Message from Patricia ...  

Vaccines may help
prevent infection in elders     

More than a third of U.S. deaths are preventable. Pneumonia and influenza remain in the top 10 causes of death for people 65 and above. 

Now is the time to encourage older adults to get a flu shot and make sure they are up-to-date on other immunizations.  

Immunizations are one of the most effective means to reduce the risk of illness for older people. Deadly diseases, such as influenza and pneumonia, are largely preventable by vaccination. Anyone who knows something about the 1918 flu epidemic that killed countless people all over the world will tell you that the flu shot is a miracle life saver. 

Most of us have experienced the loss of a patient or loved one to pneumonia or associated complications that, perhaps, could have been prevented through immunization. Many health professionals are recommending patients get the shingles vaccination to ward off the severe nerve pain flare up that may attack anyone who has had chickenpox in addition to flu and pneumovax vaccine. 

Even though immunization is available, is recommended by health professionals and is often covered by Medicare, countless numbers of older people do not receive the immunization. 

Not all healthcare professional agree on the effectiveness of immunizations in the elderly, especially as it relates to the flu.

Community health centers a vital
resource for low-income elderly

Relatively healthy older people, particularly those in the 60 to 70 age range, are likely to need services similar to other adult healthcenter populations. They may face challenges similar to their younger counterparts; language barriers, limited health literacy, or cultural factors may impact healthcare access.

Yet for the older-old, these familiar challenges are compounded by additional barriers to optimal care and quality of life. The disabled of any age often need supportive services to remain as healthy as possible and in the community. As the population ages into the 75+ or 85+ categories, there is more likelihood for the presence of disability and the need for special services. Many more health centers are now beginning to serve disabled elders and even more centers are realizing that, given demographic changes, they must plan to provide services in the future that encompass not only the physical needs of vulnerable patients, but also the psychosocial needs that significantly impact health, healthcare access and quality of life.

Most members of this population will not be affluent. Over half will live on incomes below 200% of the federal poverty level and will need help with all of the co-pays, deductibles, and services that are left uncovered by Medicare.

They will need help in applying for Medicaid. 

• Lack of income and economic security may well become an increasing problem for elders as more and more employers drop fixed-benefit pension plans and contributions to retirees' healthcare.
• In the over-85 group, more than a third will need assistance with personal care related to their disabilities.
• A greater burden will fall on health centers to provide both chronic care and the functional assistance needed for elders who wish to remain living in the community.
• Language access and other factors related to cultural sensitivity will be key quality-of-care elements for this growing patient population.

Several community health centers operate a PACE program, a home - and community-based service that allows severely disabled elders who are eligible for nursing home placement to remain in the community.

PACE is usually based in adult day health centers and operates as a small Medicare Advantage capitated managed care plan at risk for providing all Medicare - and Medicaid - covered services, including long-term care and acute hospital care. Primary care services are also provided by the PACE program in a clinic setting utilizing employed or contracted medical providers. PACE programs typically provide all personal assistance and home health services delivered in the patient's home, as well as case management and coordination of all medical specialty care, dental care, hospital care and nursing home care, should it become necessary.

PACE began as a Medicare waiver program but is now a full Medicare benefit. Since it integrates Medicaid services, it requires contracting with the state as well. Different states have varied arrangements with PACE programs regarding covered services and the Medicaid part of the capitation rate.

There are now 42 PACE programs operating in 22 states.  

Are you aware that
Medicare stops at the border?

Written by Margo Fekas,  

Marketing Executive for eSafeTravels.com

When people think of travel insurance, they're typically thinking of travel delays and baggage problems. Admittedly, cancelled flights and lost baggage are a few travel inconveniences that travelers have no control over, but one thing you can control is having the security of knowing that if you need medical care outside the country, you can be properly covered.

Here are some questions that need to be answered. Who should I buy it from - the tour operator, the travel agent or a travel insurance specialist? What type of travel insurance coverage should I buy - Medical Evacuation, Travel Medical or Trip Cancellation? When is the best time to buy travel insurance?  

