Navigating Medicare – Understanding Medical Supplies vs. Durable Medical Equipment A Guest Post by Rodger Sims

Medicare

Medicare is a health insurance program that covers people who are over 65 and can cover younger people with disabilities and people suffering from kidney failure, known as end-stage renal disease (ESRD). With over 71.3 million people enrolled, Medicare is one of the largest insurance providers for seniors in the United States. If your loved ones are enrolled in Medicare, it is important to know how to navigate your options.

There are four different parts to Medicare:

Medicare Part A

Part A covers your hospital insurance. This coverage includes inpatient hospital stays, care in a nursing facility, hospital care and even some home health care. If you’ve worked over ten years and have paid into social security taxes, this coverage is free to you. In 2015, Medicare Part A had served 7.7 million patients.

Medicare Part B

Part B covers medical insurance and includes certain doctor’s services, outpatient care, medical supplies and preventative services. In 2015, Medicare Part B had served over 33.8 million seniors.

Medicare Part C

Part C is a health care plan offered by a private company that can help you with both Part A and B benefits. Known as a Medicare Advantage (MA) Plan, services offered include health maintenance organizations (HMO), preferred provider organizations (PPO), private fee-for-service plans, special needs plans and Medicare Health Savings Account (HSA) plans. Most of the Medicare Advantage Plans offer coverage for prescription drugs.

Medicare Part D

Part D of Medicare adds prescription coverage to the original Medicare, as well as to some Medicare cost plans, Medicare HSA and some private fee-for-service plans. In 2015, 38.9 million Americans utilized Part D of Medicare. Original Medicare is the tradition fee-for-service Medicare. The government pays directly for the health care services the patient receives.

Durable Medical Equipment vs. Medical Supplies

With all that in mind, it is also important to know that there are two main types of products: medical supplies and durable medical equipment (DME). Both DME and medical supplies are used to make meeting the basic needs of the elderly, ill or disabled patients at home.

Durable Medical Equipment

As suggested by the name, durable medical equipment is meant for long-term use. Medicare defines DME by the following criteria: durability, ability to be used in the home, not usually useful to someone who isn’t sick and must have a life span of three years of use. Examples of DME include hospital beds, mobility aids, prostheses (artificial limbs), orthotics (therapeutic footwear) and other supplies. Medicare pays for DME partially under Part A if the patient qualifies for home health benefit.

To qualify for home health benefit, the patient must be unable to leave his/her home, require care from a skilled nurse and does not require custodial care, such as bathing and toilet-usage. If the patient is eligible for home health benefit, Medicare will cover 80% of the allowable amount for DME.

An example of the allowable amount is the following: a patient needs a walker that costs $200. The allowable amount for the walker in that state is $100. Since Medicare will cover 80% of the allowable amount, the patient will then have to pay $120 for the walker. Under Medicare’s Part B coverage, the co-pay is the same at 20% of the allowable amount and any other additional expense after that.

For Medicare Part B, the patient does not need to qualify for home health benefit to be eligible for coverage. If a doctor or medical professional considers the product medically necessary, Medicare will partially reimburse the patient for it. One benefit of this is the ability to rent the product being needed and still be eligible for reimbursement.

Some DME products that are not covered by Medicare include hearing aids and home adaptation items like bathroom safety and ramps. Additionally, to be reimbursed, your product supplier must be enrolled in Medicare and adhere to their guidelines. If they are not, Medicare can refuse their claims.

Make sure your providers are eligible before purchasing any products.

Medical Supplies

Medical supplies are made for short-term use. They are typically used once then thrown away. Examples of medical supplies include diabetic sugar testing strips, incontinence products (diapers, catheters, etc.) and items like bandages and protective gloves. Generally, medical supplies are not covered by Medicare, though there are a few exceptions for patients with diabetes, ostomy patients and those currently using feeding tubes. These items, however, are limited.

Ostomy products can be limited to a certain number a month. If necessary, a patient can appeal to increase the number of products received a month but must go through a process to do so. This process includes re-approval through Medicare and by a doctor.

Your Options

If you can provide insurance for your loved ones and cost isn’t a large factor, it is useful to know that Medicare can be paired up with other private insurance companies. Doing so can help get over some of the limitations that are imposed by Medicare and ensure your senior has an overall health coverage. If this is not an option, then medical supplemental health insurance, known as Medigap, can help provide funds for expenses Medicare doesn’t cover.

To qualify for the Medigap program, you must be enrolled in both Medicare Part A and Medicare Part B. Medigap can cover excess costs, like co-insurance costs such as stays in the hospital or nursing home, and deductibles in Part A and Part B plans. Costs will vary according to coverage.

