Medicare Nation

Hey Medicare Nation! It's October! Lots of changes going on in the Medicare landscape. Social Security recently announced the 2019 COLA, and for those of you on Social Security and Social Security Disability, you will be receiving a 2.8% raise in your monthly check. Social Security raise goes into effect January 1, 2019. Social Securtiy Disbility goies into effect December 31, 2018. Some more good news is.....the payroll taxes for Medicare & Social Security are staying the same in 2019. Yeah!! The combined tax rate for Social Security & Medicare will remain at 7.65% in 2019 for employees. The combined tax rate for Self Employed will also remain the same in 2019 at 15.30% When Social Security authorizes a COLA raise, that is the signal that Medicare Part B Premiums may also rise. For 2019, that's exactly what happened. Let's take a look at the 2019 Medicare Premiums & Deductibles. Medicare Part A In 2019, the Medicare Part A Deductible for being an inpatient in the hospital is going up to $1,364.00 in 2019. This means, you will have an out-of-pocket deductible when you are admitted to the hospital as an inpatient, whether you stay for one night or sixty consequative nights. You will have to pay the $1,364.00 each time you are admitted to the hospital, unless you are readmitted to the hospital less than 60 days after you are discharged from the hospital and you are admitted for the exact same reason.  SNF A Skilled Nursing Facility (SNF) has 24hr Medical care and specializes in rehabilliation. A person who had a stroke may be transferred to a SNF, to rehab the loss of sensation in a limb or to improve speech. A person who recently had hip replacement surgery may be transferred to a SNF to strengthen their leg(s) and learn to walk with a proper gait. Under Medicare, the first twenty days in a SNF is a benefit with no co-pay. If a person is required to stay day 21 and up to 100 consequative days, the co-pay will be $170.50 per day in 2019, under Medicare Part A. Medicare Part B Every person, who is a member of Medicare Part B has a monthly premium. For those with an income below the Federal threshold, the Medicare Part B Premium is paid by that individual's State Medicaid Program. For individuals on Medicare Part B, whose annual adjusted gross income is $85,000.00 or less, filing as a single taxpayer, the 2019 Medicare Part B monthly premium will be $135.50 Here is the chart for Medicare beneficiaries with a higher income, who will pay a higher Part B Premium Monthly.   Beneficiaries who file individual tax returns with income: who make Less than or equal to $85,000             $135.50 Married, filing joint returns & make less than or equal to $170,000                                                          $135.50 Beneficiaries who file individual tax returns with income: who make Greater than $85,000 and less than or equal to $107,000                                                          $189.60 Married, filing joint returns & make Greater than $170,000 and less than or equal to $214,000                     $189.60 Beneficiaries who file individual tax returns with income: who make Greater than $107,000 and less than or equal to $133,500                                                         $270.90 Married, filing joint returns & make Greater than $214,000 and less than or equal to $267,000                    $270.90 Beneficiaries who file individual tax returns with income: who make Greater than $133,500 and less than or equal to $160,000                                                         $352.20 Married, filing joint returns & make Greater than $267,000 and less than or equal to $320,000                    $352.20 Beneficiaries who file individual tax returns with income: who make Greater than $160,000 and less than or equal to $500,000                                                         $433.40 Married, filing joint returns & make Greater than $320,000 and less than or equal to $750,000                     $433.40 Beneficiaries who file individual tax returns with income: who make Greater than or equal to $500,000      $460.50 Married, filing joint returns & make Greater than $750,000                                                                        $460.50   Medicare Part B Deductible Medicare has an Annual Part B Deductible.  In 2019, the Part B deductible is going up to $185.00. After you pay your Part B deductible, you will then have to pay 20% of the Medicare Allowable for Part B services. If you are on a Medicare Advantage Plan, you probably didn't even know you had a Part B Deductible. The majority of Medicare Advantage plans absorb the Part B Deductible into their plan. The Majority of Medicare beneficiaries on a Medicare Advantage Plan do not have a Medical deducatible on their plan. I always say......"You Pay as you go." If you currently have a Medi-Gap Plan "F" or Plan "C", you also don't pay out of pocket for the Annual  Part B Deductible. Things will change in 2020, for now.....everyone is good to go.    The Medicare Annual Enrollment Period is here! If you have a question......Email it to me! If I can answer it in one paragraph....I will! If I have to do ANY kind of research, or my answer requires more than one paragraph....then you may need to hire me to consult with you. I presently charge $150.00 an hour for consulting on Medicare issues and comparisons. I can help you with just about anything to do with Medicare. I have vast knowledge in Medicare and I am very fair.  Need help with Medicare? I can help you. Send me an email to Support@TheMedicareNation.com   Things are getting busy with Medicare.  More updates will be coming soon! Until then.....I want each of you to have a Happy, peaceful and prosperous week! Diane Daniels

Hey Medicare Nation! I have a special show for you today. The FDA has issued a "Voluntary Recall" on Westminster Pharmaceuticals of all lots of their Levothyroxine and Liothyronine (Thyroid Tablets). Westminster Pharmaceuticals, LLC, which has its Corporate HQ in Tampa, Florida, is voluntarily recalling all lots, within the expiration date, of Levo-thyroxine and Lio-thyronine (Thyroid Tablets) dosages of 15 mg, 30 mg, 60 mg, 90 mg, & 120 mg up to the wholesale level. These products are being recalled by Westminster Pharmaceuticals as a precaution, because they were manufactured using active pharmaceutical ingredients that were sourced, prior to the FDA’s “Import Alert”  of Sichuan Friendly Pharmaceutical Co., Ltd., which is out of China.   The Recall comes as a result of a 2017 inspection where deficiencies were found with “Current Good Manufacturing Practices” (cGMP). Substandard cGMP practices…..could represent……the possibility of risk….. being introduced into the manufacturing process. To date, Westminster Pharmaceuticals has not received any reports of adverse events related to this product. Levothyroxine and Liothyronine (thyroid tablets, USP) for oral use is a natural preparation derived from porcine thyroid glands. Thyroid tablets contain both tetra-io-do-thyronine sodium (T4 levothyroxine) and lio-thy-ronine sodium (T3 liothyronine). Levothyroxine and Liothyronine tablets (thyroid tablets, USP) are indicated as replacement or  supplemental therapy in patients with hypothyroidism. Because these products may be used in the treatment of serious medical conditions, patients taking the recalled medicines should continue taking their medicine until they have a replacement product. According to the U.S. Food & Drug Administration Report..... [8/17/2018] FDA is alerting active pharmaceutical ingredient (API) repackagers and distributors, finished drug manufacturers, and compounders that Sichuan Friendly Pharmaceutical Co. Limited, China, is recalling certain lots of porcine thyroid API due to inconsistent quality of the API. FDA recommends that manufacturers and compounders not use Sichuan Friendly’s porcine thyroid API received since August 2015. This thyroid API comes from porcine (pig) thyroid glands and is used to make a non-FDA approved  drug product, composed of levothyroxine and liothyronine, to treat hypothyroidism (underactive thyroid). FDA laboratory testing confirmed the Sichuan Friendly API has inconsistent levels of the active ingredients – levothyroxine and liothyronine – and should not be used to manufacture or compound drugs for patient use. Risks associated with over or under treatment of hypothyroidism could result in permanent or life-threatening adverse health consequences. These lots were distributed nationwide in the USA to Westminster’s direct accounts. These lots were distributed nationwide in the USA  NDC Product Lot Expiration 69367-159-04 Levothyroxine and Liothyronine (Thyroid Tablets, USP) 15mg X 100ct 15918VP03 2/29/2020 15918VP02 2/29/2020 15918VP01 2/29/2020 15918007 3/31/2020 15918006 3/31/2020 15918005 2/29/2020 15918004 12/31/2019 15918003 12/31/2019 15918002 12/31/2019 15918001 12/31/2019 15917VP03 10/31/2019 15917VP02 10/31/2019 15917VP01 10/31/2019 69367-155-04 Levothyroxine and Liothyronine (Thyroid Tablets, USP) 30mg X 100ct 15517VP01 8/31/2019 15517VP02 8/31/2019 15517VP03 8/31/2019 15518001 12/31/2019 15518002 3/31/2020 69367-156-04 Levothyroxine and Liothyronine (Thyroid Tablets, USP) 60mg X 100ct 15618011 3/31/2020 15618009 2/29/2020 15618008 2/29/2020 15618004 12/31/2019 15618002 12/31/2019 15617VP06 11/30/2019 15617VP05 11/30/2019 15617VP04 12/31/2019 15617VP03 7/31/2019 15617VP01 7/31/2019 15617VP-02 7/31/2019 69367-157-04 Levothyroxine and Liothyronine (Thyroid Tablets, USP) 90mg X 100ct 15717VP-01 7/31/2019 15717VP-02 7/31/2019 15717VP-03 7/31/2019 15718004 3/31/2020 15717002 12/31/2019 69367-158-04 Levothyroxine and Liothyronine (Thyroid Tablets, USP) 120mg X 100ct 15817VP-01 9/30/2019 15817VP-02 9/30/2019 15817VP-03 9/30/2019 15818001 3/31/2020 Westminster is notifying its direct accounts by email and by phone to immediately discontinue distribution of the product being recalled. The FDA Advises Consumers who have the recalled products, should not discontinue use before contacting their physician for further guidance. There are several manufacturers who make “generic” Levothyroxine and Liothyronine (thyroid tablets) that your doctor can give you a new prescription for.  Call the Pharmacy where you receive your Levothyroxine or Liothyronine, and ask the pharmacist who the manufacturer of their supply is. They should be able to easily tell you that. Customers and patients with medical-related questions, information about an adverse event or other questions about the Westminster’s product’s being recalled……. should contact Westminster’s Regulatory Affairs department by phone at: 888-354-9939 ….. Live calls are received Monday-Friday, 9:00AM - 5:00PM EST with voicemail available 24 hours/day, 7 days/week or you can send an email to  recalls@wprx.com. Adverse reactions or quality problems experienced with the use of this product may be reported to the FDA's MedWatch Adverse Event Reporting program either online…..by regular mail……or by fax. To Complete and submit the report Online…....just “click” on the link & it will take you directly to the FDA MedWatch Page. FDA Med Watch Page   If you’d like to report Adverse Reactions or quality problems by Mail or Fax: Download form www.fda.gov/MedWatch/getforms.htm  Med Watch Reporting Form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form……or…….submit by Fax to 1-800-FDA- 0178   It’s almost the Annual Enrollment Period! Beginning Monday, October 15th through Friday, December 7th, many of you will be able to switch Medicare Advantage Plans, Switch Medicare Prescription Drug Plans or return to Original Medicare, with the majority of you having NEW effective dates of January 1, 2019. There are MANY Changes coming to Medicare for 2019, so I will be busy Posting Changes for you Starting the Week of October 1st. Medicare Nation, will be going back to a “weekly” episode during the Annual Enrollment Period, so that I can bring to you the most up-to-date information I can. Remember, I am here to answer ANY Medicare question you have, as long as I can answer your question in ONE paragraph. If I need to “research” anything or…..if it takes me more than one paragraph to answer your question, I will advise you that you can contact me to help you with your Medicare needs by hiring me to “consult” with you about your Medicare needs. Many of you contacted me last Medicare Annual Enrollment Period for consultations and I am here again to assist you or your parent’s Medicare Questions or concerns. Need help choosing a Medicare Advantage Plan or Prescription Drug Plan where you live? I can help you with that. Need help comparing your employer insurance plan benefits to a Medicare plan? I can help you with that too. Contact me by email at Support@TheMedicareNation.com or call the toll free number 855-855-7266 and tell me how I can help you with your Medicare Needs.   If you like Medicare Nation, I’d love for you to give Medicare Nation an honest Rating and Review on Apple Podcasts.   How to leave an iTunes rating or review for a podcast from your iPhone or iPad Launch Apple's Podcast Tap the Search Enter Medicare Nation in the search field. Tap the blue Searchkey at the bottom right. Tap the album art for Medicare Nation. Tap the Reviews Tap Write a Reviewat the bottom. Enter your iTunes passwordto login. Tap the Starsto leave a rating. Enter title text and content to leave a review. Tap Send.   If you have an ANDROID phone…..open up your “Stitcher” App or Download the Stitcher App from your Google Play App. OR……just go to ……. subscribe on Android.com When the page opens, just type in Medicare Nation into the field. Hit enter and voila! Click on the Medicare Nation Full LOGO and “click” Subscribe on Android. That’s it! Folks You now will receive my up to date Medicare Weekly episode to get you through the AEP   Thanks for listening to Medicare Nation! I appreciate it. Until next time….I want each of you to have a …..Happy, Healthy and Prosperous Week!      

