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Aging Wisely January 2014 - Aging Wisely

Medicare Rights: Medicare D Prescription Drug Transition

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Florida Medicare Part DThere are specific rules in place to protect Medicare recipients when transitioning from one Medicare Part D program to another (and when other changes take place). The Center for Medicare and Medicaid Services (CMS) wants to protect Medicare recipients from disruption in medications and ensure sufficient time to make arrangements when transitioning to new plans or when a plan’s formulary changes.

These transition rules especially help low-income beneficiaries who are automatically assigned to plans and may need time to choose a new plan, file an exception request or transition to a new drug. Many plans have formulary changes from year to year, so this transition assistance is useful for any recipients who are experiencing changes. There can also be potential disruptions when someone is changing levels of care (moving into or out of a nursing facility, going on to hospice, etc.). These protections are good news for Medicare recipients and the advocates that help them!

Here are some specifics about the rules:

  • Plans must provide a one-time 30 day supply of an ongoing medication during the 1st 90 days of coverage (applies to both new members and existing members when there’s a formulary change; applies to drugs not on the formulary and those subject to utilization management controls).
  • Plans must mail a written notice explaining that the transition supply is temporary, including instructions for identifying appropriate substitutes; notice of the right to request a formulary exception; and instructions on how to file an exception request. The notice must be mailed within 3 business days of the temporary fill.
  • Residents in long-term care facilities get further protections: Plans must provide a 31 day supply during the first 90 days. Plans must honor multiple 31 day fills during the first 90 days.
  • For Medicare recipients changing status (moving to a long-term care facility, being discharged, etc.): Early refill edits may not be used to deny an enrollee access to a refill upon admission or discharge from a facility. For members leaving facilities, plans should permit fills of prescriptions in the week before discharge to avoid gaps or delays

Medicare and the various Part D plans can be confusing for recipients and families. As your patient advocate, Aging Wisely is here to help with key information, resources and individualized assistance. Contact us today at 727-447-5845 for patient advocacy and Medicare/Medicaid assistance. We can help with a wide range of issues related to Florida Medicare and Medicaid as well as other benefits like Veteran’s benefits and state-specific programs.

Ensuring your care continuity and well-being is what we do!

 

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Dr. Phillips’ Expert Heart Health Tips

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diet for healthy heart

Hello, I’m Dr. Paul Phillips and I’ve been practicing cardiology for over 30 years at Morton Plant in Clearwater. As managing partner of Clearwater Cardiovascular and Interventional Consultants, I’ve worked with thousands of patients throughout Pinellas County. I’m pleased to offer some heart health tips to the readers of Aging Wisely today to help you get a healthy start to 2014!

Every New Year brings a sense of renewal and the potential to change our lives. Unfortunately most New Year resolutions get put on the back burner and quickly forgotten. The goals of losing weight, changing our diets, exercising more regularly and adopting a healthier lifestyle become missing in action. However, with February being Heart Month it is good time to recall some of resolutions and try to lower the risk of future cardiovascular disease.

The epidemic of obesity in our country continues. The reasons include eating more high-calorie processed foods, larger portion sizes, more meals eaten away from home, and less physically active lifestyles. We consume more foods and drinks with added sugars. Portion sizes have increased and the average adult’s daily calorie intake increased by 350 between 1977 and 2005. Many of the meals that are served at restaurants, particularly fast food restaurants, as well as prepared meals bought at grocery stores are high in saturated fats, cholesterol, added sugars and sodium. As a society we spend more time in front of televisions, computers, and video games than  ever before.  The lack of physical activity places us at risk for diabetes and cardiovascular disease.

Fad diets and appetite suppressants are not the answer to combat these problems. They usually will not lead to sustained weight loss. Unfortunately, getting healthy requires work and discipline. The key is to find a daily eating plan that keeps the pounds off and provides the right balance of calories and nutrition with an appropriate amount of exercise. Although it seems simple the rule is that to lose weight you must take in fewer calories than you use through normal metabolism and physical activity. Don’t expect to lose more than 2 pounds per week. Without increasing your amount of exercise you will need to eat 500 less calories a day to lose 1 pound per week! Try to get at least 30 minutes of exercise daily.

These are some guidelines I suggest to help create a healthy diet:

  • Eat a diet rich in vegetables and fruits. 