Medigap is available through private insurances or organizations that cater to the elderly.

Final Thoughts

Medicare covers durable medical equipment primarily under Part B, but also for DME for people under Part A with the home health benefit plan. Most medical supplies are not commonly covered by Medicare, and those that are covered tend to have limitations. Other options to ensure your senior has all their needs covered including pairing Medicare with a private insurance company or enrolling them in medical supplemental health insurance to help cover excess costs.

With the introduction and popularity of the internet, finding the supplies you need at the right cost is easier than ever before. Different websites offer low-cost medical supplies to help ensure the basic needs of your seniors are met. It is also easier to find the right insurance company for them with all the information available online.

For more information about Medicare and what it covers, got the Medicare website at Medicare.gov.

Images

https://www.shutterstock.com/image-photo/medicare-enrollment-form-glasses-398418109?src=YZoPqz-O9WK3A8VVD8TyZg-1-2

https://www.shutterstock.com/image-photo/empty-bed-on-hospital-ward-247358674?src=Q9ck6CAXE6czGlRyWlBoZA-1-2

https://www.shutterstock.com/image-photo/diabetes-test-blood-medical-equipment-506370463?src=jqL9R3jY1Q44pQysfDM6NQ-1-4

Sources:

https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html

https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/cms-fast-facts/index.html 

 

Senior Tips – Best Financial Steps to Take When You Are Forced to Retire Early: A Guest Post by Alana Downer

Closeup of young woman with couple of elderly persons

Retirement confidence is at an all-time low with employees working later into their life in the hope that they don’t outlive their savings. A recent Australian report found that 51% of retirees expected to outlive their savings. Because of stats like these, people are aiming to work longer and harder to ensure a comfortable retirement, however this isn’t always the reality. A 2015 study from the Employee Benefit Research Institute found that in 2013, 47% of workers were forced to retire earlier than planned.

Forced early retirement can be more common than you might think. There are many factors which can contribute to an early retirement, among other reasons these include, job loss, loss of stamina or poor health. So, what should you do? Whether as an employee faced with early retirement, or a carer who knows someone forced into an earlier retirement? Here’s our best financial steps you should consider taking:

Assess your cash flow and income:

Your first step is to not panic! All too often people think cancelling their gym membership will help them. This small weekly or monthly fee won’t see the quality of your retirement improve drastically and going to the gym is great for your health.

Instead, what you should do is list your monthly income and expenses. Consider what benefits you can receive now that you are a retiree. Look at your health, car, life, and other insurance plans and see where you can make some savings. You may also qualify for involuntary unemployment cover. Track all your monthly expenses and know how much money you need exactly for one month. From there you can estimate how long the money you have saved will last.

Create a retirement plan:

A retirement plan is something you should be working on before you are retired, but if an early retirement has come suddenly and you find yourself without one, it’s not too late to set one in motion. You can base your plan around either retirement goals or create a cash-flow plan.

A cash-flow plan is based around investments, income and expenses, and making assumptions about inflation and how you will be able to spend throughout your retirement.

A goal based plan lets you plan major events, trips and really anything you want to achieve during your retirement. This is a good system as you can prioritise what you want to do, understand the associated costs and foresee what and how much you will be able to do.

Look for alternative ways to create income:

If you find yourself in need some extra income, or you just want to use your time to cover some expenses so you can take that retirement holiday a little sooner, there are several options you could consider.

A popular approach with some retirees is to begin trading. In recent years trading on the Forex market has become a largely successful approach to profitable trading. Of course, this takes some time to learn as there are certain strategies which must be used.

Other options include finding part time work. Maybe you love gardening, use the forced retirement as a time to pursue any careers you might be passionate about, even if they aren’t as serious as your previous full-time career.

Consult with a professional:

Retirement can be difficult to plan for, even at the best of times. Unexpected things can happen and you want to ensure you have enough money to live out your retirement comfortably and even enjoy it.

Meeting with a financial adviser can help you take specific steps towards a better retirement. They can help create budgets, suggest where to invest your money and build a financial plan that suits your specific situation.

Also think about your pension and how you want to receive it. The rate will change depending on your status, so it’s important to ensure you understand what you are eligible for.

The key to overcoming a forced early retirement and the associated financial challenges is planning. These steps are a great start to planning your retirement and can help you to achieve any retirement goals you have in mind.

 

Bio:

Alana Downer is a financial blogger and a part of the team behind Learn to Trade, a source of educational information for traders and investors. Having been always interested in achieving financial freedom, Alana might often be found sharing her strategies online with all those who wish to earn money on the side and become financially independent.

