Life After 50 Expo

Health Tip

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A new study in the Journal of Physiology explored the connection between aging and physical activity, finding that older adults who exercised regularly experienced health and functioning similar to younger adults. The study examined the health of people who bicycle regularly, and compared the physical functioning of older cyclists to younger ones. The researchers found that the older cyclists had levels of physical functioning similar to the younger cyclists, and that they performed physical tests well. However, the older cyclists did experience less muscle mass and lower overall aerobic capabilities, which may be a result of the body aging. Overall, regular physical activity was found to help the bodily functioning of the older adults in the study.

To read more about the study from the New York Times,click here. To read the study in the Journal of Physiology,click here.
Need to Know
The Medicare Advantage Disenrollment Period occurs each year from January 1 to February 14. If you are enrolled in a Medicare Advantage plan for 2015 and are dissatisfied with the plan or its changes, you can use the Medicare Advantage Disenrollment Period to switch from your Medicare Advantage plan to Original Medicare, with a stand-alone Part D plan.

You can only switch from a Medicare Advantage plan to Original Medicare during the Medicare Advantage Disenrollment Period. To make this change, you can contact 800-Medicare.

Dear Marci,

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I have a Medicare Advantage plan, but I think I want to disenroll and switch to Original Medicare during the Medicare Advantage Disenrollment Period. I know I can also enroll in a stand-alone Part D plan if I switch to Original Medicare. Can I also purchase a Medigap policy during this time?

– Eric (Chicago, IL)

Dear Eric,

Disenrolling from a Medicare Advantage plan during theMedicare Advantage Disenrollment Period (MADP) does not necessarily give you a protected right to purchase a Medigap. Remember, a Medigap is a supplemental insurance policy that is sold by private insurance companies to help pay Medicare copays, coinsurances, and deductibles. For a full list of what Medigap plans typically cover, click here. This insurance policy is usually available in the form of twelve different plans labeled A through L and works only with Original Medicare.

Under national law, you only have the right to buy a Medigap policy if you are 65 years old and enrolled in Medicare, and if you buy your policy during a protected enrollment period. When you turn 65 and enroll in Medicare Part B, you have a six-month open enrollment period during which Medigap companies must sell you a policy at the best available rate, regardless of your health status and cannot deny you coverage.

If you are age 65 or over, national law also gives you a protected enrollment period to buy most Medigap policies within 63 days of when you lose or end certain kinds of health coverage. This includes:

  • If you lost group health insurance (through either current or previous employment) through no fault of your own;
  • If you joined a Medicare Advantage plan when you first became eligible for Medicare and disenrolled within 12 months; or
  • If your previous Medigap policy, Medicare Advantage plan, PACE program ends its coverage or commits fraud.

Finally, if you have a Medicare Advantage plan, Medicare SELECT policy or PACE program and you move out of the plan’s service area, you have the right to buy most Medigap policies. Note that national laws regulating Medigaps do not apply to people under the age of 65 who are eligible for Medicare due to disability or ESRD diagnosis.

If you do not meet the criteria listed above, you may encounter problems when trying to purchase a Medigap during the MADP. Companies can refuse to sell you a policy, or may only sell you one if you meet certain medical requirements. You also may need to pay ahigher premium and wait six months before the Medigap will cover pre-existing conditions.

Keep in mind, many states follow the national rules explained here for Medigap policies, but some allow people to more flexibility to enroll in Medigaps. Some states also apply Medigap protections to people under age 65 who qualify for Medicare based on a disability. Check out the rules in your state before purchasing a Medigap by, calling your State Health Insurance Assistance Program (SHIP). To find the contact information for you SHIP, visit www.shiptalk.org.

-Marci

Transitions from Expansion Medicaid into Medicare Examined !

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A new report from AARP Public Policy Institute (PPI) examines the challenges faced by low-income adults who enroll in expanded Medicaid coverage and later must transition into coverage under Medicare. Under the Affordable Care Act (ACA), states can expand Medicaid coverage to adults ages 19-64 earning up to 138% of the Federal Poverty Level (FPL). The Supreme Court ruled in 2012 that Medicaid expansion is a state option. To date, 28 states and the District of Columbia have chosen to expand the program to adults under age 65 who in most cases would not have qualified before the expansion.

Individuals enrolled in expansion Medicaid have little or no out-of-pocket costs when accessing covered health care, prescription medications, and other Medicaid-covered services, and these individuals rarely pay a premium. When a person turns 65 or becomes eligible for Medicare under the age of 65, however, that person generally can no longer qualify for expansion Medicaid and must instead be covered under Medicare.

The AARP PPI report highlights additional costs for low-income adults transitioning from expansion Medicaid into Medicare, and discusses restrictive income and asset limits associated with programs available to help low-income Medicare beneficiaries with their Medicare premiums and cost sharing. Specifically, the report highlights the Medicare Savings Programs (MSPs), all of which pay a Medicare beneficiary’s Part B premium, and automatically qualify that individual for assistance with Medicare prescription drug costs, through the Extra Help program. Eligibility for full Medicaid benefits and for MSPs for individuals age 65 or older (and those with Medicare who are under 65) are often stricter and can count a person’s assets, whereas assets are not counted to determine eligibility for expansion Medicaid.

The Seniors Explanation !

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Brains of older people are slow because they know so much. People do not decline mentally with age, it just takes them longer to recall facts because they have more information in their brains, scientists believe.  Much like a computer struggles as the hard drive gets full, so, too, do humans take longer to access information when their brains are full.

Researchers say this slowing down process is not the same as cognitive decline.   The human brain works slower in old age, said Dr. Michael Ramscar, but only because we have stored more information over time. The brains of older people do not get weak. On the contrary, they simply know more.

Also, older people often go to another room to get something and when they get there, they stand there wondering what they came for.  It is NOT a memory problem, it is nature’s way of making older people do more exercise.

SO THERE!!


I have more friends I should send this to, but right now I can’t remember their names.   So, please forward this to your friends; they may be my friends, too.
Happy 2015!
Thanks to a dear friend for sharing this.

AARP Public Policy Institute Highlights Medicare ACOs

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In December, the AARP Public Policy Institute published an article on Medicare Accountable Care Organizations (ACOs). Established by the Affordable Care Act, ACOs are networks of hospitals, doctors, and other health care providers. These networks share a primary goal— to coordinate and improve the quality of, expand access to, and reduce the cost of care for beneficiaries with Original Medicare.

Medicare ACOs are unlike Medicare Advantage (MA) plans in two important ways. First, MA plans have defined provider networks and may impose utilization controls, like prior authorization, on access to particular services or prescription medicines, but ACOs do not. Beneficiaries who receive care from an ACO are encouraged to see doctors within their ACO, but have the option to seek care from any doctor that is part of Original Medicare. Second, Medicare beneficiaries proactively enroll in an MA plan. Original Medicare beneficiaries who are “attributed” to an ACO, however, may not know they are part of the ACO.

Medicare beneficiaries’ quality of care measures appear to have improved for those beneficiaries receiving care from ACOs. Citing empirical research, AARP notes that quality of care improved on multiple measures, including timely access to care, coordination between specialty and primary care, and whether the patient was offered the doctor’s visit notes at the end of an appointment.