Hey Medicare Nation! Medicare Nation The topic of Medical Marijuana is BOOMING! I had to bring back Dr. Rachna Patel to update us on what's going on in the Medical Marijuana Community. Currently, there are 9 States, plus the District of Columbia (DC), that have "Legalized" the "Recreational" use of Marijuana. The 9 States are: 1. Alaska 2. California 3. Colorado 4. D.C. 5. Massachusetts 6. Nevada 7. Oregon 8. Vermont 9. Washington Twenty-Nine (29) States, have Legalized Medical Marijuana usage. The 29 States are: 1. Alaska 2. Arizona 3. Arkansas 4. California 5. Colorado 6. Connecticut 7. Delaware 8. Florida 9. Hawaii 10. Illinois 11. Maine 12. Maryland 13. Massachusetts 14. Michigan 15. Minnesota 16. Montana 17. Nevada 18. New Hampshire 19. New Jersey 20. New Mexico 21. New York 22. North Dakota 23. Ohio 24. Oregon 25. Pennsylvania 26. Rhode Island 27. Vermont 28. Washington 29. Washington D.C. 30. West Virginia   Dr. Patel commonly treats patient with the following conditions for Medical Marijuana: 1.  Chronic Pain - especially patients with Fibromyalgia, Arthrittis, Back Pain, Migraines, Neuropothy 2. Anxiety 3. Insomnia Dr. Patel is consulting with patients across the U.S. to help guide patients step-by-step on the usage of Medical Marijuana. You can reach Dr. Patel by going to her website, www.drrachnapatel.com You can also go to her Facebook page, Facebook.com/DoctorRachnaPatel Here's her YouTube Channel with GREAT videos! The Medical Marijuana Expert - Dr. Rachna Patel Thanks for listening to Medicare Nation! If you find my content interesting, please give us a Review on Apple Podcasts!  

Hey Medicare Nation! www.TheMedicareNation.com Special Election Period Extended through March 31, 2018 for Medicare Beneficiaries Affected by California Wildfires. The Centers for Medicare & Medicaid Services (CMS) has extended the Special Election Period (SEP) for Medicare Beneficiaries affected by the California Wildfires to March 31, 2018. Any Medicaer Beneficiary who resides in, or resided in an area for which the Federal Emergency Management Agency (FEMA) declared a disaster area is eligible for the SEP......if......the beneficiary was unable to enroll in a Medicare Advantage Plan or stand-alone-prescription drug plan, during the annual enrollment period (AEP) or other qualifying election period. Also....if you don't live in the affected counties of California, but you receive assistance from someone living in one of the affected areas that was declared a disaster area, you are eligible for the SEP. You can call Medicare at 800-633-4227, or you can contact a Medicare Advisor or Medicare Consultant to assist you in finding a plan that will suit your unique needs. How do you find a Medicare Advisor or Medicare Consultant like me? Google it! Type in ......Medicare Consultant Los Angeles California....or Medicare Advisor San Francisco California. After you get beyond the "ADS" by all the paid advertisers.....you will start seeing results for what you asked for. So here are the COUNTIES  in California affected by the WildFires, which have a SEP: Butte Lake Los Angeles Mendocino Napa Nevada Orange Riverside San Diego Santa Barbara Solano Sonoma Ventura and Yuba. You can also go to the FEMA website and read more infomation at: www.fema.gov/disasters Any questions? Have a special guest you'd like to hear on Medicare Nation? Send Diane an email to -  Support@TheMedicareNation.com Need help with Medicare......Contact Diane and she will schedule a call with you to determine your needs. Send your request to Support@TheMedicareNation.com Have a Happy, Peaceful and Prosperous Week! www.TheMedicareNation.com  

Hey Medicare Nation! It's October, and that means it's Medicare season! If you need help navigating the 2018 Medicare Advantage Plans or Medicare Prescription Drug Plans, I'm available to help! Go to my website...... www.TheMedicareNation.com  and click on the "contact" button. Send me a short email of how I can assist you and I'll get back to you with details.   How many of you receive excess letters, brochures and booklets from Medicare insurance companies? I'm sure most of you do. How many of you, in the past, have received an "official looking" postcard or letter, that you believed came from Medicare or the Social Security Administration...... only to find out it's a "scam?"  Again.....I'm certain many of you did. Right now, many of you or your parents, have or will be receiving an actual letter from the social security administration, that is real! I'm serious.....it's not a scam! That's right...... in a joint venture to promote the Medicare Savings Program and the Extra Help Program, the federal government has been sending letters to Medicare beneficiaries, who may qualify for one or both programs. The letter details the criteria to qualify for the programs, as well as how to apply for each program. So..... what is the Medicare Savings Program? The Medicare Savings Program is run by your State's Medicaid Program. The program assists those who can't afford Medicare premiums or Medicare deductibles, co-insurance and/or co-payments. To qualify for a Medicare Savings Program, your "monthly" income and total "resources" (like money in the bank, stocks, annuities etc.) must be at or below the amounts the program has set as "The Threshold."  The house you live in, as well as one car you own, does not count towards the "resource" level. Let's take a look at those "thresholds" now. Medicare Savings Program 2017 Monthly Income Limit: Single Person $1,377.00  Married (living together) $1,847.00   2017 Total "Resource" Limit: Single Person $7,390 Married (living together) $11,090 To apply for the Medicare Savings Program, go to the official Medicare website www.Medicare.gov/contacts or.... call Medicare and ask them for your State's Medicaid office telephone number (800-633-4227). Now....let's take a look at the "Extra Help" program. The "Extra Help" program is run by the Social Security Administration.  Extra Help is a Medicare program that may help you or your parents pay Medicare prescription drug (Part D) deductibles, premiums, co-insurance and/or co-payments. You must be enrolled in Medicare Part D to be considered for the Extra Help program. You don't have to file two separate applications to apply for the Extra Help and the Medicare Savings Program. When you apply for the Extra Help program, Social Security will send your information to your State Medicaid office, to see if you also qualify for the Medicare Savings Program. If you don't want to apply for the Medicare Savings Program, you will need to indicate that on the application or advise the State Medicaid representative that you do not want to apply for the Medicare Savings Program. Let's take a look at the criteria for the Extra Help program. Extra Help Program 2017 Monthly Income Limit: Single Person $1,507.50  Married (living together) $2,030.00   2017 Total "Resource" Limit: Single Person $13,820.00 Married (living together) $27,600.00 To Apply for the Extra Help program, go to the official social security website - www.socialsecurityl.gov/extrahelp or call Medicaid......800-772-1212 to ask for an application. You can also go to your local Social Security office and wait in line if you'd like...... go here to find your local office - www.socialsecurity.gov/locator That's it for today Nation! I"ll see you next week with more Medicare information and resources! Diane