 

 

 

 

 

 

12 Dietary Choices That May Lead to Restless Sleep A Guest Post By Megan Crants

 

High Resonance Healing Words
Healer’s outstretched open hand surrounded by random wise healing words on a rustic stone effect background

Sleeping and eating are both critical elements of recovery, but not necessarily in quick succession. Many healthcare providers will encourage putting away all food at 8pm because eating causes the body to go into an arousal state and devote energy to digestion, when ideally it should be settling down for sleep. If you’re starving or hypoglycemic, a small snack is acceptable before bed to avoid mid-night awakenings, but otherwise it’s best to avoid food and drink right before lights-out. Try to plan out your eating patterns so that your last meal falls well before you fall asleep.

In fact, planning out the foods you eat throughout the entire day is not a bad idea either in terms of assuring a good night’s sleep. Certain dietary options have been linked to decreased sleep quality and can have effects on the body that last well into the night:

  1. High Fat/Fried Foods. Fatty foods stimulate digestive tract contractions, which can either cause your stomach to empty slowly, worsening constipation, or they can cause your stomach to empty rapidly, leading to diarrhea. As a result of this gastrointestinal distress, you are more likely to experience fragmented sleep.
  2. Caffeinated Beverages. Caffeine is a stimulant that causes temporary alertness by increasing adrenaline production and preventing certain sleep-inducing chemicals from taking effect. It’s best to avoid caffeine after 2pm, because it has a tendency to alter the body’s sleep/wake cycle for a long time after consumption. If you’re going to consume caffeine, we recommend drinking a shot of it before a 20-minute power nap. This strategy has been scientifically demonstrated to enhance the napping experience, since caffeine takes about 20 minutes to cause arousal.
  3. Cocoa beans naturally contain caffeine so any source of chocolate is going to harbor some form of the stimulant. Darker chocolate contains a higher percentage of cocoa beans, and therefore a higher percentage of caffeine. In addition, chocolate contains theobromine, a compound known to increase heart rate and cause arousal. To learn more, click here: http://www.nytimes.com/2009/01/13/health/13real.html
  4. Tyramine-Rich Foods. Foods such as aged cheeses, eggplant, soy sauce, and tomatoes contain an amino acid called tyramine. This compound causes the brain to release a stimulant called norepinephrine, which causes wakefulness.
  5. Fruits and Vegetables with a High Water Content. Celery, cucumbers, watermelons, etc. are chock-full of water and therefore natural diuretics. Waking up multiple times throughout the night with a full bladder is sure to disturb your sleep cycle, so try to avoid these foods close to bedtime.
  6. Sugary Foods. Candy, or other treats high in sugar, will likely cause spiking blood sugar levels and rapid release of insulin to control them. The spiking blood sugar levels may cause a “sugar crash” that may make it easy to fall asleep, but ultimately the fluctuations will make staying asleep a difficult task.
  7. Studies have shown that the scent of peppermint may increase alertness, decrease fatigue, and work as a central nervous system stimulant. To learn more, click here: http://www.wju.edu/about/adm_news_story.asp?iNewsID=1484&strBack=%2Fabout%2Fadm_news_archive%2Easp
  8. Sorbitol-Rich Foods. Sorbitol is an artificial sweetener that is not only added to gum and diet foods, but is also naturally found in prunes, apples, and peaches. Sorbitol commonly causes digestive problems such as gas, bloating, and diarrhea so try to avoid it when possible.
  9. Citric Fruits. Citric fruits, such as oranges, lemons, limes, and grapefruits, contain large amounts of citric acid, which can cause gastrointestinal distress and/or heartburn. In addition to the pain they cause, these ailments may also exacerbate asthma or previously existing sleep breathing disorders, such as sleep apnea.
  10. Spicy Foods. Spicy foods stimulate the digestive system, which can potentially cause gastric distress while you’re trying to sleep. Try to stick to bland foods as bedtime approaches.
  11. High Fiber Foods. Comfort is key for ideal sleeping conditions, so neans, broccoli, cauliflower, and other high fiber foods should be avoided. These dietary additions are likely to cause bloating, gas, and general discomfort which can prevent you from falling asleep or can cause you to wake up during the night.
  12. Many people believe that alcohol serves as an effective sleep aid, as it initially has a sedating effect, but it is ultimately a detriment to high quality rest. Alcohol disturbs rapid eye movement (REM) sleep, meaning that sleep quality is significantly lowered after drinking. This lack of REM sleep negatively affects daytime memory, concentration, and motor skills, not to mention mood. It can suppress breathing, triggering sleep apnea and other breathing difficulties that cause nighttime awakenings. Additionally, alcohol damages the lining of the stomach and changes liver metabolism, which can cause indigestion and other health problems that may keep you up at night.

