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NAVIGATOR SUCCESS OF THE MONTH
After a one-year effort, Patient Navigator successfully appealed a denied medical insurance claim, including escalating the appeal up to the state insurance commissioner. Our happy client will receive many thousands of dollars back from the insurance company, just in time for Christmas! He wrote us to say "You are a hero, a champion, a medalist, a gladiator!"
If you have an insurance problem, give us a call!
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| Volume 1 Issue 4 | December 2010 |
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Dear Colleagues and Friends,
Welcome to the December 2010 issue of "Navigator Notes," a monthly newsletter designed to inform our readers about important health topics.
Patient Navigator's mission is to bring health care and life care together through advocacy, education and a patient-centered approach to solving problems and overcoming obstacles in the health care system. Elisabeth Schuler Russell Founder and President Patient Navigator, LLC
Guiding your journey through illness .... |
Medicare Open Season - Time to Check on Seniors
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Medicare Open Season lasts until December 31. If you are involved with elderly parents or other seniors, now is a good time to review their Medicare coverage, in particular their Part D Drug Coverage Plans.
Traditional Medicare Part A covers hospitalization, skilled nursing facilities, some home health and hospice. Part B covers physician and outpatient services and requires a monthly premium. Under the new health care law, Medicare will now pay 100 percent of the cost of annual physicals and other kinds of preventive health care, such as cholesterol and obsesity screening.
At this time of year, beware of slick advertising directed at your seniors from Medicare Advantage programs. These Medicare Advantage (Part C) programs are HMOs run by private insurers and carry the same pitfalls as standard HMO plans. They seek to lure seniors out of traditional Medicare with promises of extra benefits. Don't be fooled. These insurers impose more restrictions on the doctors you can see and the benefits you can receive. The extra benefits they advertise, such as dental and vision care, will be phased out as the government cuts back the subsidies it pays to Advantage plans.
Medicare Part D drug benefits are an important component and require some work to find the right plan. Fortunately, there are excellent tools available tools to help you. The starting point is to develop your list of prescription medications. The variables to consider are brand vs. generic drugs, whether it makes sense to have a lower monthly premium and a higher deductible or vice-versa, the plan's formulary and authorization requirements, and the plan's cost. A great place to start is through the government Medicare site's Resource locator. You can create a drug list and use it to begin your search. There is a wide price range among the private insurance companies that offer Part D plans. The right match for your senior's medication needs can save thousands of dollars a year.
The final component of your senior's Medicare coverage is probably a Medigap supplement plan. Medigap is designed to fill the gaps in original Medicare coverage, such as deductibles, co-insurance and co-payments. These plans, also offered through private insurers, offer standardized benefits. However, the price among companies can vary widely. The government Medicare site also offers a tool to compare Medigap plans.
For more information, you can download the Medicare guide or learn more from the Medicare Rights Center.
This is just the tip of the Medicare iceberg, but Patient Navigator can help you help your senior. Please call or email us for a free consultation about a Medicare review for your loved one. Back to Top
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| Holiday Grieving - My Tips for Survival | Many people experience depression during the holiday season. This is not surprising given that we are bombarded with loud Christmas music wherever we go, incessant advertising and a non-stop drumbeat to shop, buy, spend and create the perfect Hallmark holiday. It is hard not to feel stressed out if you then add the pressure of entertaining, houseguests and a long list of expectations.
Now imagine trying to face all this when you are grieving the loss of a loved one.
It is very hard. It is painful. It is unbearably sad.
I lost my mother very suddenly and unexpectedly in May 1990, when she was 63 and I was 31. I made the decision to skip Christmas entirely that year - no tree, no gifts, no decorations. I simply could not bear it. Fortunately, my boyfriend (now husband) understood and supported me, and there were no children to worry about back then. It was the best I could do.
The pressure to go along with the holidays is intense. Here are my own tips on how to get through them if you are grieving.
1. Don't let anyone pressure you or try to tell you what will make you feel better. Only you know what helps.
2. Remember your loved one in whatever way seems right - a walk in the woods, a prayer service, watching their favorite movie, setting a place at your table. You don't need anyone's permission or concurrence.
3. Don't be afraid to tell people that it really is not a Merry Christmas or Happy Holiday for you. Let your colleagues at work know that the season is hard for you and ask them to understand if you are distant.
4. Learn to say no.
5. Give yourself permission to mourn. It is normal and necessary. And then tell yourself gently, over and over, that you will not always feel this way. And, in time, you won't.
I've learned a great deal over the years about loss and grief. I've learned to grow from each loss in my life, but it has taken a lot of work and faith. If you are grieving this holiday season, you are not alone. But please know and believe, with all your heart, that you will not always feel the way you do now. Time does heal. Things will get better.
For more information on grief and the holidays, I suggest:
Therese A. Rando, PhD. Grieving: How to Go on Living When Someone You Love Dies. (Note: This book saved me as I grieved the loss of my mother).
Elaine Tiller, M.Div. When Grief Comes Home for the Holidays, How do you Manage?
Capital Hospice. Good Mourning: A Resource for Healing.
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Food Science - Part 3
| In September, we began our series focused on the science and research of nutrition to help you become more informed about food choices. If you missed Part 1, you can read it here. If you missed Part 2, you can read it here.
Last time, we wrote about the six problems of our modern diet. This month we'll talk about what you can do.
In addition to not containing enough fiber and protein, processed foods contain unwanted chemical flavorings, colorings, sweeteners, chemically treated trans fats and salts like MSG and other hydrolized vegetable proteins and chemical preservatives in the foods and packaging. Here are two things we can do:
1. Cut back on all sweets and replace with fruits (fresh and dried). Raisins have no added sugar and dried apricots are very low in sugar. Use honey, maple syrup, or agave to sweeten cereals, plain yogurt, whole grain pancakes or waffles, tea and coffee.
2. Eliminate processed foods and replace refined flours and potatoes with whole wheat breads, crackers, pastas, long grain rice or brown rice, rye flour, millet, buckwheat, oatmeal, bulgar, seed flours such as sunflower flour, flax flour, and sesame flour found in gluten free products, and quinoa. (Whole grain or whole wheat refers to the "whole" seed; the bran, germ and endosperm). Switch to sweet potatoes and squash instead of using white potatoes.
Whole wheat is a good source of calcium, iron, fiber and selenium. It has more protein fiber and gluten than refined flour. White whole wheat flour is a whole grain from white wheat instead of red wheat and tastes more like refined flour. It is commonly used in Europe. ("Wheat" breads may not be "whole" wheat breads so check the labels carefully.) Brown rice is whole grain rice as is long grain wild rice. Each has more fiber, nutrients and protein than refined rice. Quinoa is a whole grain and is also a complete protein, which is rare for a plant.
The Mayo Clinic site offers recipes using whole grains.
Sources:
(1) Notes from a lecture by John Bagnulo MPH, PhD., at the Center for Mind-Body Medicine's Food as Medicine Forum, Washington, DC. May 2010.
(2) From notes on a lecture by Kathie Swift MS, RD, LDN, at the Center for Mind-Body Medicine's Food as Medicine Forum, Washington, DC. May 2010. For more, you can review this illustrative list of research studies on food science.
You can visit the Center for Mind Body Medicine's Food as Medicine site to learn more about this education and training program.
Guest "Food Science" Columnist Deborah Roney holds a degree in biology and received her certification from the Food as Medicine program at the Center for Mind-Body Medicine in Washington, D.C. in May 2010. |
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