Hey Medicare Nation! www.TheMedicareNation.com Today, I'm finishing up my series on the Medicare Plan Sponsors that CMS has issued Sanctions and/or Civil Money Penalties for in 2020! THREE more plan sponsors to discuss! CMS sent notice to Ms. Aparna Abburi, President of Health Care Service Corporation (HCSC), on February 28, 2020, that CMS was imposing a Civil Money Penalty in the amount of $381,272.00! HUGE Penalty people! According to CMS Summary of Non-Compliance, HCSC disclosed to CMS that it "discovered" a backlog of unprocessed Part C (Medical) Appeals. The Majority of these appeals were from claims from providers (doctors and/or facilities) or ..... reimbursement requests from enrollees. HCSC has the right to Appeal CMS Decision.   NEXT Up..... is Triple-S Management Corporation! CMS sent a Notice to Ms. Madeline Hernandez-Urquiza, President of Triple-S Management Corporation, on February 28, 2020. CMS notified Triple-S that they had made a determination to impose a civil money penalty in the amount of $329,872.00! CMS reported that Triple-S failed to comply with Medicare requirements related to Part D Formulary and benefit administration. Triple-S has the right to Appeal CMS decision. Last up..... is Tufts Health Plan, Inc.  CMS sent notice to Mr. Thomas Crosswell, President and CEO of Tufts Health Plan, Inc., to advise them of CMS' determination to impose a Civil Money Penalty in the amount of $28,302.00. CMS Auditors reported that Tufts failed to comply with Medicare requirements related to Part D Formulary and benefit administration and coverage determinations, appeals, and grievances in violations of Medicare regulations. Tufts has the right to Appeal CMS' decision. If YOU are unhappy with any of the three Medicare Advantage Plan Sponsors, give Medicare a call. You can request a "Special Election Period," based on your experience with any of these companies. Call Medicare at  800 - 633 - 4227  24hrs a day, 7 days a week. www.TheMedicareNation.com   Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!  

Hey Medicare Nation! Medicare Nation CMS Imposes a Civil Money Penalty against HUMANA! CMS conducted an "Audit" of Humana's Medicare Operations from June 3, 2019 through June 21, 2019. Humana failed to comply with Medicare requirements related to Part D formulary and benefit administration and coverage derterminations, appeals, and grievances in violation of 42 C.F.R. Part 423, Subparts C and M. Humana's failures in these areas were systemic and adversely affected, or had the substantial likelihood of adversely affecting, enrollees. CMS provided notice to Humana's CEO, Mr. Bruce Broussard, on February 28, 2020, that CMS imposed a Civil Money Penalty in the amount of ........ $257, 262! Humana failed to properly administer the CMS "transition" policy. This means if you are enrolling in a new plan, and you take a prescription that is NOT on the new plan's formulary (drug list), the plan MUST allow you to "transition" by allowing you a 31 day supply of your prescription drug.  This allows you time to speak with your doctor to see if there is an alternative prescription drug on the new plan ...... or...... you can request a "Formulary Exception." This means your doctor is requiring you to take this medication, because it is the one that is stablizing or correcting your condition, and that you need to continue to take it. If the drug is NOT on the new plan's formulary and they Approve the formulary exception, you WILL be charged a higher amount for taking a drug that is not on their formulary. Humana has the right to appeal the decision by requesting a hearing. The notice is signed by John Scott, Acting Director of the Medicare Parts C and D Oversight and Enforcement Group. Medicare Nation NEXT CMS Penalty is given notice to......... SOLIS Health Plans out of Miami, Florida On December 4, 2019, CMS gave notice to Mr. Daniel Hernandez - CEO of Solis Health Plans. CMS imposed a CIVIL MONEY PENALTY of $41,552.00! CMS stated in their summary that Agents employed by SOLIS engaged in an aggressive marketing campaign that was conducted by a contractor provider clinic. Solis Agents conducted a marketing presentation in a secluded area and enroll patients upon conclusion of the presentation. CMS determined that Solis violated the communication and marketing requirements, which had the substantial likelihood of adversely affecting its enrollees. Solis Failed to oversee and manage the marketing process to ensure its agents and brokers did not engage in inappropriate marketing practices including "misleading" beneficiaries. Solis may request a hearing to appeal CMS's determination. Both notices are signed by John Scott, acting director of the Medicare parts C and D Oversight and Enforcement Group. Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels    

Hey Medicare Nation! Medicare Nation Today, I'm informing you about The Centers For Medicare & Medicaid Services Notice, given to Mr. Art Carlos, CEO of Delaware Life Insurance Company. In a notice dated January 31, 2020, CMS notified Mr. Carlos that they were immediately imposing Intermediate "Sanctions" against Delaware Life Insurance Company. CMS determined that Delaware Life Insurance Company is "in substantial violation of Medicare Advantage and Prescription Drug Plan requirements." SIX specific violations were listed in the notice to Carlos. LISTEN to the episode to learn about the violations and what you can do if YOU are a beneficiary under one of Delaware Life Insurance Company's Medicare Advantage Plan or Prescription Drug Plan. www.TheMedicareNation.com Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels Medicare Consultant

Hey Medicare Nation! www.TheMedicareNation.com Medicare has taken many steps to assist you during the COVID-19 crisis. Coronavirus tests Medicare Part B (Medical Insurance) covers a test to see if you have coronavirus (officially called COVID-19). This test is covered when your doctor or other health care provider orders the test. I spoke about testing for COVID-19 in the previous episode, dated April 1, 2020. Listen to episode 101 to learn more about COVID-19 Testing. Your costs in Original Medicare for COVID-19 Testing. You pay nothing for this test. NADA! This includes the newly available COVID-19 “Antibody” test, which determines if you have antibodies in your blood, that were created to recognize the COVID-19 Virus in your body. Hospitalization Medicare covers All medically necessary hospitalizations. This includes if you're diagnosed with COVID-19 and might have been discharged from the hospital after an inpatient stay, but……. instead you need to stay in the hospital under quarantine.   Your costs in Original Medicare ZERO!   3     VACCINE FOR COVID-19 At this time, there's no vaccine for COVID-19.  However, If and when one becomes available, it will be covered by all  MEDICARE Prescription Drug plans -  Which is Part D of Medicare.   TELEHEALTH  SERVICES During the National Emergency for COVID-19, you will be able to receive a specific set of services through telehealth These services include: Evaluation and management visits (common office visits), mental health counseling and preventive health screenings  without a copayment if you have Original Medicare.  Your costs in Original Medicare  $0  Co-Pay if you have Original Medicare. You can use your smart phone or computer to access Telehealth services. 5.    Virtual check-ins virtual check-ins (also called “brief communication technology-based services”) with your doctors and certain other practitioners. What is it ? Virtual check-ins allow you to talk to your doctor or certain other practitioners, like nurse practitioners or physician assistants, using a device like your phone, integrated audio/video system on your laptop or computer, or captured video image without going to the doctor’s office. Your doctor or other practitioner can respond to you using: Phone Audio/visit Secure text messages Email Use of a patient portal   Virtual Check-Ins can be used for treatment for the Coronavirus from ANYWHERE……including places of residences….HOMES. Nursing Homes, AND Assisted Living Facilities.       Things to know You must talk to your doctor or other practitioner to start these types of visits. The communication must not be related to a medical visit within the past 7 days and must not lead to the medical visit within the next 24 hours (or the soonest appointment available). You must verbally consent to the virtual check-in, and your consent must be documented in your medical record. Since January 1, 2020 your doctor may obtain a single consent for a year’s worth of these services.        Your costs in Original Medicare      Normally, you would pay for “Virtual Visits” under Part B of Medicare.      During the National Emergency, your co-insurance and deductible will be waived, and you will have “No Co-insurance, or deductible” for Virtual Visits for COVID-19 services.   Certain Skilled Nursing Facility Care requirements have been waived during the National Emergency for COVID-19. During the COVID-19 Pandemic, some people may be able to get renewed SNF coverage without first having to start a new benefit period.  Original Medicare covers up to “100 consecutive days” in a Skilled Nursing Facility.” For each benefit stay. During the National Emergency for COVID-19, your Doctor may request an extension of days for your benefit period.   If you’re not able to be in your home during the COVID-19 pandemic or are otherwise affected by the pandemic, you can get SNF care without a qualifying hospital stay.   if you have a Medicare Advantage Plan, you have access to these same benefits. Medicare allows these plans to waive cost-sharing for COVID-19 lab tests. Many plans offer additional telehealth benefits beyond the ones described above and many plans have waived Hospital co-pays during the pandemic. Check with your plan about your coverage and costs for ALL services covered for COVID-19. Review your Summary of Benefit Booklet for 2020 from your Medicare Advantage Plan Carrier. Don’t have one……… Go to the plan’s website to download a digital copy. OR…… Call the Customer Service number on the back of your Identification card and ask them to mail you a “Formulary” for your Specific plan.     Preparing for healthcare needs   Be sure you have over-the-counter medicines and medical supplies like tissues….cough drops…. Tylenol…etc.  to treat fever and other symptoms.   Most people will be able to recover from COVID-19 at home.   Have enough household items and groceries on hand…..Soup, Macaroni and Cheese, Bread for Toast…. Whatever it is you will eat & drink when you’re sick….so that you'll be prepared to stay at home for a period of time.   Check out the following websites for updates on COVID-19   Centers for Disease and Control - CDC.gov …..  has the latest public health and safety information from the CDC and for the medical and health provider community on COVID-19.   USA.gov -  has the latest information about what the U.S. Government is doing in response to COVID-19.   CoronaVirus.gov - is the source for the latest information about COVID-19 prevention, symptoms, and answers to frequent questions.   Visit your State Department of Health for local COVID-19 Information about YOUR State.   You can search on Google for your State’s Health Dept. by typing in ……… NY State Health Depart……… CA State Health Dept……..Florida State Health Depart……    Visit my website for a LIST of EVERY State Health Department’s Phone Number…… By going to www.TheMedicareNation.com/COVID19     Many of you are turning 65 and have no idea what to do to enroll in Medicare or what Plan to enroll in. I invite you to contact me….. so that I can assist you with all this. Send me your question to Support@TheMedicareNation.com   I answer ALL emails myself! No Assistants, NO Virtual Assistants….. I do! I will answer your question in one paragraph. If I cannot, I will let you know how to contact me if you wish to reach out to me for a consultation. Until next time……. Practice Social Distancing…..Do things to Make you Happy……. AND Stay Healthy!! Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!   The information on this podcast and/or website is not a substitute for examination, diagnosis, and medical care provided by a licensed and qualified health professional, which neither I nor anyone else associated with Medicare Nation LLC is not! Please consult with your physician before undertaking any form of medical treatment and/or adopting any exercise program or dietary guidelines. If you think you may have a medical emergency, call your physician and/or 911 immediately. Medicare Nation LLC reserves the right to add, remove or edit content on this page at its’ sole discretion.