For more information, check out our tips for high-quality sleep at https://twodreams.com/holistic-health/sleep-hygiene

Megan Crants is a staff writer at Two Dreams (www.twodreams.com) and can be reached via email at mcrants@twodreams.com.

 

Sources Cited:

http://www.health.com/health/gallery/0,,20628881,00.html

http://abcnews.go.com/Health/Wellness/16-best-worst-foods-sleep/story?id=19404975

 

 

 

 

 

 

 

 

Assisted Living Could Mean Better Quality of Life for Seniors: A Guest Post by Paul Birung

the best vision is insight phrase  on a vintage slate blackboard
the best vision is insight phrase on a vintage slate blackboard

When our parents retire, we are so busy with our jobs to care for them at home. It is tempting to put our folks in homes where they can receive round the clock care but mostly, they are against the idea. We may bend to their wishes and keep them at home but as time goes by, their needs increase and it can be quite daunting for the family.

Why Assisted Living over Home Care for Seniors?

Seniors can definitely enjoy security, contact, and support in a residential community. In such an area there is access to nutrition, wellness services, and personal care tailored to each one of them. All this is achievable without having to compromise their independence.

Assisted living is different from a nursing facility where seniors receive medical care 24/7. For example at assisted living in Hilton Head, the elderly can receive any help they need even if their family is far away. These are the reasons you should think about assisted living for the sake of your loved ones’ quality of life.

  1. Opportunities for Physical Fitness

As assisted living communities there are group exercises, top notch gym facilities and personal trainers who do more than a caregiver would at home.

  1. Chances of Social Contact

It can be quite lonesome for a senior lying alone at home where they cannot reach their friends. Assisted Living offers common areas, planned trips, and activities that make it inevitable for seniors to socialize with peers.

  1. Safety

You must senior-proof and make modifications at home to make sure that your loved ones are safe. Such changes are definitely expensive and needs keep adding up as physical health wanes. Assisted living centers are designed for the seniors with keen attention to mobility, avoiding accidents and accessibility.

  1. Monitored Nutrition

Family members may not be able to keep up the nutrition demands of seniors who may not be able to make their own meals. There are chances of better nutrition in an assisted living facility where meals are prepared according to each resident’s needs.

  1. Help with Daily Activities

Bathing, dressing or feeding a loved on may be stressful for family members. With assisted living, residents get help with these activities. This is one of the basic offerings for assisted living and it, therefore, saves families the cost of a homecare assistant. This way, older adults can keep their independence.

  1. Housekeeping

The task of caring for seniors at home leaves families with extra chores to do. It isn’t easy to keep the house clean, weed the garden or cook with a senior in need of care. When these adults reside in assisted living, this burden is relieved so family members have more time to focus on themselves.

  1. Transportation

The facility will be responsible for residents’ transportation needs to the hospital, social engagements, and other appointments. With this taken care of, family members can enjoy more free time on their daily activities.

Assisted living certainly offers more independence to the seniors and their families. By giving each individual a chance to live life to the fullest, assisted living ensure that families stay happy, and this is the hallmark of quality living.

Hospice: The Gentle Goodbye A Post by Phyllis

Angel Wings 2
Pair of angel wings on heavenly blue background

Just after dawn on December 11, 2007, my mother went to God. There was a beautiful peacefulness that fell over that bright, winter morning that seemed perfect. Mom had battled several chronic, debilitating diseases that slowly robbed her of her energy and physical function. Her mind was always clear and her determination to live to see her grandchildren grow and to be with her husband of 59 years was intact. Unfortunately, her body had betraying her. Mom and I were very different. Our life’s journey together could best be described as rocky but the journeys end was her last gift to me.

It began one Thursday evening when I went to visit my parents. Mom had just come home from yet another unavoidable hospitalization. She was out of immediate danger but the likelihood of a relapse and perhaps a challenging surgery was weighing heavy on her mind. She looked tired, frail and was having difficulty speaking. I could sense she was in pain although she characteristically denied it. As I sat down next to her, she looked me right in the eye and in a clear voice said, “I’m too weak to live and too strong to die. I want to go to God.” She went on to explain that she was done taking her medications, had seen her last doctor, and had been to the hospital for the last time. If those declarations weren’t enough she asked me, “What are you going to do?” I knew immediately what she meant. She wanted me to take control of this out-of-control situation. She was entrusting me to help her live her last days in comfort and dignity. She wanted me to ensure that her transition from this life would be as gentle on her husband, children, grandchildren, and family as possible. The best solution was to arrange for hospice services.