Buying Travel Insurance

Most, but not all, tour operators and travel agents do not hold the proper insurance licenses to offer all types of travel insurance, so they are limited in their offerings. Keep that point in mind when you are being asked to purchase travel insurance.

When booking any travel, ask if travel insurance is already included in the rate. Ask for an outline of coverage and ask about the medical insurance portion of the policy if any. If it's not what you want, then you must opt out of the program.

Travel Insurance and Medicare Recipients 

The exposure to financial harm is high for anyone traveling outside the United States, especially for seniors who are on Medicare, since Medicare stops at the border except for limited circumstances. If you have a Medicare Supplement, there is some relief for emergency medical care, but that too has limits which can cause you to dip into retirement savings. The lifetime maximum for foreign travel coverage outside the United States on Medicare Supplement policies is only $50,000.

Without Travel Medical Insurance, you are required to pay for services at the time you receive them. However, if you have travel medical insurance, those issues are handled by the travel insurance company, not you. A call to the customer service line of the insurance company you selected is all that is necessary to begin the payment process.

Our Recommendation on Travel Insurance

We have analyzed many travel insurance programs and with our twenty years of insurance experience, our recommendation for traveling seniors is to purchase an International Medical Travel Insurance policy with a trip cancellation/interruption rider. This type of policy will give you the protection on both sides of the potential problem areas which are international medical care, travel delays, interruptions, lost luggage, etc.  

When to purchase travel insurance?

The best time to buy travel insurance is within 14 days of putting down the initial deposit on your trip. This will normally qualify you for coverage for any pre-existing medical conditions, especially for Medicare Recipients.

For more information, please contact Abroad Travel Insurance, a division of eSafeTravels.com at 866-253-8067 or visit  www.abroadtravelinsurance.com.

Energize your Aging! with Dr. Wayne Phillips 

The Lifestyle Habits of
Successful Aging: Be Self-Vigilant! 

Dr. Wayne Phillips, Ph.D. FACSM, Intrinsic Coach

For the past several months I have been writing about the concept of "Successful Aging", beginning with a brief overview of 9 "Habits of Successful Aging". My subsequent columns have described and explained these habits in greater detail and suggested some avenues and options to more successfully include them in your lifestyle.  

This month's habit for discussion is Be Self-Vigilant:

Check in with yourself

Being self vigilant about your overall physical, mental and medical condition involves conducting your very own personal "Wellness Audit". This completes your "Circle of Wellness" by serving as a natural complement to all the Components of Successful Aging we have talked about so far, and will continue to talk about. Being self vigilant means asking yourself questions (e.g. "How do I feel?"), listening to the answers, and taking action where necessary.

Regular physical self-checks are an important part of self vigilance. While taking a shower or bath, for example, feel for any unusual lumps, bumps or skin discolorations. Ask yourself "How does this feel - how is it supposed to feel? How does this look - how is it supposed to look? There are a number of websites that can show you how to do this, e.g.  WebMD.

Being self vigilant also involves establishing a good relationship with your physician. A regular 'physical' is a good opportunity for discussion. It can also provide the chance to follow up with him/her if your self-checks reveal something for which you feel you need more information.

A typical 'physical' will focus predominantly on medical issues - blood pressure, medications etc. - and will provide essential information for your "wellness audit". Adding a more functionally oriented assessment would broaden your self-awareness, and for this you would need to visit a physical therapy or rehab clinic. A small number of progressive clinics specialize in older adults and provide a more behavioral 'wellness-oriented' approach to treatment. Some of these clinics (e.g. ActiveRx Rehabilitation) offer a 'walk in' service for a comprehensive functional assessment that would include gait, balance, strength, flexibility, and coordination. Assessments such as these are highly predictive of future limitations and can also reveal risk factors for catastrophic life events such as falls.

Successful Aging is all about pursuing an active, healthy and meaningful lifestyle. Being self-vigilant is an essential, though often underestimated, aspect of this.

Checking in with yourself provides the best opportunity to do something about your future before your future does something about you!

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