als o r equire ‘step t herapy’ on cer tain dr ugs. This me ans y ou must tr y o ne o r mo re simila r, lo wer cost dr ugs b efore t he p lan will co ver the prescribed drug.” It is a good idea to check with each Medicare dr ug p lan y ou’re co nsidering t o mak e sur e y our c urrent p harmacy is in the plan’s network, or there are p harmacies co nvenient t o y ou. Some Medicare dr ug plans may offer a ma il-order p rogram t hat will allo w you to have drugs sent directly to your home. Even if y ou’re not changing plans,
make s ure y our p harmacy i s s till in your p lan’s netw ork next y ear. Pla ns may c hange t heir netw ork p harmacies each year.
Most M edicare dr ug p lans ha ve a coverage ga p (als o called t he “donut hole”). This means that there’s a t emporary limi t o n w hat t he dr ug p lan will cover for drugs. The coverage gap begins a fter y ou a nd y our dr ug p lan have spent a cer tain amount for covered dr ugs. I n 2016, o nce y ou en ter the coverage gap, you pay 45 p ercent of t he p lan’s cost f or co vered b randname dr ugs a nd 58 p ercent o f t he plan’s cost f or co vered g eneric dr ugs until you reach the end o f the coverage gap.
Automatic reﬁlls by mail
Some p eople wi th M edicare g et their p rescription dr ugs b y usin g a n automatic r efill s ervice t hat deli vers prescription dr ugs w hen t hey are about to run out.
Page 6 Our Life • Friday, October 21, 2016
North Memorial offers TotalCare program for seniors BY SUE WEBBER CONTRIBUTING WRITER Senior citizen patients at North Memorial Health Care qualify for the TotalCare for Seniors program. The program’s geriatric specialists work with seniors and their families to provide post-hospital services, through long-term care, Transitional Care Units, assisted living, indep endent li ving o r hosp ice s ettings. “When a pa tient is dis charged, if t hey need transitional care, they are referred by a p rimary ca re p rovider to a n urse p ractitioner, who follows them into long-term care,” s aid Teresa B loom, ma nager o f t he TotalCare program. Patient c are is ma naged o nsite, a t t he facility where the client lives. Physicians a nd n urse p ractitioners work as a team to provide the care at the patients’ choice of 13 facili ties w hen they leave the hospital.
“A lot of facilities ask us to help take care of their residents. We have to focus our resources on the places we work closely with to continue to deliver high-quality service.” - Dr. Joseph Sicora
TotalCare for Seniors is available at the following facilities: Annandale Health & C ommunity, Annandale Centennial V illa A ssisted Li ving, A nnandale Colonial Acres Health C enter, G olden Valley Good Sa maritan Am bassador, N ew Hope Good Samaritan Robbinsdale, Robbinsdale Maranatha, Brooklyn Center North Ridg e H ealth & Reha b, N ew Hope Pioneer Est ates A ssisted L iving, Eden Prairie St. Therese, New Hope St. Therese – Oxbow, Brooklyn Park The Birches at Trillium Woods, Pl ymouth The V illa a t S t. L ouis P ark, S t. L ouis Park The Villa at Osseo, Osseo Transitional Care by St. Ther ese, Robbinsdale Wellstead of Rogers, Rogers Clients a t T CUs a re visi ted o nce o r twice weekly, w hile patients in lo ng-term care are visited monthly. Those in assisted
Heading North Memorial Health Care’s TotalCare for Seniors program in Robbinsdale are, from left: Teresa Bloom, manager of the TotalCare program; Dr. Joseph Sicora, medical director; and Sarah Johnson, nurse practitioner. (Submitted photo) living a nd indep endent li ving a re visi ted every three to six months. Visits a re s cheduled in b etween if t he client is ill. “We have 500 patients in t he program, and it’s growing rapidly,” said Sarah Johnson, one of nine nurse practitioners in the program. J ohnson s aid t he p rogram includes three physicians. Dr. J oseph S icora is medical dir ector of North Memorial Home & C ommunity Services, which includes TotalCare for Seniors, as w ell as H ome Health, a nd Hospice and Palliative Care. He also is medical director a t S t. Therese in N ew H ope a nd
St. Therese Oxbow Lake in Brooklyn Park. “North Memorial always has taken care of patients in nursing homes,” Sicora said. “The last three years we have structured it better s o do ctors a nd n urse p ractitioners work as a team. A lot of facilities ask us to help take care of their residents. We have to f ocus o ur r esources o n t he p laces w e work c losely wi th t o co ntinue t o deli ver high-quality service.” TotalCare for S enior s erves p ost-acute people in r ehab, t hose w ho ha ve b een in the hosp ital a nd need sho rt-term r ehab before they’re ready to return home. They also serve as a p rimary care pro-
vider for those who are too frail or elderly t o co me t o t he c linic, o r w ho ha ve no transportation. “There are a lot of health care facilities trying t o figure o ut ho w t o t ake ca re o f these people,” Sicora said. North M emorial als o is o ne o f a f ew hospitals s tatewide t o offer a n in patient Collaborative A cute C are f or t he E lderly (CACE) uni t t o addr ess t he ac ute ca re needs of frail, aging adults. It a lso o ffers home health care, as wel l as hosp ice su pport t o pa tients a nd lo ved ones w ho a re facin g a t erminal illness, death and dying.