I was the nurse in the family and I tried my best to collaborate with mom’s private doctor. We spoke so often that we were on a first name basis for many years. Dr. Bob had grown very fond of my parents and their relation. Our common goal was to keep mom comfortable and out of the hospital. Once my mom’s wishes were clear, my role was then to ensure that those wishes were carried out. First, I helped my dad understand and accept her decision. Next, I call Dr. Bob and explained her request. He was very supportive. We both knew that the only treatment he could offer her was palliative. Clearly, in his medical opinion, mom had less than six months to live. He made all the arrangements from his office. Finally, it was now time to call my sister.  The inevitability of losing our mom to death was here. Thankfully, as in all things pertaining to our parents, we would do this together.

The next twelve days were exceptional. Mom was peaceful with her decision. She enjoyed her days with dad, her visits with her grandchildren, and her messages from family and friends. Although she refused to take any more medication, she did allow the hospice nurse to obtain an order for pain meds so she could be truly comfortable. The hospice team arranged for a priest to come to the house. She received the sacraments of Holy Communion and the Anointing of the Sick. Mom prayed her rosary daily and in a few days slipped into a coma.

For twelve days the angels from hospice supported my family through the process of letting go. They immediately responded to phone calls and answered endless questions. Nurses came daily with supplies, understanding, and support. Their presence and professionalism allowed me the opportunity to be a daughter and not a nurse. On the day that mom died, it was the hospice nurse that we called first. She came right away, pronounced her and walked us through the next step.

The Value of Choice

I have been a nurse for 30 years now. For the majority of my career I practiced in critical care and emergency trauma units. I fought death constantly with knowledge, skill, medications, and technology. I had limited success. During the last 10 years however, my focus has shifted from the length of one’s life to a profound appreciation for the quality of one’s life. High tech healthcare has its place when lives need to be saved. However, death does come to us all.

Hospice services allow for the care of loved ones to take place in safe, familiar surroundings with those they love close by. It empowers the patient through their last days, offers them the respect of honoring their choices and the dignity of privacy. Hospice care assists the family during horrific moments of anger, regret, and grief that under less supportive circumstances could seriously challenge the family’s unity.

It’s important to understand that hospice is a philosophy of care rather than a specific place. It is an option for people whose life expectancy is six months or less. Treatment outcomes are based on pain and symptom relief rather than pursuing curative measures. This approach enables the person to live his/her last days with dignity, grace and support. Hospice affirms life and does not hasten or postpone death. Hospice care focuses on all aspects of physical, social, emotional, and spiritual well-being. There is no age restriction. Anyone in the last stages of life is eligible.

Hospice Care Services

  1. The Interdisciplinary Team: Team members include doctors, nurses, social workers, counselors, home health aides, clergy, therapists, and trained volunteers who offer support based on their areas of specialty. The team provides a comprehensive palliative plan of care aimed at relieving symptoms and giving social, emotional, and spiritual support.
  2. Pain Management and Control of Symptoms: The goal of these services is to help the patient to achieve comfort while allowing them to remain alert enough to make important decisions and remain in control.
  3. Spiritual Care: Since people differ in their spiritual needs and religious beliefs, spiritual care is individualized and never forced.
  4. Home Care and In-patient Care: Hospice care is typically centered in the home. However, it may be necessary to admit the patient to a hospital, extended-care facility, or a hospice in-patient facility. The hospice team can then facilitate this transfer and stay involved in the patient’s treatment. The team can also facilitate resuming in-home care when appropriate.
  5. Family Conferences: These conferences are facilitated by the hospice nurse or social worker. They serve to help family members stay informed about the patient’s condition and what to expect. Family conferences also provide an opportunity and safe forum to share fears, feelings, talk about expectations, and learn about the process of dying.
  6. Bereavement Care: Bereavement is the time of mourning following a loss. The hospice team works with surviving family members to help them through the grieving process. The team can refer family members and friends to other professional services if necessary. Bereavement follow-up services are provided for at least a year after the loved one’s death.

Hospice Care Settings

Approximately 80 to 90 percent of hospice services are provided in the home. But, it is important to know that if the patient’s lives in a nursing home, hospice services can be offered there as well. Hospitals that treat seriously ill patients often have a hospice program too. Some hospitals have a dedicated hospice unit, while others have hospice teams who visit patients in any unit. Lastly, many communities have independently owned hospice centers that feature in-patient care as well as home care hospice services. Independent hospice center can benefit individuals who do not have family caregivers.

Who is eligible for Hospice Care?

  1. You are eligible for hospice care if your doctor has certified your prognosis as not longer than six months. This applies to anyone of any age. Should you be blessed with improved health and no longer need hospice care, you will remain eligible to reapply for hospice care if it is necessary in the future.
  2. While the majority of hospice referrals are cancer related, hospice is not exclusively for cancer patients. People with terminal neuromuscular diseases or any end stage disease can also benefit greatly from the services. It is not uncommon for people with Alzheimer’s to be referred to hospice when they are in the final stages of the illness.

