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RI ARA

Affiliated with the Rhode Island AFL-CIO “Fighting for the future of our members.” “NOW, more than ever!!!” All Rights Reserved RI ARA 2018©

Publication 2018 Issue 42 Published in house by the RI ARA

October 21, 2018 E-Newsletter From the Alliance for Retired Americans: Statement by Retiree Leader Richard Fiesta

The following statement was issued by Richard Fiesta, Executive Director of the Alliance for Retired Americans, regarding the government's announcement that there will be a 2.8% benefit increase for millions of Social Security beneficiaries, disabled veterans and federal retirees next year: “The members of the Alliance for Retired Americans are pleased that there will be a small benefit increase of 2.8% for

millions of Social Security beneficiaries in 2019. “The average Social Security monthly benefit is a modest $1,400, meaning that millions of seniors, surviving spouses and people with disabilities really need this cost-of-living adjustment (COLA). However this COLA is not enough to keep up with the cost of health care and especially prescription drugs, which are far exceeding the rate of inflation. That is why we need

to strengthen and expand Social Security with COLAs that reflect the real expenses seniors face. “We urge Congress to adopt the formula known as the CPI-E, the Consumer Price Index for the Elderly, to calculate future COLAs. The CPI-E is based more on health care and housing costs, things that seniors actually spend their money on. “And we urge every member of the House and Senate to join Expand Social Security

Congressional Caucus, a new congressional group committed to expanding, Rich Fiesta protecting and strengthening Social Security for all Americans. Announced in September, the Expand Social Security Caucus is now the largest congressional caucus with more than 150 members in both the House and Senate.” See more information page two.

New Study: More than Half of Older Workers Are Forced Into Retirement Despite low unemployment numbers, new figures from the Retirement Equity Lab show that many older workers are retiring involuntarily. At least 52% of workers over age 55 were forced into retirement due to factors such as declining health or job loss. Forty-eight percent voluntarily chose to enter retirement, according to economist and retirement expert Teresa Ghilarducci.

Older workers often find themselves working longer to make up for inadequate retirement savings and lost pensions, and pushing them into retirement involuntarily can also affect their ability to find another job. Those who are forced into retirement are unemployed longer compared to younger workers and typically earn 25% less than their previous

salary when they do find another job. Those who have inadequate retirement accounts and leave the workforce involuntarily are also at risk of being downwardly mobile and falling into poverty. “This data strengthens the case for strengthening and expanding Social Security,” said President Roach. “Social Secur ity is the

only reason there aren’t millions of more people in this situation.” “Raising the retirement age Joseph would exacerbate Peters, Jr. the problems this population faces,” added Joseph Peters, Jr, Secr etar y-Treasurer of the Alliance. “I would tell anyone who thinks that’s a good idea to 0

Mitch McConnell Calls to Cut Social Security, Medicare After instituting a $1.5 trillion tax cut and signing off on a $675 billion budget for the Department of Defense, Senate Majority Leader Mitch McConnell said Tuesday that the only way to lower the record-high federal deficit would be to cut entitlement programs like Medicare, Medicaid and Social Security. "It’s disappointing but it’s not a Republican problem," McConnell said of the deficit, which grew 17 percent to $779

billion in fiscal year 2018. McConnell explained to Bloomberg that "it’s a bipartisan problem: Unwillingness to address the real drivers of the debt by doing anything to adjust those programs to the demographics of America in the future." The deficit has increased 77 percent since McConnell became majority leader in 2015. New Treasury Department

analysis on Monday revealed that corporate tax cuts had a significant impact on the deficit this year. Federal revenue rose by 0.04 percent in 2018, a nearly 100 percent decrease last year’s 1.5 percent. In fiscal year 2018, tax receipts on corporate income fell to $205 billion from $297 billion in 2017. Still, McConnell insisted that the change had nothing to do with a lack of revenue or

increased spending and instead was due to entitlement and welfare programs. The debt, he said, was very “disturbing” and driven by “the three big entitlement programs that are very popular, Medicare, Social Security and Medicaid...There’s been a bipartisan reluctance to tackle entitlement changes because of the popularity of those programs. Hopefully, at some point here, we’ll get serious about this.” ...Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 riarajap@hotmail.com • http://www.facebook.com/groups/354516807278/