Our Life â€˘ Friday, October 21, 2016 Page 7
Medicare counseling available BY SUE WEBBER CONTRIBUTING WRITER Dawn L und calls her self â€œ a M edicare nerd.â€? â€œIâ€™ve al ways w orked in t he agin g field,â€? said Lund, who is director of Medicare programs a t S enior C ommunity S ervices in Minnetonka. Fall has b een a b usy time f or the agency for the last 20 y ears, when they began offering Medicare health insurance counseling. â€œOur ag ency a nd L inkage L ine a re t he only tw o in M innesota w ho o ffer unbiased counseling,â€? L und s aid. â€œ We assist p eople with non-biased guidance on Medicare options year-round.â€? In 2015, a n estima ted 1,717 c lients r eceived help through Medicare health insurance co unseling c lasses o ffered a t S enior Community S ervices. I t is j ust o ne o f t he programs offered at the agency, whose vision is to â€œmobilize the community to reimagine aging.â€? The agency offers educational workshops at several locations, plus confidential, individual assistance by appointment at nine locations for people who need more help. A t otal o f 45 ac tive v olunteers co nduct the classes, after receiving 20 hours of training. â€œThe caliber of people [volunteers] we get is kind of incredible,â€? Lund said. The o pen-enrollment p eriod f or in surance this year runs from Oct. 15 to Dec. 7. You ca n s elect co verage f or t he first time then, or make changes in y our current coverage. â€œEverybodyâ€™s si tuation is different, Lund said. â€œItâ€™s like a puzzle.â€? During t he enr ollment p eriod, y ou ca n make changes to various aspects of your coverage. â€˘ You can switch from Original Medicare to Medicare Advantage, or vice versa.
â€˘Â YouÂ can als oÂ switch f rom o neÂ Medicare AdvantageÂ plan to another, or from one Medicare Part D (prescription drug) plan to another. And if y ou didnâ€™t enroll in a M edicare Part D plan when you were first eligible, you can do s o during t he general open enrollment, although a late enrollment penalty may apply. Among t he most im portant decisio ns newly retired people must make is what to do about health care once they are no longer covered by their employerâ€™s plan. Even if theyâ€™ve