Are Hospice Services Expensive?

Hospice care customarily costs less than conventional care in a hospital or nursing home. This is because with home hospice, you pay only for the specific care that you need. In addition, volunteers may often provide many services at little or no cost, such as telephone support, meal preparation and running errands. Most private insurance plans, Medicare and Medicaid cover the services.

While patients usually pay out-of-pocket for any services not covered by insurance, hospice services can be provided without charge if you have limited funds. If you are unable to pay, most hospices will try to provide care using funds raised from community donations and charitable foundations.

Closing Thoughts

Hospice care truly provides for the gentlest of goodbyes. It allowed me the space and time to be able to cherish my last moments with my mom. I look back on those days in peace not pain and I will always be grateful for the last gift my mom gave me, her trust.

References

National Hospice & Palliative Care Organization

http://www.nhpco.org/custom/directory/main.cfm

Center for Medicare & Medicaid Services

http://www.cms.hhs.gov/center/hospice.asp

National Association for Home Care & Hospice

http://www.nahc.org/

Health Care Bill Endangers Coverage: A Message From AARP

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Premiums would become unaffordable for many older Americans: Originally published |Comments: 14

 PLEASE CLICK ON LINK PLAY VIDEO MESSAGE:
New Numbers: Same Bad Bill
The Congressional Budget Office just released its report on the health care bill. What does it mean for you?

A new analysis of the American Health Care Act passed by the House of Representatives estimates that 23 million people would lose their health insurance if the bill were enacted into law. People age 50 to 64 would be hit particularly hard, especially those with lower incomes.

According to the nonpartisan Congressional Budget Office (CBO), premiums for a 64-year-old earning $26,500 a year would increase by a whopping $14,400 in 2026. In addition, people with preexisting conditions may not even be able to purchase health insurance because the prices would be prohibitively high.


Three weeks ago, the House voted 217 to 213 to repeal and replace the Affordable Care Act (ACA) without waiting for the CBO to analyze the effects of the legislation. Today the CBO and the staff of the Joint Committee on Taxation (JCT) provided their assessment, which is required before the bill can be sent to the Senate for consideration.

Among other things, the CBO estimated a reduction in the deficit of $119 billion under the bill over a 10-year period.  The bill would lower health-related spending by the federal government through steep reductions in Medicaid and the replacement of current subsidies with less-generous tax credits. At the same time, the bill would grant large tax cuts to drugmakers and insurance companies.

The congressional analysts warn that for a significant segment of the population, the individual insurance market “would start to become unstable in 2020” because of two provisions added to the House bill in the days before the May 4 vote. One would allow states to receive waivers allowing insurers to eliminate coverage for essential health benefits, such as emergency services, hospitalization and chronic disease management. The other is a waiver that would allow insurers, contrary to current law, to charge higher premiums to people with preexisting conditions such as cancer and diabetes.

According to the report, “less healthy people would face extremely high premiums” in states likely to receive these waivers. “People who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive nongroup health insurance at premiums comparable to those under current law, if they could purchase it at all.”

AARP reiterated its strong opposition to the bill and called on the Senate to shelve the House-passed legislation. AARP said the bill would impose an “age tax” on older Americans by allowing insurers to charge premiums five times what they charge others and cutting the current level of subsidies.

“The CBO analysis found that premiums would go up to unaffordable levels by inflicting an age tax and removing current protections for people with common conditions including diabetes and weight gain,” said Nancy LeaMond, AARP Executive Vice President. “Putting a greater financial burden on older Americans is not the way to solve the problems in our health care system.”

AARP said it rejected the bill because it worsens the financial outlook for Medicare by reducing Medicare’s revenue and slashes Medicaid spending by over $800 billion over 10 years.

 

Trump Calls for a Massive Cut in Medicaid

New budget proposal also would slash health research funding

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AARP Opposes Proposed Budget
It cut billions from programs older Americans depend on
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En español | The Trump administration today released a federal budget proposal that would cut more than a trillion dollars over 10 years from Medicaid, the nation’s largest source of health care coverage, which provides a lifeline for children and adults with disabilities and low-income seniors.  Under the president’s proposal, Medicaid would face a $600 billion decrease. That’s in addition to the more than $800 billion cut in the American Health Care Act (AHCA) passed this month by the House of Representatives.

The budget, released while President Trump was in the Middle East on his first foreign trip as president, also would shrink funding for the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Children’s Health Insurance Program (CHIP), Social Security disability, environmental protection, and housing and transportation assistance.