They are high in nutrients and low in calories.  Eat whole vegetables and fruits (fresh, frozen, or canned) instead of drinking juices. Prepare without adding sugar, salt, or fats.

  • Eat whole grain and high fiber foods.

They can lower your cholesterol level and help you to feel full to help manage your intake. Whole wheat oats, wild rice, corn, barley, and popcorn are good choices.

  • Eat fish at least twice a week.

Grill, bake, poach, or broil (don’t fry). Use herbs, spices, lemon, and citrus juices instead of salt, lard, butter, or cream choices.

  • Select low fat dairy products.

Use low fat cheeses like mozzarella, Parmesan, and cottage cheeses and use fat free cheeses when available. For desert use frozen yogurts sorbets, sherbets, and fat free ice creams.

  • Give up sugar-sweetened soft drinks.
  • Limit the amount of food with saturated fat and cholesterol.
  • Use oils that stay liquid at room temperature like olive, corn, safflower, and canola.
  • Grill, bake, or broil meat and poultry.
  • Choose lean and extra lean meats.
  • Use chicken without the skin.
  • Avoid processed meats i.e. hot dogs, luncheon meat, ham, and bacon.
  • Shellfish are acceptable in moderation.
  • Avoid trans fats found in margarine or shortening.
  • Limit the intake of French fries, cakes, cookies, pies, and doughnuts.

Some other tips to promote weight loss:

  • Control portion size.
  • Don’t snack between meals or eat anything other than fruits and vegetables after dinner.
  • Avoid, bread, pasta, white rice, and potatoes (sweet potato is a better alternative).

Now for some good news! A glass or 2 of wine a day promotes heart health, although wine does have calories you will have to burn off.

Make this a healthy year! Modify your diet, lose weight, get regular exercise, and enjoy some wine.

heart health month

Thanks to Dr. Phillips for sharing his valuable advice with our readers. Dr. Phillips works with many of our clients and is well known throughout the area for his excellent work as a cardiologist and his contributions to the community.  Here is a quick bio about Dr. Phillips: Paul L. Phillips, M.D., F.A.C.C. received his medical degree from the University of Virginia Medical School. His post graduate training continued with an internship, residency, and cardiology fellowship at New York Hospital- Cornell Medical Center. Dr. Phillips has practiced for over 30 years at Morton Plant and is currently managing partner of Clearwater Cardiovascular and Interventional Consultants. He received the Excellence in Medicine Award in 1999 and the teaching award from the Morton Plant Primary Care Program in 2005. He serves as an affiliate professor at the University of South Florida School of Medicine. 

In the days leading up to heart month, our Aging Wisely and EasyLiving blogs have been focusing on heart health for elders and caregivers and sharing resources for a healthier lifestyle. We hope these help inspire you towards good health in 2014. If you need any specific information or have a suggestion, we invite you to contact Aging Wisely any time.

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Caregiver Care Corner: Loving Y-O-U

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As we start off the new year, we are taking time to help you focus on Y-O-U…and ways you can show love to your mind and body for a holistically healthy life. Throughout our site and blog, we offer lots of caregiver tips and eldercare resources. We know having good information and knowing where to turn for help is vital. We also occasionally share simple health and stress reduction tips. To start, you may want to read our post about respite options for caregivers, which also includes links to a number of caregiver stress and resource articles.

We recently found a great resource online we’d like to share with you. This presentation, from the Pennsylvania Department on Aging, gives some solid advice for caregiver health. We often hear the same old admonitions, but this presenter offers scientific evidence for the advice and the latest health research. She provides very specific information about sleep, exercise, and diet as well as some good resource links. Some of the information at the end of the presentation references state of Pennsylvania resources, but she also talks about nationwide resources and things that many states offer (to know more about what’s available here in the state of Florida, reach out to us any time!).

So, today, take a little time (this video is about 25 minutes) for Y-O-U by watching this presentation on caregiver health and self-care:

And, don’t forget, we’re here to help YOU!!! Feel free to give us a call at 727-447-5845 or contact Aging Wisely’s advocates online. We can help with anything from respite care to assessments and advocacy for your family. Having a little help from our care team can better equip you in elder caregiving and boost both your own health and that of your loved one. Our Senior Care Consultant, Sue Talbott, can arrange to come out to meet with your family (free of charge) to discuss your needs and concerns.