Hey Medicare Nation! www.TheMedicareNation.com It’s April 1st and over One Million People have been diagnosed with the COVID-19 Virus Worldwide! On this week’s episode….. I provide a time-line of the events of the Pandemic as well as updates on COVID-19 testing and Important phone numbers should you have symptoms or questions about COVID-19. I also have a “list” of phone numbers, for EACH Health Department in All 50 States! You can email me at  Support@TheMedicareNation.com for the list or check the show notes for an attachment. Here is an important phone number for the CDC HOTLINE on COVID-19 800 -232- 4636 - CDC Hotline Advent Health 24hr Hotline -  877 – 847 – 8747 You can also download the Advent Health App on iTunes or Google Play in order to have a “Virtual” visit with an Advent Health Doctor.  Bay Care Virtual Doctor Hotline -  800 – 229 – 2273 You can also go to this website for a “virtual” visit with a Bay Care Doctor – www.BayCareAnywhere.org  The Florida Department of Health Hotline is  866 – 779 – 6121   State Health Department List of Phone Numbers   Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Contact Me! Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!

Hey Medicare Nation! We're smack in the middle of a Corona Virus Pandemic! The Medicare Nation I wanted to give you an episode that is full of USEFULL information. I know you've been hammered by the news, internet and newspapers about the Corona Virus. Let's start with a very important fact: Human coronaviruses were first identified in the mid-1960s. The 1960's people! the coronavirus gets its name from a distinctive corona or in a scientists world…a “Crown of Sugary Proteins,” that projects from the surface of the virus. There are four main types of Human Corona Viruses Alphacoronavirus,  Betacoronavirus,  Gammacoronavirus, and  Deltacoronavirus. The first two only infect mammals, including bats, pigs, cats, and humans.   Gammacoronavirus mostly infects birds such as poultry (chickens) and Deltacoronavirus can infect both birds and mammals. Do you recognize the Virus named SARS? Severe acute respiratory syndrome abbreviated as …. (SARS-CoV) SARS-CoV (the beta coronavirus.  Guess what it causes?  It causes severe… acute…..respiratory syndrome, SARS was first recognized as a distinct strain of coronavirus in 2002. The source of the virus has never been clear, though the first human infections can be traced back to the Chinese province of Guangdong in November of 2002. The virus then became a pandemic, causing more than 8,000 infections of an influenza-like disease in 26 countries with close to 800 deaths. In the United States, only eight persons were laboratory-confirmed as SARS cases. There were NO  SARS-related deaths in the United States. All of the eight persons with laboratory-confirmed SARS had traveled to areas where SARS-CoV transmission was occurring. By July of 2003….. the World Health Organization declared the outbreak over. On February 11, 2020 the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak, first identified in Wuhan China. The new name of this disease is….SARS-COV-2 aka coronavirus disease 2019, abbreviated as COVID-19.  ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease. The Medicare Nation COVID-19 is a new disease, caused by a novel (or new) “coronavirus” or strain of “Corona Virus” that has not previously been seen in humans. What are the Symptoms of COVID-19?  The CDC (Centers of Disease Control) have listed these as the most common symptoms of COVID-19: Fever Cough Shortness of breath Symptoms may appear 2-14 days after exposure. Reported illnesses have ranged from mild symptoms….like a dry cough…. to severe illness, with high fever and shortness of breath, requiring hospitalization and there have been deaths reported for confirmed coronavirus disease 2019 (COVID-19) cases.   Currently……according to the WHO… as of March 13th….there are over 132, 758 reported cases of    COVID-19 …. Worldwide. Of those cases….. there are 4,955 Deaths worldwide. Over 80% of the reported cases are recovering. In the U.S…… there are currently 1,629 reported cases…… in 47 of the 50 States. No reported cases yet….in Idaho, Alabama and West Virginia. There have been 41 Deaths reported in the U.S. ….. with 37 Deaths coming from the State of Washington. The deaths mainly being reported from a nursing facility, with those being elderly and having underlying medical conditions prior to contracting the CoronaVirus. What do we mean by Underlying medical conditions????  If you have a blood disorder.... like sickle cell disease... or ... you have chronic kidney disease.... you're currently receiving chemotherapy or radiation. You may have congestive heart failure or coronary artery disease. You may have chronic asthma or chronic obstructive pulmonary disease or you may need oxygen at home. All of these conditions..... as well as many more..... may raise your risk of contracting COVID-19. You may NOT contract the virus. Just be more cognizant of your surroundings and who you are in contact with. What do you do if you believe you have symptoms of the COVID-19? NUMBER 1…. Call your Primary Doctor. Speak with the Nurse or Physician’s Assistant. Tell them your symptoms and they will advise you of what to do.  IF You CANT get Through to your Doctor……. If you have a Medicare Advantage Plan…… the Plan most likely has a 24 hr. Nurse’s Line.  CALL THEM!!  Tell the nurse  your symptoms. They will advise you. Call your STATE Health Department for Advise. Each State has an information line dedicated to the COVID-19 Crisis and will be able to assist you with answering question. If you have any severe symptoms….. as in Difficulty Breathing, fluid in your lungs, High fever of over 104 degrees…. CALL 911!   If you do have symptoms, and your doctor wants you to have the test to confirm COVID-19…. Where do you go?? According to the FDA….. here is the current list of laboratories across the U.S. that will be offering testing for the COVID-19 very soon  Advent Health Laboratories  Lab Corp Quest Laboratories As well as many other public health, university and private labs will be available on the FDA list of laboratories to test for the COVID-19. Medicare IS Covering the Test for COVID-19 as a Preventative Diagnostic Test….and therefore ….. you will have NO COPAY when you take the test. There are currently  TWO Testing Codes for the COVID-19 Test Is for having the Test at a Public Health Lab ( your local community Health Department) which is U0001 The 2nd is for having the test at a commercial or private lab (like Lab Corp) which is U0002.   If you are diagnosed with COVID-19, self-quarantine yourself in your home, away from your family members and pets, until you have tested negative. We ALL need to SELF-Police ourselves and HELP STOP the Spread of COVID-19….. so we can curtail the spread and help stop the pandemic.  Remember to Drink lots of fluids….. eat plenty of chicken soup and crackers ….. and get lots of REST!! The Medicare Nation You can go to the Center for Disease Control website for daily updates on the Corona Virus 19 situation ….. go to….. www.CDC.gov   You can also go to the World Health Organization website…. Go to …. www.who.int   AND…. PLEASE go to your STATE”S Health Department website for local information by “Googling” your State.  That’s all for today Nation. Call your Parents….. Make sure they’re ok and help them subscribe to Medicare Nation…. So they can hear this episode as well as over 100 other episodes about Medicare and it’s Resources. Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!      