At the urging of the president’s daughter Ivanka Trump, the budget proposes spending $25 billion over the next 10 years on paid parental leave, a new initiative.

Members of both parties in the House and the Senate have strongly opposed trimming Medicaid in the past.

Many of the other cuts also face strong bipartisan opposition on Capitol Hill. For example, Rep. Tom Cole (R-Okla.), chairman of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies, has sharply criticized the cuts earmarked for the NIH and CDC.

White House Budget Director Mick Mulvaney reiterated the administration’s view that the AHCA does not go far enough on Medicaid. “We go another half a step further and ratchet down some of the growth rates that are assumed into AHCA,” he said in a call with reporters on Monday.

During today’s press briefing, Mulvaney said that “we’re no longer going to measure compassion by the number of programs or the number of people on those programs, but by the number of people we help get off of those programs.”

AARP staked out a strong position against the president’s budget.

AARP “opposes the budget proposed today because it explicitly harms the very people we are counting on the President to protect,” said AARP Executive Vice President Nancy LeaMond in a statement. “Today’s budget proposes to cut Social Security benefits, as well as funding for critical health, hunger, housing and transportation assistance to low and middle income seniors.  The budget sends a powerful message to older Americans and their families that their health and financial security is at risk.”

AARP sounded a positive note on the administration’s parental leave initiative. “We do want to acknowledge the Administration’s paid leave proposal,” LeaMond said.  “Although it must be improved so that it addresses the workplace needs of family caregivers, we hope that it leads to a national conversation about ways to support family caregivers in the workplace.”

The budget assumes economic growth reaching 3 percent a year by 2021, a figure widely seen as unrealistic.

The budget also includes a dramatic decrease in the Supplemental Nutrition Assistance Program (SNAP), also known as food stamps. “If you are on food stamps, we need you to go to work,” said Mulvaney. “If you are on disability and should not be, we need you to go back to work.”

The president’s budget is the first step in a lengthy process. Congress will set its own priorities as it develops its own budget resolution.


6 Easy Ways To Stay Organized and Productive as a Caregiver A Guest Post by Maggie Drag

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Being a caregiver is arguably one of the most noble professions out there – but it can also take a serious toll on your personal life. Here are 6 work-life balance tips to help you reduce stress, and ultimately make you the best caregiver for not only your clients, but for yourself, too!

1.) Plan Ahead

If you have multiple clients, or work as a live-in caregiver, keeping track of their favorite foods, interests, and medications may seem like a job in itself. Keeping a daily planner can help! If you’re constantly on your phone, try downloading an app like Fantastical, ReQall and Evernote. They are super easy to use and will allow you to set up alerts and various notifications in case you’d like to be reminded of their doctor appointments, and even your own appointments with your caregiving agency, for example. At the end of the day, keeping on top of your clients’ needs and preferences will save you a lot of stress and in the future.

2.) De-Clutter

From old receipts and grocery lists, you may have trouble remembering which documents belongs to who! Here are some easy ways to help both yourself and your client, and try doing it together and make it fun while you’re at it! First, organize your bills and clients’ bills in a binder for safe-keeping. Next, divide up your coupons into a handy coupon organizer for easy access. Finally, keep track of your own caregiving documents, from contracts, care plans and emergency contacts in a folder. Try organizing each folder by client if you have multiple, and keep a small notepad to jot down any other helpful information.

3.) Think Ahead

As a caregiver, you know that life as you know it may change in a second, whether it be your client’s health, a sudden re-assignment, and not to mention changes in your personal life. First, make sure you have a list of emergency contacts (including your agency) prepared in case you are unable to help your client or need to be relieved at any point. Next, be sure you have a plan set up for a medical emergency based on your client’s health history. Keeping track of their food allergies for one is a simple but critical step to preventing emergencies in the future.

4.) Reconnect with Loved Ones

If you’ve lost touch with a close friend, since you started another assignment, remember this: Caring about your job is one thing, but caring about your relationships is far more important in the long run. Call your distant relative via Facetime – you could even plan a day where you help your client Facetime their grandchildren after you connect with your own family!

You carry a great responsibility as a caregiver, and while your friends and family should understand that you are often very busy, don’t forget to show them some appreciation and keep in touch!

5.) “Me” Time

Being a caregiver takes a lot of work, but it is incredibly rewarding and allows you to build meaningful relationships and touch so many lives. However, as much as you may love your job, don’t forget to carve out some time for yourself each day– even if for only an hour, to do some gardening, watch some old movies, surf the internet, and even go out for a relaxing day at the spa. If you are a live-in caregiver, ask your client if they’d like to join in on the fun! This will help you stay productive and engaged in your assignment in a much more meaningful way.