Social Security Announces 2.8 Percent Benefit Increase for 2019 Social Security and Supplemental Security Income (SSI) benefits for more than 67 million Americans will increase 2.8 percent in 2019, the Social Security Administration announced today. The 2.8 percent cost-of-living adjustment (COLA) will begin with benefits payable to more than 62 million Social Security beneficiaries in January 2019. Increased payments to more than 8 million SSI beneficiaries will begin on December 31, 2018. (Note: some people receive both Social Security and SSI benefits). The Social Security Act ties the annual COLA to the increase in the Consumer Price Index as determined by the Department of Labor’s Bureau of Labor Statistics. Some other adjustments that take effect in January of each year are based on the increase in average wages. Based on that increase, the maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase to $132,900 from $128,400. Social Security and SSI beneficiaries are normally notified by mail in early December about their new benefit amount. This year, for the first time, most people who receive Social Security payments will be able to view their COLA notice online through their my Social Security account. People may create or access their my Social Security account online at www.socialsecurity.gov/myaccount. Information about Medicare changes for 2019, when announced, will be available at www.medicare.gov. For Social Security beneficiaries receiving Medicare, Social Security will not be able to compute their new benefit amount until after the Medicare premium amounts for 2019 are announced. Final 2019 benefit amounts will be communicated to beneficiaries in December through the mailed COLA notice and my Social Security’s Message Center. The Social Security Act provides for how the COLA is calculated. To read more, please visit www.socialsecurity.gov/cola. 2019 SOCIAL SECURITY CHANGES Cost-of-Living Adjustment (COLA): Based on the increase in the Consumer Price Index (CPI-W) from the third quarter of 2017 through the third quarter of 2018, Social Security and Supplemental Security Income (SSI) beneficiaries will receive a 2.8 percent COLA for 2019. Other important 2019 Social Security information is as follows: Tax Rate

2018

2019

Employee

7.65%

7.65%

Self-Employed

15.30%

15.30%

NOTE: The 7.65% tax rate is the combined r ate for Social Secur ity and Medicare. The Social Secur ity por tion (OASDI) is 6.20% on earnings up to the applicable taxable maximum amount (see below). The Medicare portion (HI) is 1.45% on all earnings. Also, as of January 2013, individuals with earned income of more than $200,000 ($250,000 for married couples filing jointly) pay an additional 0.9 rcent in Medicare taxes. The tax rates shown above do not include the 0.9 percent. 2018

2019

Maximum Taxable Earnings Social Security (OASDI only)

$128,400

Medicare (HI only)

$132,900 No Limit

Quarter of Coverage $1,320

$1,360

Retirement Earnings Test Exempt Amounts $17,040/yr. $17,640/yr. Under full retirement age ($1,420/mo.) ($1,470/mo.) NOTE: One dollar in benefits will be withheld for every $2 in earnings above the limit. $45,360/yr. $46,920/yr. The year an individual reaches full retirement age ($3,780/mo.) ($3,910/mo.) NOTE: Applies only to earnings for months prior to attaining full retirement age. One dollar in benefits will be withheld for every $3 in earnings above the limit. Beginning the month an individual None attains full retirement age.

This is just a sampling of all the increases. Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 riarajap@hotmail.com • http://www.facebook.com/groups/354516807278/


Nearly two-thirds say they've seen no increase in take-home pay from GOP tax cuts: Gallup Almost two-thirds of Americans polled say they haven't seen an increase in their take-home pay as a result of last year's Republican tax-reform bill, according to a new survey. A Gallup poll published Wednesday found that 64 percent of respondents said they haven't seen a raise in their take-home pay as a result of reduced federal income taxes. That finding is identical to results in Gallup's February/March poll taken shortly after the tax changes went into effect.

The poll also found that a slim majority of Americans polled - 51 percent - say the law hasn't helped their family's financial situation. Meanwhile, 26 percent of respondents said the law has helped a "little" and 12 percent said it has helped "a lot." As this fall's midterm elections near, more Americans disapprove of the tax overhaul than approve of it, per the Gallup poll. The poll found that 46 percent of respondents

disapproved of the GOP tax cuts, while 39 percent approved of them. Those approval ratings are unchanged from the previous Gallup poll about seven months ago. The poll before that, taken in January, found that 55 percent of respondents disapproved of the tax cuts and 33 percent approved. Americans' views of the tax cuts are divided by party lines, with 8 percent of Democrats approving and 76 percent of

Republicans approving, according to the poll. The poll's results were based on telephone interviews conducted Sept. 24-30 with a random sample of 1,462 adults. The poll's margin of error is 3 percentage points. Proponents of the tax bill have previously argued that polls could be misleading if they include adults who are unemployed or self-employed and thus wouldn't be impacted by withholding changes.