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Patient Advocacy for Comprehensive Heart Health

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patient advocacy heart and stroke

February is National Heart Month so now is a  great time to celebrate our amazing cardiovascular systems and learn a little bit more about how to keep our hearts healthy. Even if you have heart disease or have suffered a heart attack or stroke, there is a lot you can do to keep your system as healthy as possible. Aging Wisely’s patient advocates are here to help with information, resources and health management services.

HEART facts…did you know?

  • Every day, your heart beats about 100,000 times, sending 2,000 gallons of blood surging through your body (a kitchen faucet would need to be turned on all the way for 45 years to equal the amount of blood pumped by the heart in an average lifetime).
  • Laughter really may be great medicine: a good belly laugh can send 20% more blood flowing through your body.
  • Don’t ever claim men don’t have big hearts! An adult woman’s heart weighs about 8 ounces, an adult male heart about 10 ounces.

Prevention, health management and safety are all part of a smart heart plan. Here’s a holistic plan for keeping heart healthy and some ways we can help in each area:

  • Eat a healthy diet. A well-balanced diet keeps your body strong and your cardiovascular system healthy. This shouldn’t feel overwhelming…even small changes can make a big difference and a healthy diet can be a tasty one. The American Heart Association recommends: eating an appropriate number of calories for your activity level, eating a variety of foods from all the food groups (emphasizing whole grain foods/fiber, fruits and vegetables and getting at least a couple servings of fish/week), and eating less nutrient-poor foods. These tips are especially important as we age because our calorie and nutrition needs change. Nine out of ten Americans consume too much sodium, which increases risk for high blood pressure–check out this infographic about sodium consumption and ways to reduce intake. Aging Wisely’s patient advocates can refer you to professionals who can create a nutrition plan for you, can set up meal delivery or home caregiver services to ensure you have easy access to healthy meals that you enjoy and can help you monitor your nutrition intake and make changes.
  • Get sufficient physical activity. We work closely with In-Home Fitness, a great group of personal trainers who specialize in older clients and helping individuals rehabilitate. We’d love to set up a consultation with them for you. We can also help with all kinds of resources for staying fit and set up caregiver visits to help keep you on track with regular activities. Some of our EasyLiving home care clients go out dancing each week or get a ride to their local fitness center or swimming pool. We want to keep you doing what you love (and staying physically and mentally healthy at the same time)!
  • Manage stress and lifestyle factors. Quitting smoking is an important component of better health. If you need help with smoking cessation programs and support, we can offer advice and resources. As holistic care managers, we emphasize quality of life and overall well-being. Small changes in your lifestyle and connecting to healthy activities can be a vital part of a healthy, happy life. Physical activity and creative outlets can protect against stress.
  • Be knowledgeable and know where to go for help. Check out the information from the American Heart Association: know the signs of a heart attack and stroke, prevention guidelines and understand your conditions (we’ll be bringing you the key information throughout the next month in our blogs and newsletter). We help filter through the information available to bring you reputable sources, expert referrals and the latest health news.
  • Get good heart and medical care. Practice preventative medicine (did you know Medicare now covers most preventative care and screenings with no copay?) and talk to your providers about your risk factors. We can refer you to specialists and help you prepare for doctor’s appointments. Coordinated care produces better outcomes…that’s what we’re here for!
  • Get help when you need it. Every individual should have a Vial/File of Life prepared so that emergency medical providers can access the information they need to help you. You might also want to consider a personal emergency response system for your home. If you live in an assisted care facility, your care manager can help ensure your chart is updated and key contacts are listed so your family and providers are notified if there is a problem or changes. We can help you when there is an emergency, with on-call services for Aging Wisely clients. There is nothing worse than trying to navigate a medical emergency without help and support. We can be there throughout the emergency, hospitalization (and discharge planning) and rehabilitation to help guide the way and ensure you understand what is happening and your options.

Give us a call at 727-447-5845 for help in any of these areas! We welcome your comments about what information you would like to see about heart health (and if you have not already signed up for our monthly Wise Words newsletter, you can sign up right on our home page or contact us with a request or comment).

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Our goal is to enable every individual we work with to live the most fulfilling life possible, with utmost dignity, focusing on their physical, mental, spiritual, family and financial wellbeing.