6.) Take Care of Yourself

As much as you care about your job as a caregiver, don’t forget that the first step to being an amazing caregiver is taking good care of yourself. Keep up with exercise, eat a balanced diet but make sure you’re getting the necessary rest between assignments first and foremost- especially if you work overnight. Sleep allows your body and brain to replenish, not to mention stay alert on important assignments and throughout the day if your client needs extra supervision when taking medications, for example. Losing sleep can ultimately take a serious toll on your health in the long run, so don’t be afraid to ask your agency about rescheduling your assignments or for tips on how to manage your sleep schedule to help you be your best for your clients.

About the author:

Maggie Drag is the owner and founder of a homecare agency located in central Connecticut. With over 27 years of experience in the industry, Maggie shares her knowledge and tips about care at home.  Visit homecare4u.com  to learn more about Maggie Drag.

4 Top Strategies for Finding Your Dream Job by Phyllis

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Originally Publish Date: March 16, 2017 https://www.aorn.org/aorn-org/surgicalexpo/conference-blog/find-your-periop-dream-job

 

I want to share some career coaching guidance with you:

1. Build a Strong Resume that Reflects Your Worth

Ensure your full name with credentials appears at the top in the header along with your contact information. The correct formatting is, name (middle initial optional), highest academic credential, RN, certification. For example, Mary A. Smith, MSN, RN, CNOR. A summary or statement of intent is no longer advised.

Your first section should be Academic Education. Start with your highest degree. If you’re still in school, it’s acceptable to note the date you started and an anticipated date of graduation. Next list your Professional Experience, Certifications & Memberships and Continuing Education & Computer Skills. End with Honors/Awards & Achievements.

If you find a job posting on the AORN Career Center site or other site, read it carefully and make sure that important phrases contained in that job posting language are also contained somewhere in your resume. This will increase the likelihood that the computer will recognize the language and select your resume, over others, for the recruiter to read.

2. Develop an Elevator Pitch

Once your resume is pulled, it is likely that you’ll get a screening call from a recruiter. This could be a make or break conversation. A successful screening conversation is the gateway to an actual interview. When the recruiter asks, “why did you apply for this position?” or “tell me about yourself?” you must be ready to share a ninety-second clear, passionate, and compelling answer that communicates you’re a serious candidate.

Take your time to form the exact four to five sentences that make your point. It may take an hour’s worth of revisions to get this just right but the return on your investment could be huge. You want to sound prepared but not rehearsed in your delivery. You may use your elevator pitch more frequently than expected. It’s always professional and polished to have it ready when networking and speaking with colleagues or vendors.

3. Invest in Your Own Resilience

Nurses downplay the need to take care of themselves so they can take care of others. Caring comes so naturally that we often forget that we cannot render quality, safe care when we’re physically tired or energetically depleted. Ensuring that we take good care of ourselves is actually quite generous. Building resilience allows us to stay fresh and available so we can deliver a consistent caring product every day.

Here are two suggestions for keeping your resilience well full. Incorporate some silent, still time into your life. Nurses are professional doers and always on the go. That may mean you take a walk and just experience the outdoors. It could mean that you discover meditation or yoga. There’s peace in stillness and we can all use a break from the endless noise of our thoughts.

Allow yourself to be cared for by others. Nurses are always giving and the only way to balance that is to allow yourself to receive. Lose the need for control and perfection by finding a way to delegate more at work and at home. Resist the urge to host every holiday and enjoy being a guest. Both of these practices will be hard at first but stick with it and notice the change in your energy level and yourself.

It’s been my honor to be the career coach for AORN since 2012. Each year at the conference, I have the opportunity to meet some AORN members for the first time and reconnect with members from past events. The most common question I’ve been asked over the years is, “so what is coaching all about?” This brings me to my final piece of career advice – career and personal coaching.

4. Consider Career and Personal Coaching

Career coaching is a great way to get individualized guidance and assistance with establishing your professional goals, making career choices, creating an academic roadmap, polishing interview techniques, and becoming skilled in marketing yourself. It often involves reviewing and revising resumes and learning how to increase your chances of getting your resume into the right hands once it’s uploaded to an organization’s career page. Sharpening your social media skills on sites such as LinkedIn is often useful as well.

Personal coaching is the process of supporting personal growth in a nonjudgmental manner. It can be challenging to remain clear and authentic about your goals and yourself as you try to navigate your life. Responsibilities, set-backs, and the demands of an adult life can overshadow your understanding of the present and cloud your vision for the future. Our human nature creates blind spots to options and solutions. Coaching provides vital support as one explores behaviors and attitudes that can short-circuit success in life and career.