Hey Medicare Nation! www.TheMedicareNation.com It's still January...but February is right around the corner. Spring WILL come. I promise! Let me give you some good news! Medicare is now covering Acupuncture! As of January 21, 2020, The Center for Medicare & Medicaid Services (CMS), will cover acupuncture for "Chronic Low Back Pain." Let's look at the coverage in the Medicare National Coverage Determination Manual. Section 1862(a)(1)(A) of the Social Security Act  Up to "12" visits in 90 days are covered for Medicare Beneficiaries under the following circumstances: a. Chronic Low Back Pain which lasts "12 weeks or longer," b. the Chronic Low Back Pain is "non-specific," in that it has NO identifiable systemic cause (NOT associated with metastatic, inflammatory, infectious, disease). c. the Chronic Low Back Pain is NOT associated with surgery d. the Chronic Low Back Pain is NOT associated with pregnancy. An ADDITIONAL "Eight" (8) sessions WILL be covered for those patients demonstrating an improvement. No more than "20" acupuncture treatments may be administered annually. Treatment MUST be discontinued if the patient is NOT improving or is regressing. The Acupuncture must be Administered under the supervision of a doctor of medicine or osteopathy. Need more information?  Check out our website www.TheMedicareNation.com What plans cover Acupuncture? Acupuncture for Chronic Low Back Pain, will be covered under ORIGINAL Medicare.  If you present your Medicare ID Card to providers as your Health Insurance..... You may start utilizing this treatment now. If you present your Medicare ID Card, as well as a Medi-Gap (Medicare Supplement) Plan..... You may start utilizing this treatment now. If you have a Medicare Advantage Plan, you need to check your Summary of Benefits Book under your plan, to see if they cover Acupuncture. If you can't find it.... call the customer service number on the back of your ID Card and ask the representative. Acupuncture is NOT covered under Medicare Part D. Part D is ONLY for Prescription Drug Coverage. If you have any questions.... send them to Support@TheMedicareNation.com   Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels                                                                            Medicare Consultant Support@TheMedicareNation.com    

Hey Medicare Nation! www.TheMedicareNation.com It's 2020!  Love the sound of that! Right now...... the Medicare Advantage Open Enrollment Period is in full swing. If you are on a "Medicare Advantage Plan," you have the opportunity to make a ONE TIME change, between January 1st through March 31st. You can change from one Medicare Advantage Plan to another Medicare Advantage Plan. You can "disenroll" from the Medicare Advantage Plan you're on and go back onto "Original Medicare." With Original Medicare, you can add a stand-alone-prescription drug plan and ..... you can enroll into a Medicare Supplement Plan (aka Medi-gap) to help defray the costs of Original Medicare. Here are options you can do during the Medicare Advantage Open Enrollment Period:  Change from a Medicare Advantage Plan back to Original Medicare. Switch from one Medicare Advantage Plan to another Medicare Advantage Plan. Switch from a Medicare Advantage Plan that doesn't offer drug coverage to a Medicare Advantage Plan that offers drug coverage. Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn't offer drug coverage. Join a Medicare Prescription Drug Plan. Switch from one Medicare drug plan to another Medicare drug plan. Drop your Medicare prescription drug coverage completely   I'm adding the EXACT language from the Medicare Managed Manual, regarding the Medicare Advantage Open Enrollment Period. 30.5 – Medicare Advantage Open Enrollment Period (MA OEP) 42 CFR 422.62(a)(3) (Rev. 1, Issued: July 31, 2018; Effective/Implementation: 01-01-2019) During the MA OEP, MA plan enrollees may enroll in another MA plan or disenroll from their MA plan and return to Original Medicare. Individuals may make only one election during the MA OEP. This chart outlines who can use the MA OEP and when: Who can use the MA OEP: MA OEP occurs: Individuals enrolled in MA plans as of January 1 – March 31 New Medicare beneficiaries who are enrolled in an MA plan during their ICEP The month of entitlement to Part A and Part B – the last day of the 3rd month of entitlement Individuals may add or drop Part D coverage during the MA OEP. Individuals enrolled in either MAPD or MA-only plans can switch to: • MA-PD • MA-only • Original Medicare (with or without a stand-alone Part D plan) The effective date for an MA OEP election is the first of the month following receipt of the enrollment request. NOTE: The MA OEP does not provide an opportunity for an individual enrolled in Original Medicare to join a MA plan. It also does not allow for Part D changes for individuals enrolled in Original Medicare, including those enrolled in stand-alone Part D plans. The MA OEP is not available for those enrolled in Medicare Savings Accounts or other Medicare health plan types (such as cost plans or PACE). You may also go onto Medicare.gov to view information on the Medicare Advantage Open Enrollment Period. If you decide to make a change during the MA OEP, you will be "locked-in" to the new plan, until the next enrollment period.... which is....the Annual Enrollment Period, from October 15th through December 7th. You may also make a change to your plan if you have a "special circumstance." These are listed under the "Special Election Periods" for Medicare on Medicare.gov You can also LISTEN to my previous show on Special Election Periods..... Episode 051, which was published on July 29, 2016. The episode is titled..... "Special Election Period Q & A" I go into detail about the Special Elections available. www.TheMedicareNation.com Remember Medicare Nation listeners........ an "Insurance Agent," is NOT allowed to "solicit" you during the Medicare Advantage Open Enrollment Period.  There are strict Medicare regulations regarding this. YOU must make the first move in contacting or telling your "Agent" or Medicare Specialist, that you are unhappy with your current plan. No one should be calling you, texting you, emailing you ..... or worse...... knocking on your door, telling you about the Open Enrollment Period. If someone does...... tell them to "Take a Hike!" You don't need a dishonest person like that helping you with your Medicare needs! If you need help finding a new plan during the OEP, contact you're Medicare Advisor. If you are all set with your Medicare Advantage Plan for 2020, You don't need to do anything! Just enjoy your family, friends and activities!    Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Contact me on my website - www.TheMedicareNation.com Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels                                                                          Medicare Consultant                                                                  Medicare Nation LLC.

Hey Medicare Nation! CMS just announced the 2020 Medicare Part B Premium increase! CMS also announced 2020 Part A Deductible and co-pays, as well as the Part B annual deductible. Here's a look at what's changing in 2020: Medicare premiums, deductibles, and co-payment amounts are adjusted each year in accordance with the Soc Sec Act.      SOCIAL SECURITY   Increase:    1.6%  (Avg $24 more a month)   Average Monthly SS Check $1,503.00       2020 - PART A DEDUCTIBLE AND COINSURANCE   Inpatient Hospital Deductible:                       $1408.00 Daily Coinsurance Days 61-90:                    $  352.00 Daily Coinsurance-Lifetime Reserve:           $  704.00 Skilled Nursing Facility-Days 21-100:           $  176.00       2020 - PART B PREMIUM AND ANNUAL DEDUCTIBLE   Standard Monthly Premium:                 $ 144.60  ($9.00 More) Annual Deductible:                                $ 198.00   It's a great time to review your plan for 2020. Is it the right plan to fit your unique needs? If so........ keep it! If not....... change it! I am available to assist you with your Medicare Plan choices for 2020. If I can answer your email in one paragraph or less, I WILL answer your question for you! If the answer to your question requires any research or my response is longer than one paragraph..... I will let you know that you will need to hire me to answer that question. If you live outside of Florida, you can hire me as your consultant at a rate of $200.00 an hour ( The hourly rate is going up to $250.00 an hour, starting January 1 2020). If you are a Florida resident, I can assist you in enrolling into the plan that fit's your unique needs at no additional charge. I will receive a commission from the insurance carrier once you are enrolled. The commission is regulated by Medicare. The Annual Enrollment Period ends December 7th, so make sure you do your "due dilligence" and find the plan that works for you! Until next time..... Have a Happy, peaceful & prosperous week! Diane Daniels Medicare Consultant 855-855-7266