been retired for some time and c hose a he alth p lan in t he past, e ach yearâ€™s o pen-enrollment p eriod gi ves r etired persons a chance to reconsider other, sometimes b etter, o ptions. I t is wis e, d uring t he open enrollment p eriod, to check a p lan to see if t here will b e changes; check prescription lists a nd co verage f or t hose p rescriptions; a nd t hen c heck o n ne w p lans a nd changes to other plans to be sure coverage is being provided at the most affordable cost. According t o L und, i t is im portant t o have a secondary plan in place to assist with the costs t hat Medicare does not cover. For example, when you go to a doctor, Medicare covers 80 p ercent of t hat cost. W ith no thing else in place, you are responsible for the remaining 20 percent. For p eople w ho ca nnot a fford another plan, Lund said, Senior Partners Care is â€œone of the best kept secrets in Minnesota.â€? â€œIt is no t in surance,â€? she s aid. â€œ It is a community-based p rogram t hat ena bles Minnesota Medicare recipients to access the medical care they need.â€? The program bridges the financial gap between an individualâ€™s medical bills and his or her Medicare coverage. SCS is lo cated at 10201 Wayzata Blvd., Suite 335, M innetonka. Pho ne: 952-5411019. Online: seniorcommunity.org
-AĂ?Â—Ă´AĂś Â¨Â¨ÂˇnĂ?AĂ?Â?Ăłn Â¨| ĂŚĂ?ÂŁĂ“ĂłÂ?Â˜Â˜n
/!/ < -/
$ÂŽ$- $ " ÂŻĂ˜Ă˜Â¤ <AÂŁÂ—nn Â¨Â¨eÂ˜n /Â¨Ae AÂƒAÂŁb !" ~~ÂŻĂ¤ÂŻ Ă˜~ÂŻÂ˝Â¤Â¤Â Â˝Ă˜Ă—Ă—s : $! 2$ $/ :$//< / 0"$/ 9"
" 4 "a Z 4ÂˇeAĂ?ne ÂŁĂ?nĂ?ÂŁnĂ?b -ÂŒÂ¨ÂŁnb 4Ă?Â?Â˜Â?Ă?Â?nĂ“ I 29 Z ÂŁÂŽÂŒÂ¨Âžn AĂŚÂŁeĂ?Ăś Z 0Ă?Â¨Ă?AÂƒn 4ÂŁÂ?Ă? Z 4ÂŁenĂ?ÂƒĂ?Â¨ĂŚÂŁe -AĂ?Â—Â?ÂŁÂƒ Z :n AĂ?n A 0ÂžÂ¨Â—n Ă?nn ĂŚÂ?Â˜eÂ?ÂŁÂƒ
Â </ :""/
AÂ˜Â˜ |Â¨Ă? A Ă?Â¨ĂŚĂ? Â¨| Â¨ĂŚĂ? Ă“ÂˇA[Â?Â¨ĂŚĂ“b QnAĂŚĂ?Â?|ĂŚÂ˜ ÂŒÂ¨ÂžnĂ“ |Â¨Ă? ~~Ă
$-"" /< "$9! /
Z Ă?nĂ“ÂŒ Ă“Ă„ĂŚnnĂşne $b Ă“Âˇn[Â?AÂ˜Â˜Ăś Ă?Â¨AĂ“Ă?ne [Â¨||nnb QAĂ?Ă?nĂ?Ă“ ÂžAen |Ă?Â¨Âž Ă“[Ă?AĂ?[ÂŒ eAÂ?Â˜ĂśÂ˝ Z ĂŚÂŁ[ÂŒ Ă“nĂ?Ăłne !Â¨ÂŁeAĂś ÂŽ Ă?Â?eAĂś ÂŻÂŻÂŽĂ&#x;Â˝ Z :n ÂŒAĂłn AÂŁ nĂľĂ?nÂŁĂ“Â?Ăłn ÂƒÂ˜ĂŚĂ?nÂŁÂŽ|Ă?nn ÂžnÂŁĂŚÂ˝ Z Â¨Âžn ĂłÂ?Ă“Â?Ă? Â¨ĂŚĂ? Â¨Ă?ÂŒnĂ? Â˜Â¨[AĂ?Â?Â¨ÂŁĂ“ Â?ÂŁ eÂ?ÂŁAb enÂŁ -Ă?AÂ?Ă?Â?nb AÂŁe /Â¨Ă“nĂłÂ?Â˜Â˜nz
||Â¨Ă?eAQÂ˜n !AÂ?ÂŁĂ?nÂŁAÂŁ[n Ă?nn Â?ĂłÂ?ÂŁÂƒ |Â¨Ă? [Ă?Â?Ăłn eĂŚÂ˜Ă?Ă“ ~~ AÂŁe $ĂłnĂ?
