Medicare Part D Plan Open Enrollment Every October 15 through December 7th Medicare Part D plans have Open Enrollment. The programs begin on January 1st. Medicare Part D is prescription drug coverage with a formulary of prescription drugs, managed by a plan sponsor. If a person participates in Medicare Part A or Part B, then the Part D enrollment is voluntary. If a person has Medicaid, then they must enroll in a Part D plan, or one will automatically be assigned. Medicaid coverage helps with costs of premiums, deductibles and co-pays. FLORIDA APPROVED PART D PLANS FOR 2019 SilverScript Choice Wellcare Classic Basic Plan for the Average Person Monthly premiums average $32.50 per month Annual deductible is $415.00 Co-pays for prescriptions is 25% up until $3,850 has been paid out of pocket “Donut Hole” – is a gap in prescription coverage Coverage for drugs stops at $3,850 Beneficiary is responsible for 100% of drug costs from $3,850 until $5,100 out of pocket Once the annual cost of drugs reaches $5,100, Medicare Part D pays 95% of costs During Open Enrollment Oct – Dec Letters will be mailed to all “choosers” regarding their status The designated person that choose a plan any year since 2006, will remain the “chooser” and will select a plan for the beneficiary “Once a chooser, always a
Post Traumatic Stress and the Elderly After Hurricane Irma that displaced thousands of people and left them without power many elderly patients find it hard to “bounce back” from the stress. The sudden and overwhelming nature of natural disasters can leave many shocked, emotional and uncertain about their future. The constant warning and 24/7 news coverage of destructive weather this year can take a major toll on anyone’s mental health. People can develop PTSD (post-traumatic stress disorder” at any time after experiencing a traumatic event, but 30 days is the minimum to receive a diagnosis. After Hurricane Harvey and the catastrophic flooding, many people are suffering acute symptoms such as depression, anxiety, panic disorder and fear of the unknown. For the elderly and those who have a history of mental illness or dementia they are at a greater risk for developing PTSD. Signs of PTSD include flashbacks and nightmares, avoidance of situations that bring them back to the trauma, heart pounding, trouble breathing. The condition can also lead to feelings of depression and anxiety as well as insomnia. Being displaced during a storm, staying with other people (even family) needing to throw away damaged items, having to buy a refrigerator’s food, dealing with blocked streets and downed trees are stressful for healthy adults and even more so for an elderly
With the two high profile suicides of Kate Spade and Anthony Bourdain, mental health and dealing with depression was in the news. If you have a friend or family member who you think may be considering taking their own life, experts say to come right out and ask them. Contrary to scaring them, this question will come as a relief. Here are ten ways to deal with feelings of depression and isolation: Talk about feelings Eat well Keep in touch Take a break Do something you’re good at Keep active Drink sensibly Ask for help Care for others Accept who you are And if you find yourself having suicidal thoughts, call the National Suicide Prevention Lifeline 1-800-273-8255. It is available 24 hours a day, every day.
Question: Sliding Scale orders for insulin is time consuming and sometimes confusing. Is there a better way to prescribe insulin for elderly patients? Answer: According to recent guidelines published in February 2017 by the American Diabetes Association sliding-scales are NOT RECOMMENDED in long-term care. Diabetes affects up to 33% of patients in long-term care facilities The most commonly prescribed insulin therapy for patients in long-term care is sliding-scale insulin (SSI), the use of finger-stick blood glucose testing to assess the need for insulin administration based on current blood glucose levels. Its sole use for long-term treatment is specifically not recommended Recent updates to several published guidelines, including CMS, the Beers criteria, the American Medical Directors Association, and the American Diabetes Association regarding the use of SSI-only insulin regimens for elderly patients in long-term care all advise simplified treatment regimens and avoidance of “sliding-scale” regimens. Below is a summary of the recommendations: Hypoglycemia risk is the most important factor in determining glycemic goals due to the catastrophic consequences in this population. Simplified treatment regimens are preferred and better tolerated. Sole use of SSI should be avoided. Liberal diet plans have been associated with improvement in food and beverage intake in this population. To avoid dehydration and unintentional weight loss, restrictive therapeutic diets should be minimized. Physical activity and exercise are important
Lean, green fighting machine! Cucumber has a high water content and actually cools the body down, making this recipe cleansing and hydrating. SERVES: 2 2 c spinach 1 c peeled and chopped cucumber 1 c water (or coconut water) 1 orange, peeled 1 lime juiced 1 c diced fruit (pear, peach, apple, melon, berry) 1. BLEND the spinach, cucumber, and water until smooth. 2. ADD diced fruit and blend again. .
Question: Is there a difference between pneumococcal vaccines? Answer: Since 2005, Centers for Medicare and Medicaid Services required nursing home to ensure that their residents receive pneumococcal vaccinations. Facilities must offer pneumococcal bacteria: Prevnar, Prevnar13(PCV13), Synflorix and Pneumovax23(PPSV23). There are differences in the way that they are made. Prevnar, Prevnar 13 and Synflorix are conjugate vaccines, while Pneumovax23 is polysaccharide vaccines. Prevnar offers protection against 7 common strains of pneumococcal bacteria, Synflroix against 10 types, Prevnar13 against 13 types and Pneumovax23 against 23 strains of the bacteria. According to recent guidelines, the Advisory Committee in Immunization Practices (ACIP) recommends sequential administration of 2 pneumococcal vaccines for adults over 65 years of age. CMS guidelines recommends the administration of Prevnar 13 followed by Pneumovax23 6 to 12 months later. Those in the 19 to 64 age group are still recommended to receive one dose of Pneumova23 every 5 years. The decision is based on age group and if the patient has been vaccinated previously.