Hey Medicare Nation! www.TheMedicareNation.com It's October! That means it's Medicare Time! The Annual Enrollment Period is just around the corner. Did you receive your "Annual Notice of Changes (ANOC)" for your Medicare Advantage Plan or Prescription Drug Plan? If not....contact your plan and request the ANOC. Today......I want to talk with you about Part D Prescription Drug Coverage for 2020! Medicare has set the maximum Part D Deductible for 2020 at $435.00. Medicare Advantage Plans and Stand-Alone Prescription Drug Plans have the option to charge the maximum deductible amount of $435.00...... or....... They can eliminate the Deductible altogether.... or...... They can charge an amount in between. You MUST do your "Due Dilligence" in determining which Prescription Drug Plan will fit your unique needs for 2020. Contact your Medicare Specialist and request their assistance in finding a Prescription Drug Plan for 2020. If you have a question about Medicare or your Prescription Drug Plan.... You can send me an email to Support@TheMedicareNation.com If I can answer your question in ONE Paragraph, I will answer your question! If I cannot ...... I will request you hire me as your consultant. I currently charge $199.00 an hour for my consultation services.  I always do my best to answer your questions in ONE paragraph. The "initial coverage period (ICP)" for Part D, has a threshold of $4,020.00 When you hand in a prescription, the total amount of the prescription is applied towards the ICP. If you have a Deductible, that is applied towards the ICP too. When the total amount of your prescriptions reaches $4,020.00..... you will now enter a new phase called the "coverage gap." In this stage.... you will now pay 25% of generic drugs.... and you will pay 25% of brand name drugs. If you reach $5,018.75 you will enter the next stage, which is called.... The "Catastrophic Stage." In the Catastrophic Stage, you will now pay a 5% co-insurance or $3.60 for Generic Drugs..... or.... $8.95 for Brand or non-preferred Drugs.... which ever is a greater amount. You will remain in the Catastrophic Stage until your out-of-pocket spending reaches $6,350 or..... when the ball drops on New Year's Eve! I know prescription drugs can be very expensive! There are programs available for those of you with lower incomes. The program is called "Extra Help," or "Low Income Subsidy." To apply for Extra Help, go to the social security website - www.socialsecurity.gov/extrahelp If your individual income is less than $1,562 a month, you would qualify for the LIS program. If your income is more than $1,562 a month, but is less than $1,900 a month....APPLY! You have nothing to lose! All they can say is No! You can also appy for the "Medicare Savings Program" If you qualify, CMS will pay for your Medicare Part B Premium. Depending on your qualifications, CMS may pay your premium, deductible and co-insurance. Apply for the Medicare Savings Program here: https://www.medicare.gov/Contacts/#resources/msps Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels  

Hey Medicare Nation! www.TheMedicareNation.com How Do I get treatment & prescriptions during a weather emergency? Hurricane Dorian is moving up the East Coast of the U.S., and MILLIONS of people have evacuated the coastlines, to seek safety. What happens if you get sick or you need to fill prescriptions while you’re away from home during a weather emergency? Or…. What happens if you need to move into a Skilled Nursing Facility, but you haven’t fulfilled the “3 Day Prior Hospitalizaton” Rule….due to the weather emergency? Let’s take a look at these questions for you. After President Trump Declared Emergencies in Puerto Rico, Florida, Georgia & South Carolina….. Health & Human Services Secretary ….. Alex Azar….Declared Public Health Emergencies in those States.  Secretary Azar also declared a “Blanket Waiver” for Hurricane Dorian. What that means…… is some restrictions under Medicare are more “Flexible” during the Declaration. For example……. You evacuated your home in Savannah Georgia, to go stay with your relatives in Michigan. Prior to evacuating your home, you were receiving home health care for physical therapy…due to a sprained ankle. If you are on Original Medicare, you can contact “Any” home health agency that accepts Medicare to re-start your physical therapy at your relative’s home. They should be able to contact Medicare to get copies of the orders you had for the Physical Therapy. If you’re on a Medicare Advantage Plan, you will need to contact your Plan carrier…… advise them you evacuated from a Public Health Emergency area and that you need to “Resume” physical therapy at home ASAP. The plan should contact a home health care vendor in the area you’re temporarily staying in, to resume your physical therapy. If you have a Medicare Specialist, call them! You WILL need their help in expediting the process. Remember…… MILLIONS of people have evacuated coastal areas! Don’t Delay!!! If you need to use your Medicare benefits…. CALL as soon as possible. For Prescription Medications……let’s say in the stress of having to “evacuate,” you forgot all your prescriptions at home. under a Medicare Advantage Plan, call your carrier & tell them what happened. You should be able to get a “Refill” under the “Emergency Waiver,”  for most prescriptions. If you need an Extension for 60 – 90 days for your prescription, due to being out of the area, call your plan and ask them if they “offer” extended day prescriptions. If you’re on an “opioid” prescription……… call your plan & advise them of your situation. Hopefully, you can get a refill…. for at least a day…. or two…… under the waiver, until you can be seen by a doctor in the area you’re temporarily staying at. Your carrier will tell you which Pharmacy is “IN” network…. Where you’re staying.  If there is NO pharmacy “In” Network where you’re staying, ask the carrier if they will “reimburse” you for the cost of the prescriptions. You will need a receipt with the Pharmacy name,  prescription name, and the price you paid for the prescription on the receipt to submit to your Medicare Advantage Carrier for reimbursement. If you had Durable Medical Equipment …… Orthotics, Prosthetics,  or Oxygen Supplies for example….. that was lost, destroyed, “irreparably damaged” ….. or otherwise rendered unusable…… you should be able to replace it from a vendor in the area you’re staying….. with the “flexibility” to WAIVE the replacement requirements that are normally in place. If you are on a Medicare Advantage Plan, contact your carrier for assistance in getting a replacement…. And advise them the “Blanket Waiver” is in place. They will assist you in finding a local vendor to “Replace” your equipment.    For those of you needing to stay at a “Skilled Nursing Facility,”Under “Normal” Circumstances…… if you or a loved one needed to enter a “Skilled Nursing Facility,” you would be required to have a “ 3 Day Prior Hospitalization” … prior to entering the Skilled Nursing Facility. Under the “Blanket Waiver,” the 3 Day prior hospitalization is “waived,” so that you can enter the Skilled Nursing Facility without further delay. This rule would be in effect “temporarily,” for those who are …… “ evacuated, transferred, or otherwise…. “dislocated” as a result of the emergency. So….. if you “evacuated” your home in Puerto Rico, Florida, Georgia or South Carolina, due to Hurricane Dorian….. and let’s say you’re temporarily staying with relatives in Pennsylvania………and you need to enter a Skilled Nursing Facility……you would be able to enter the facility without the 3 day prior hospitalization. If you are on a Medicare Advantage Plan, you must contact your carrier to assist you in determining which “Skilled Nursing Facilities” has room for you to be admitted into.   These are examples of how Medicare “requirements” are more flexible during a Public Health Emergency WITH a “Blanket Waiver.”   How long does the Blanket Waiver Last? Until Secretary AZAR signs an order stating the Public Health Emergency is over. NOW….. let’s take a look at how FEMA affects enrollment into Medicare.   FEMA… which stands for the Federal Emergency Management Agency, also declared emergencies in Puerto Rico, Florida, Georgia, South Carolina AND the Virgin Islands (which are St. Croix, St. John, St. Thomas AND Water Island) ….., which creates a “Special Election Period” for Medicare Beneficiaries, who needed to enroll in a Medicare Plan during that time, but were unable to ….. due to the effects of Hurricane Dorian. This means if you needed to enroll in Medicare, or into a Medicare Advantage Plan for September 1st…….. you will be given a Special Election Period to do so…. Under the Emergency “Weather Event.” So….if you need to enroll into a Medicare Advantage Plan…..OR…. a Stand-Alone Prescription Drug Plan…. you can do so, most likely through the end of October…… or even November in South Carolina & Georgia, under the FEMA Emergency. You can call Medicare at  800 – 633 – 4227 or your Medicare Specialist for more information.   If you feel you are overly “stressed” with all the information on TV & social media, about Hurricane Dorian…… #1 ….. STOP watching the news continuously!  Listen to some music…. Read a book….. play a board game. Go out for a walk. Continuously Watching the news about the weather is the worst thing you could do! If you need to speak with someone, you can call the “Disaster Distress Helpline.” Call  800 – 985  - 5990 to connect with a trained counselor, who can assist you with your distress. You can even “TEXT” ….. TALKWITHUS   type the letters all together and send it to…. 66746. You can also go online to get more Public Health & Safety info by going to https://www.phe.gov/Dorian Finally….. if you would like to help those affected by Hurricane Dorian in the Bahamas….OR ….any of the other impacted States….. Call your local TV Station or go onto their websites to find information on how to volunteer or donate supplies. If you’d like to “donate” money to a cause….. For Animals. Go to the Humane Society of the United States website… HumaneSociety.org/Disaster-Relief The Humane Society is evacuating animals form Animal Shelters across Florida and the other States. They have already helped transport almost 100 animals here in Florida, that they will place in “safe shelters,” with the hope of being put up for adoption. If you’d like to contribute to a Humanitarian Charity….. or one that is specifically helping those in the Bahamas…… go to the Charity Navigator website & they have a list of highly ranked charities that are providing relief. Go to   http://charities.foundation/dorian To donate to one of these funds. That’s all for this special show and I wish everyone out there, in the path of Dorian…… that you & your loved ones are safe. Till next time.... Have a Safe & Peaceful week! Diane 

Hey Medicare Nation! www.TheMedicareNation.com If you are turning 65 or still working on  an employer group insurance plan, you may need assistance in finding the Medicare plan that fits YOUR unique needs. You may have a loved one in a nursing home or in an assisted living facility, who is not receiving proper care. Call me! You can hire me as a consultant to assist you with Medicare issues! Call 855-855-7266 or eMail me at Support@TheMedicareNation.com Tell me the situation and I'll personally get back to you! Today, I am speaking to you about Shingles Vaccines! There are two Shingles vaccines licensed in the United States available. The first one is the "Zoster Vaccine Live," also known as "Zostavax." Many of you probably have received this vaccine, which is a "Live" vaccine and the CDC reports it as being 51% effective against Shingles. The second vaccine is the "Recombinant Zoster Vaccine," also known as "Shingrix" has been used since October of 2017. The CDC reports the Shingrix vaccine is about 91% effective against Shingles. The cost of the Shingles vaccine is covered under Medicare "Part D." You can look up the Zostavax vaccine or Shingrix vaccine in your plan's formulary, or you can call the customer service number on the back of your identification card. Every plan can have a different cost for either vaccine, so it is important you check with your plan, prior to getting the vaccine. There are side effects that can be associated with either vaccine. Go to the CDC website to learn more about Shingles and the vaccines  www.cdc.gov/vaccinesafety Learn more about how Shingles is transmitted, the sign & symptons and treatment for Shingles here: www.cdc.gov/shingles I'm not a doctor! If you have any health related questions regarding shingles and/or vaccines, due your own due diligence or contact your health care provider for more information. Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!    

