According to the National Council on Aging (NCOA), “feeling and expressing gratitude is beneficial for your physical health, mental health, and social well-being.” Feeling gratitude likely comes naturally when things are going well in life. When things are not going as well, though, finding something to be grateful for can feel like a real challenge. NCOA reminds us that even when we are facing adversity, we should try our best to feel grateful for something, as small acts of gratitude can make big impacts on our health. If you’re unsure where to start, try writing a thank you note to someone who has helped you recently or made a difference in your life.

Dear Marci,

I have Original Medicare but have been seeing a lot of ads for Medicare Advantage Plans that seem great. I don’t want to fall for just good marketing, though. Are Medicare Advantage Plans better than Original Medicare? How should I choose?

-Lauren (Chicago, IL)

Dear Lauren,

It’s great that you are taking the time to learn about your options before enrolling in a plan. There are many important choices to make about your health care coverage, and being informed can help you make the best decisions for your own needs.

People with Medicare can get their health coverage through either Original Medicare or a Medicare Advantage Plan (also known as a Medicare private health plan or Part C). While there are many differences between the two, remember that Medicare Advantage Plans must provide the same benefits offered by Original Medicare, but may apply different rules, costs, and restrictions.

Let’s review some of the main differences between these two ways to get your Medicare:

Costs

Original Medicare: You will be charged for standardized Part A and Part B costs, including a monthly Part B premium ($170.10 in 2022). You are responsible for paying a 20% coinsurance for Medicare-covered services if you see a participating provider and after meeting your deductible.
Medicare Advantage: Your cost-sharing varies depending on plan. You usually pay a copayment for in-network care. Plans may charge a monthly premium in addition to Part B premium.
Supplemental insurance
Original Medicare: Have the choice to pay an additional premium for a Medigap policy to cover Medicare cost-sharing.
Medicare Advantage: Cannot purchase a Medigap policy.
Provider access
Original Medicare: Can see any provider and use any facility that accepts Medicare (participating and non-participating).
Medicare Advantage: Typically can only see in-network providers.
Referrals
Original Medicare: Do not need referrals for specialists.
Medicare Advantage: Typically need referrals for specialists.
Drug coverage
Original Medicare: Must sign up for stand-alone prescription drug plan.
Medicare Advantage: In most cases, plan provides prescription drug coverage (you may be required to pay a higher premium).
Other benefits
Original Medicare: Does not cover vision, hearing, or dental services.
Medicare Advantage: May cover additional services, including vision, hearing, and/or dental (additional benefits may increase your premium and/or other out-of-pocket costs).
Out-of-pocket limit
Original Medicare: No out-of-pocket limit.
Medicare Advantage: Annual out-of-pocket limit. Plan pays the full cost of your care after you reach the limit.
Between the two options, one is not better than the other. Medicare Advantage and Original Medicare are just different, and you may prefer one over the other depending on your needs and priorities. To review the differences and receive counseling on your options, I recommend calling your local State Health Insurance Assistance Program (SHIP).

-Marci

Health Tip
While hydration is key in these summer months, it is crucial year-round. Water helps our bodies maintain a normal temperature, pump blood to our heart, lubricate and cushion joints, and protect our spinal cord and other sensitive tissues. As we get older and our body composition changes, it’s even more important to stay hydrated. A study from the University of California, Los Angeles School of Nursing found that up to 40% of older adults may be chronically underhydrated. The National Council on Aging provides some tips to increasing water intake:

Keep water with you always

Change it up by adding cucumber or lemon to your water or having sparkling water (but remember that tea and coffee can actually be dehydrating)

Avoid or reduce your alcohol intake

Build hydration into your routine

Choose foods with higher water content if drinking more water is a challenge

Dear Marci,

As my spouse and I grow older, it has been more difficult for me to help take care of him. It would be really helpful to have an aide come to our home and help with his personal care. Does Medicare cover long-term care?

-Remi (Point Marion, PA)

Dear Remi,
Unfortunately, Medicare usually does not cover long-term care (LTC) services.

LTC refers to a range of services and supports that help you perform everyday activities. LTC can be provided in your home, a nursing home, an assisted living facility, or other setting, and may include medical care, therapy, 24-hour care, personal care, and custodial care (homemaker services).

Just because something is not covered by Medicare, though, doesn’t mean it isn’t needed. There are other ways you can receive this help. Let’s discuss a few:

Medicaid is a state and federal program that provides health coverage if you have a limited income. Medicaid is the country’s largest payer of LTC services and will pay for nursing home care. Medicaid benefits also coordinate with Medicare. While Medicaid can vary from state to state, all states should have a Medicaid program that covers long-term care for those who need care at home and those who need long-term care in a nursing home. Call your local Medicaid office to learn if meet the eligibility criteria in your state.

An Area Agency on Aging (AAA) may be able to provide counseling and connect you with low-cost services in your area.

Local senior centers may have programs that can deliver meals, provide transportation and shopping assistance, and offer case management. To find senior centers in your area, call your local AAA or use the Eldercare Locator tool.

Faith-based organizations and charities may offer services, financial assistance, and/or referrals to other organizations in your area.

Geriatric care managers are health and human services professionals who work privately with you and your family to create a plan of care that meets your needs.

While Medicare does not cover long-term care, it does cover home health care. Under the home health benefit, Medicare pays in full for an aide if you require skilled care (skilled nursing or therapy services). A home health aide provides personal care services, including help with bathing, toileting, and dressing. However, Medicare will not pay for an aide if you only require personal care and do not need skilled care.

In other words, if your spouse needs skilled nursing care or therapy services in addition to personal care, Medicare may cover the cost of an aide. If you are unsure what kind of care your spouse needs, start by speaking with his health care provider.

I hope this helps with your and your spouse’s situation. You can also contact your State Health Insurance Assistance Program (SHIP) for more counseling.

-Marci

During the summer months, older adults are at a significantly increased risk for hyperthermia, the name for heat-related illnesses. Hyperthermia can include heat stroke, heat edema (swelling in your ankles and feet when you get hot), heat syncope (sudden dizziness after exercising in the heat), heat cramps, and heat exhaustion.

The National Institute on Aging makes these suggestions for avoiding hyperthermia:

Stay indoors on particularly hot or humid days.

Drink plenty of liquids and wear light-colored, loose-fitting clothes in natural fabrics.

If you do not have a fan or air conditioner, go somewhere else that is cool. A local senior center may provide a cooling center, or you can to a public air-conditioned place like a mall, movie theater, or library.

Look for symptoms of heat stroke, which include fainting, a change in behavior, dry, flushed skin with a strong and rapid pulse, lack of sweating. If you believe someone is suffering from heat stroke, call 911.