-AĂ?Â—Ă´AĂś ÂŒAĂ“ ÂžAÂŁĂś AÂžnÂŁÂ?Ă?Â?nĂ“ Â?ÂŁ[Â˜ĂŚeÂ?ÂŁÂƒa
ÂŻÂŻ~ ĂŚĂ?ÂŁĂ“ĂłÂ?Â˜Â˜n -AĂ?Â—Ă´AĂś Z ĂŚĂ?ÂŁĂ“ĂłÂ?Â˜Â˜nb !" ~~Ă&#x;Ă&#x;Ă— Ă´Ă´Ă´Â˝ÂˇAĂ?Â—Ă´AĂś[Â¨Â¨ÂˇQĂŚĂ?ÂŁĂ“ĂłÂ?Â˜Â˜nÂ˝[Â¨Âž
AĂ?Ă?Ăś Â¨ĂŚĂ? AĂłAÂ?Â˜AQÂ˜nÂ˝ /nĂ“nĂ?ĂłAĂ?Â?Â¨ÂŁĂ“ |Â¨Ă? Â˜AĂ?ÂƒnĂ? ÂˇAĂ?Ă?Â?nĂ“ !Â¨ÂŁeAĂś Ă?ÂŒĂ?Â¨ĂŚÂƒÂŒ Ă?Â?eAĂśÂ˝
$ÂˇnÂŁ Ă˜aĂ&#x;ĂźAÂž Ă?Â¨ Ă&#x;ÂˇÂž nĂłnĂ?ĂśeAĂśÂ˝
ĂŚĂ?ÂŒnÂŁĂ?Â?[ nÂŁĂŚÂ?ÂŁn Â¨Â¨eÂŁnĂ“Ă“ Z Ă“Ă?Â˝ ÂŻÂ¤~Ă&#x; ĆŽĆŽĹ–ČĄ
Z :Â¨Â¨e 0ÂŒÂ¨Âˇ Z Â˜Â¨Ă“n Ă?Â¨ 0ÂŒÂ¨ÂˇÂˇÂ?ÂŁÂƒb /nĂ“Ă?AĂŚĂ?AÂŁĂ?Ă“b Â˜Â?ÂŁÂ?[Ă“b AÂŁe Ă?ÂŒn nAĂ?Ă? Â¨| Ă?ÂŒn Â?Ă?Ăś
Z Â¨QQĂś Z Ă?nAĂ? /Â¨Â¨Âž Z Â?Ă?ÂŁnĂ“Ă“ nÂŁĂ?nĂ? Z Â?QĂ?AĂ?Ăś
Č´Č„ĆžČŒĘ Ć˜ĆŽĆŽĹ– Ĺ–ĆžČĄĹ–Č„
Ç‹ÇŽ vĹƒÇŽ ĹžČ°
ÂŻÂ Ă&#x;~ÂŻ "Â?[Â¨Â˜Â˜nĂ? Â¨ĂŚĂ?Ă? ĂŚĂ?ÂŁĂ“ĂłÂ?Â˜Â˜n ~~Ă&#x;ĂźĂ˜ Â¤~Ă¤ÂŽs~Ă˜ÂŽĂ¤Ă˜Â Ă˜ Ă´Ă´Ă´Â˝Â¨ÂˇÂŒÂžÂŁÂ˝[Â¨Âž
Â¨Ă´ÂŁÂ˜Â¨Ae Ă?ÂŒn "Â¨ :AÂ?Ă? AÂˇÂˇ AÂŁe ÂƒnĂ? Â?ÂŁ Â˜Â?ÂŁn |Ă?Â¨Âž ÂŒÂ¨Âžn
Page 8 Our Life â€¢ Friday, October 21, 2016
1 * 6 "#6 ##!*,( , 68 6)5 ," #4* 1 % ", 1# % % 61 #4* "" 1!,( 1, 8#4 ##, *#! % ", 11 #5* %*,*%1#" *4, 1*5 86* "1 1",, %*#*!, 5* "*,+ 1",, " !#*( * * #6 #* "# #%8, #* %*!*8 * 5,1, 61 !#,1 % ",( " 8#4) 1 1# 1 1# * %*,#" 3/- 6" 8#4 4,1#!* ,*5( 1), 4,1 61 8#4) 7%1 *#! 1 * 11 ,1*1, 61 8#4(
*" !#* #41 1 "1, #
" #4* 4 1# * 1 ( * &1# *' $--32$$ &' $99.32 (!( 1# %(!( 8(
,,!( !#1,( '(,',!( 1 ##1& ( !',! ( !, !#, ('#,! ! ,(& !,, , # !' !' !',!& ,( *!' !#1,( 1 ! .'1 " ! 1'& ' !' !'( ( # 0, ' !,',& '!, ' !' !'( #( ! !,', '0& -2" ' - /2 ""/) #, $2 -2-2"%