Hey Medicare Nation! www.TheMedicareNation.com Help your PARENTS, Spouses and Friends "SUBSCRIBE" to Medicare Nation! With almost 100 episodes on Medicare and Medicare Resources available, your loved-one will be able to find answers to their Medicare questions! Use the "Purple" colored icon on an Apple phone or .... download Stitcher, Himalaya or Player FM when using Android phones. Search for "Medicare" and "click" on the Medicare Nation logo. You'll see the "subscribe" button on the page. "Click" subscribe and they'll get the NEWEST Medicare Nation episodes delievered to their phone. TODAY.... I'm discussing NEW information released from CMS.   CMS Decision Summary Ambulatory Blood Pressure Monitoring  Devices July 2, 2019…..The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to cover Ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension in Medicare beneficiaries.  What is hypertension (high blood pressure)? The American Heart Association (AHA) defines blood pressure as…. a force that pushes blood through a network of arteries, veins and capillaries. The blood pressure reading is the result of two forces: the systolic pressure occurs as blood pumps out of the heart and into the arteries; diastolic pressure is created as the heart rests between heart beats (American Heart Association, 2018). Elevated blood pressure, or hypertension, leads to harm by causing tiny tears in the interior lining of the arteries and coronary vessels…..stimulating a local immune response in the endothelial cells within the atrial walls.  In these regions, the arterial intima retains apolipoprotein B, which attracts lipid-rich macrophages (foam cells).   These preatherotic lesions develop into atherosclerotic plaques which become increasingly fibrotic and can form fissures, hematomas, thrombi, and calcifications (Swirski and Nahrendorf, 2013). The end result is stiff, thickened arteries that narrow the flow of blood to organs and limbs….which both increases pressure on target organs and limits oxygenation of them. There is also the risk of atherosclerotic plaque rupture, resulting in distal vascular obstruction and ischemia and infarction of end organs, such as stroke in the brain (U.S. Department of Health & Human Services, 2018). CMS is lowering the blood pressure threshold for hypertension… from the current policy of 140/90 down to 130/80 to align with the latest society recommendations regarding the diagnostic criteria.  This will allow more patients to use ABPM and receive appropriate treatment if needed. General Ambulatory blood pressure monitoring (ABPM) is a diagnostic test… that allows for the identification of various types of high blood pressure. ABPM devises are small… portable machines that are connected to a blood pressure cuff worn by patients…. that record blood pressure at regular periods over 24 to 48 hours while the patient goes about their normal activities..including sleep. The recording is interpreted by a physician or non-physician practitioner….and appropriate action is taken based on the findings. Diagnosis and treatment of high blood pressure is important for the management of various conditions…. including cardiovascular disease and kidney disease.   Ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension in Medicare beneficiaries is covered under the following circumstances: For beneficiaries with suspected “white coat hypertension,” which is defined as an average office blood pressure of systolic blood pressure greater than 130 mm … but less than 160 mm … or diastolic blood pressure greater than 80… but less than 100… on two separate clinic/office visits …..with at least two separate measurements made at each visit and with at least two blood pressure measurements taken outside the office which are <130/80 mm Hg. For beneficiaries with suspected “masked hypertension,” which is defined as average office blood pressure between 120 and 129 for systolic blood pressure or between 75 and 79 for diastolic blood pressure on two separate clinic/office visits…. with at least two separate measurements made at each visit and with at least two blood pressure measurements taken outside the office which are ≥ 130/80 ABPM devices must be: capable of producing standardized plots of blood pressure measurements for 24 hours with daytime and night-time windows and normal blood pressure bands demarcated; provided to patients with oral and written instructions and a test run in the physician’s office must be performed; and interpreted by the treating physician or treating non-physician practitioner. For eligible patients, ABPM is covered once per year.   CMS has covered ABPM since 2001 only for those patients with documented suspected white coat hypertension. On January 16, 2003, a technical correction for this National Coverage Determination was issued…. to clarify that a physician is required to perform the interpretation of the data obtained through ABPM…. but that there are no requirements regarding the setting in which the interpretation is performed. CMS received a complete, formal request for a reconsideration of the national coverage determination from the American Heart Association and American Medical Association. You can view the formal request letter on the tracking sheet on the CMS website. Benefit Category Medicare is a defined benefit program. For an item or service to be covered by the Medicare program, it must fall within one of the statutorily defined benefit categories outlined in the Social Security Act. ABPM may be considered to be within the benefits described under sections: other diagnostic tests  (§1861(s)(3). Medicare regulations state in part, that "…diagnostic tests must be ordered by the physician who is treating the beneficiary, that is, the physician who furnishes a consultation or treats a beneficiary for a specific medical problem and who uses the results in the management of the beneficiary’s specific medical problem." (42 CFR 410.32(a))    UNDER APPENDIX C (Current Section 20.19 of the National Coverage Determination Manual) Item/Service Description Ambulatory blood pressure monitoring (ABPM) involves the use of a non-invasive device which is used to measure blood pressure in 24-hour cycles. These 24-hour measurements are stored in the device and are later interpreted by the physician. Indications and Limitations of Coverage ABPM must be performed for at least 24 hours to meet coverage criteria. ABPM is only covered for those patients with suspected white coat hypertension. Suspected white coat hypertension is defined as: Office blood pressure >140/90 on at least three separate clinic/office visits with two separate measurements made at each visit; At least two documented blood pressure measurements taken outside the office which are <140/90 and No evidence of end-organ damage. The information obtained by ABPM is necessary in order to determine the appropriate management of the patient. ABPM is not covered for any other uses.   In the rare circumstance that ABPM needs to be performed more than once in a patient, the qualifying criteria described above must be met for each subsequent ABPM test. For those patients that undergo ABPM and have an ambulatory blood pressure of <135/85 with no evidence of end-organ damage, it is likely that their cardiovascular risk is similar to that of normotensives. Patients should be followed over time. Patients for which ABPM demonstrates a blood pressure of >135/85 may be at increased cardiovascular risk, and a physician may wish to consider antihypertensive therapy Resources:    Medicare.gov Website     Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels

Hey Medicare Nation! www.TheMedicareNation.com Today, I'm discussing how the Centers for Medicare & Medicaid Services (CMS) SLAPPED Agewell New York LLC with a Civil Money Penalty of $39,200! CMS conducts audits to ensure Medicare Advantage Prescription Drug Plans are following conditions of the current contract as well as Medicare rules & regulations.  From March 9, 2018 through May 15, 2018, CMS Conducted an audit of Agewell's 2016 Medicare financial information. In a financial audit report issued on September 20, 2018, CMS auditors reported that Agewell failed to comply with Medicare requirements related to Part C (Medicare Advantage) cost sharing. Specifically, auditors found that in 2016 Agewell failed to comply with cost-sharing requirements by charging "incorrect" co-payments to enrollees for medical services. Enrollees were affected in the following area: Bronx, NY; Kings County Brooklyn, NY; Nassua County, NY, Manhattan, Queens and Westchester County, NY. Agewell's failure was "systemic," and "adversely affected" enrollees or the substantial likelihood of adversely affecting enrollees because they experienced out-of-pocket costs. CMS determined that Agewell was charging a $30 "specialist" co-pay was applied to "primary care physician" claims instead of a $0 co-pay as stated in the plan's Explanation of Coverage. Enrollees were NOT Refunded the overcharged amounts until AFTER the financial audit concluded, which was 2 years after the incurred cost. In 2016, If you paid a $30 co-pay to see YOUR Primary Physician, when you were only obligated to pay $0,  you should contact Agewell at 888-586-8044 and ask to speak to a supervisor, regarding the CMS penalty. Advise the supervisor of the date & time of your appointment with your Primary Doctor and that you have proof of a payment that you made of $30 for your visit. Advise the supervisor that you would like to be refunded the $30 immediately.  Write down the name of the supervisor, the date & time you called Agewell and what the supervisor stated Agewell would do for you. If you donot receive your refund within 14 business days, call Medicare directly at 800-633-4227 and advise Medicare of the situation. If you have any "complaints" regarding the way you were treated by any representative at Agewell, you can make an annonymous complaint to Agewell's confidential hotline - 888-336-7240. You can also make a complaint to Medicare directly by calling 800-633-4227. If you have a complaint, regarding any physician or facility in the Agewell network, you can call the Agewell confidential hotline to make your complaint - 888-336-7240. If you are uncomfortable making a formal complaint and you would like assistance with your complaint you can : 1. contact the Insurance Agent or Medicare Specialist who enrolled you into the Agewell plan  or 2. contact your local "SHIP" (State Health Insurance & Assistance Program) representative by "clicking" on your State here - https://www.shiptacenter.org/ when the page opens, go all the way to the bottom of the page and you'll see an "orange" button that reads - Find Your Local SHIP "Click" on that ORANGE buton and a list will come up of all 50 States. "Click" on the State where you reside, to contact your local SHIP center. If YOU need help with finding the Medicare Advantage Plan that is right for your UNIQUE needs, contact me at either: Support@TheMedicareNation.com or  call me at 855-855-7266 If I can answer your question in ONE paragraph in an email, I will directly answer your question! If it takes more than one paragraph to answer your question or I need to do research to answer your question....then....I will respond by advising you that you will need to contact me and request my consultative services.  I currently charge $199.00 an hour, and I consult with Medicare beneficiaries and the Adult Children of beneficiaries ALL over the country! Please SUBSCRIBE to Medicare Nation so that you will receive EVERY NEW episode that is published! Give Medicare Nation a ***** 5-Star Review on iTunes! The more reviews we get, the more people can find the show! Go to www.itunes.com and type MEDICARE NATION in the search bar. When the page opens, "Click" on the Review tab and leave your review! Thanks so much for listening! If you'd like to hear about a specific topic on the show or you'd like a specific guest on the show...... send me an email to Support@TheMedicareNation.com I appreciate your Support! Diane Daniels  

Multi Target Stool DNA Test  vs. Fecal Occult Blood Test  Hey Medicare Nation! www.TheMedicareNation.com Have you subscribed to Medicare Nation? Don’t know how? If you have an Apple iPhone……. Click on the “Purple” icon…. With the white microphone. When the page opens….Click on SEARCH. Type in Medicare. Medicare Nation comes right up… WHY……BECAUSE….. it’s a TOP 100 APPLE PODCAST Nation! Click on that Beautiful Flag “Medicare Nation” Logo. When the page opens….Click on the SUBSCRIBE button! That’s it. You’ll get the latest information on Medicare and you can search through the almost 100 episodes on Medicare Information! Are Your Parents subscribed to Medicare Nation? Come On “Sandwich Generation” Show your parents HOW to Subscribe to Medicare Nation! Once they subscribe…. They will STOP asking you questions about Medicare, because they WILL Find the answer by listening to Medicare Nation episodes! Let’s give YOU back some time…. So that YOU can have more time for yourself   Today…..I’m going to be talking to you about the Differences Between Multi Target Stool DNA Test  vs. Fecal Occult Blood Test Medicare offers these Preventative Tests to determine if you have blood in your stool and/or suspected cancerous characteristics. ColoRectal  cancer (CRC) is the second most frequent cause of cancer DEATH in the United States.  The Most Frequent Cause of Cancer Death is…… Lung Cancer. This year, an estimated 145,600 adults in the United States will be diagnosed with colorectal cancer. According to Cancer.net…… an estimated 51,020 of the 145,600 adults will die this year…..due to ColoRectal Cancer. When colorectal cancer is found early, it can often be cured. CURED Nation! This is due to improvements in treatment and increased screening….. which finds colorectal changes before they turn cancerous and cancer at earlier stages. Medicare Part B offers TWO Preventative Screening Tests The First…. Is a Fecal Occult Blood Test “Fecal Occult” Blood Test is just a scary way of saying….. “ Looking for Blood in your Poop.”  The test ONLY detects the “presence” or “absence” of blood in your stool. The test does not indicate potential sources of bleeding and it does not “Diagnos” disease. “Fecal” means……“Stool” or “Poop”….and…. “Occult Blood” means you can’t see the blood in your stool with the “naked eye,” so….. the specimen is sent to the lab for a closer look. Blood in the stool may indicate polyps…. or it may indicate cancer in the intestine or rectum….though not all cancers or polyps bleed. If blood is detected through the “Fecal Occult Blood Test,” additional tests may be needed to determine the source of bleeding as well as “diagnosing” an ailment or disease. Blood in the stool could also mean Hemorrhoids….which are swollen veins in the lowest part of your rectum and anus. Sometimes the walls of these blood vessels stretch so thin….. that the veins bulge and get irritated, especially when you poop! Straining while pooping is a major factor in Hemorrhoids.  EAT more Fiber Nation! Eat More Vegetables….try Metamucil or Miralax. Straining to poop is not good. Drink more water! You should try to drink at least 96 oz. a day. I use a 24oz bottle I fill 4 x a day….. to get my 96 oz of water. You can do it. It’s important. Hemorrhoids can cause itching & pain.  Hemorrhoids can also bleed. There are several types of Fecal Occult Blood Tests, I’m going to discuss the “newer version,” which is called a “ Immunochemical Fecal Occult Blood Test,” (aka iFOBT or FIT) The IFOBT or FIT test is less of a mess and easy to administer. Typically, you have a “spoon-like” device to collect the sample of stool and you place the device into a collection container then seal it. You either return the collection container to your doctor’s office, or you mail it. There are no dietary restriction with the iFOB-IT and the test can be performed on any random sample of your stool. Your Doctor will review the results and there are just two options: Negative Result, which means no blood was detected in the stool sample you provided. OR…….. Positive Result, which means blood WAS detected in the stool sample you provided.   This type of test ISN’T ALWAYS accurate. Your fecal occult blood test could show a negative test result when cancer is present (false-negative result) if your cancer or polyps don't bleed. If you had the test to screen for colon cancer and you're at average risk — you have no colon cancer risk factors other than age — your doctor may recommend waiting one year and then repeating the test.  If you have a “positive result,” You may need additional testing — such as a colonoscopy — to locate the source of the bleeding. Under Medicare…… The Fecal Occult Blood Test…. can be given ONCE every 12 months if you’re 50 or older, at ZERO Cost to you.        Now….. let’s take a look at Mult-Target Stool DNA Tests. You will know the “Multi-Target Stool DNA Test” more commonly known as “ColoGuard.” ColoGuard …….   addresses several barriers to colorectal screening. Patient concerns with colonoscopy. Include…having to schedule a separate and lengthy appointment at the testing facility. The need to undergo a “Stay Close to my Bathroom” bowel preparation the exposure to sedation or anesthesia……and the discomfort associated with an invasive imaging process…. Of sticking either the “colono-scope” during a colonoscopy or a flexible sigmoud device up your butt.   By comparison, the “Multi Target Stool DNA” screening test is a noninvasive, “multi-marker”, stool-based ColoRectal Cancer screening test….. that detects altered De-oxyribo-nucleic Acid (DNA), , as well as a fecal immunochemical test (FIT)… for blood released from cancer and precancerous lesions of the colon. The presence of fecal hemoglobin….. even in the absence of elevated DNA markers…..can lead to a positive result given the weighted nature of the Multi Target Stool DNA algorithm. Patients may collect and mail stool specimens from their homes with no bowel preparations and no dietary or medication restrictions.   Medicare covers this at-home multi-target stool DNA lab test…. once every 3 years…if you meet ALL of these conditions:   You’re  between the age of  50-85. You show NO CURRENT symptoms of colorectal disease including, but not limited to one of these: Lower gastrointestinal pain Blood in stool Positive Guaiac fecal occult blood test….which is an older version of the Immunochemical Test… where you “smear” stool onto a TEST Card with a wooden applicator or brush. The Guaiac test has dietary restrictions and you are required to collect “TWO” or more samples from the same Stool Sample for the test. Much Messier than the Immunochemical Fecal Blood Occult Test. OR…… A Positive Result from a Fecal Blood Occult Test ALSO    YOU NEED TO BE….. at average risk for developing colorectal cancer, meaning: You have no personal history of  (adenomateous ) polyps”  which are …..  a common type of polyp. They are gland-like growths that develop on the mucous membrane that lines the large intestine. They are also called adenomas: You have no personal history of  … colorectal cancer, or inflammatory bowel disease, including Crohn’s Disease and ulcerative colitis. OR…… You have no family history of colorectal cancers or adenomatous polyps, familial adenomatous polyposis, or hereditary nonpolyposis colorectal cancer.   If you meet the above criteria….. You pay nothing for this test if your doctor…. or other qualified health care provider accepts Medicare.   So that’s the difference between Multi Target Stool DNA Tests vs. Fecal Occult Blood Test.   If you haven’t had one of these preventative tests, speak to your primary doctor and get one. It could very well SAVE YOUR LIFE!   If you have any questions about Medicare…. Send me an email to – Support@TheMedicareNation.com   I answer ALL my emails. As long as I can answer your question in a paragraph, I’ll answer your question. If my response involves any research or it will take more than one paragraph to answer you….. I’ll send you a suggestion to hire me as your Medicare Consultant.   I charge $199.00 an hour. I’m one of the TOP Medicare Experts in the Country Nation…… I could easily command $400 or $500 an hour, but I CARE about each and every one of you! My time is extremely valuable and I want to help as many of you as I can with your Medicare problems and Medicare Plan Comparisons.   Also…..if you’d like to have me speak about Medicare … go to the website…  www.TheMedicareNation.com and click on the Contact tab and send me your information. I’ve already started booking speaking engagements for the Annual Enrollment Period…. Starting in October…so contact me now to schedule me for your corporation or event.   Thanks for listening to Medicare Nation! I appreciate your loyalty and referrals. Until next time…. I want YOU to have a Peaceful, Happy & Prosperous Week!   Diane