Prescriptions for Millions of Opioid Pills Lead to Charges Against 5 Doctors It was not hard to tell when the doctor was in at the Staten Island office of Carl Anderson. Noisy crowds of people, some with visible signs of drug addiction, stood in long lines at all hours of the night, seeking prescriptions for oxycodone pills, the authorities said Thursday. Sometimes, the noise outside Dr. Anderson’s office got so loud that it prompted neighbors to call the police, and more than once ambulances were called to treat

pill-seeking patients, a series of new indictments show. Several patients, including two of his employees, overdosed and died, the authorities said. Dr. Anderson, 57, was one of five doctors charged on Thursday with taking millions of dollars in return for prescribing oxycodone pills to purported patients with no legitimate medical need for them, according to the

indictments and a criminal complaint unsealed Thursday in federal court in Manhattan. Another doctor, Dante A. Cubangbang, 50, who helped run a medical clinic in Queens, and a nurse practitioner prescribed 3.3 million pills that were paid for by Medicare and Medicaid over a three-year period — making him the highest prescriber in the state, one indictment says.

“Instead of caring for their patients, these doctors were drug dealers in white coats,” said Geoffrey S. Berman, the United States attorney for the Southern District of New York, in a news conference on Thursday. “These are people who’ve taken an oath to help their patients,” Mr. Berman said. “They should be on the first line of defense to combat this type of opioid abuse and instead they’re part of the problem.”….Read

Medicare Advantage Riding High As New Insurers Flock To Sell To Seniors Health care Medicare Advantage has according to experts widely doubled to more than 20 million a report out expected the enrollees, growing from a Monday Affordable Care quarter of Medicare from the Act to hobble Medicare beneficiaries to more than a Kaiser Advantage, the governmentFamily third. funded private health plans that “The Affordable Care Act did Foundation. millions of seniors have chosen not kill Medicare Advantage, (KHN is an as an alternative to original and the program looks poised to editorially Medicare. continue to grow quite rapidly,” independent To pay for expanding coverage said Bill Frack, managing part of the to the uninsured, the 2010 law director with L.E.K. Consulting, foundation.) cut billions of dollars in federal which advises health companies. Overall, payments to the plans. And as beneficiaries get set to Medicare Government budget analysts shop for plans during open beneficiaries predicted that would lead to a enrollment — which runs from can choose sharp drop in enrollment as Monday through Dec. 7 — they from about 3,700 plans for 2019, nearly 23 million people in 2019, insurers reduced benefits, exited will find a greater choice of or 600 more than this year, a 12 percent increase. Enrollees states or left the business insurers. according to the federal shopping for new plans this fall altogether. Fourteen new companies have government’s Centers for will likely find lower or no But the dire projections proved begun selling Medicare Medicare & Medicaid Services. premiums and improved wrong. Advantage plans for 2019, CMS expects Medicare benefits, CMS officials Since 2010, enrollment in several more than a typical year, Advantage enrollment to jump to say….Read More Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 riarajap@hotmail.com • http://www.facebook.com/groups/354516807278/


Kaiser Family Foundation Analyzes Health Care Expansion Proposals As policymakers debate next steps for expanding health insurance coverage and lowering health costs, some have introduced legislation that would broaden the role of public programs, such as Medicare and Medicaid. In light of recent characterizations of such proposals, the Kaiser Family Foundation (KFF) assessment of what these bills do (and do not do) is particularly important. In the past two years, eight proposals were introduced, ranging from bills that would create a new national health insurance program for all U.S. residents, replacing virtually all other sources of public and private insurance (Medicare-forAll), to more incremental approaches that would create a new public plan option as a supplement to private sources of

coverage and public programs. KFF analyzed these eight legislative proposals, highlighting the implications for consumers, health care providers and payers, employers, states, the federal government, and taxpayers. Key policy differences relate to eligibility, the size and scope of the public plan, covered benefits and cost sharing, premiums, subsidies for premium and cost sharing, cost containment strategies, and the likely interactions with current public programs and private sources of coverage. The proposals also vary in their level of detail; some bills, according to their sponsors, are intended to serve as blueprints for reform, and are expected to

include greater specificity over time. Although these bills are unlikely to advance in the current Congressional session; they illustrate the range of options that will likely serve as prototypes for legislation that may introduced in the future. The public plan proposals fall into four general categories: Two proposals would create Medicare-For-All, a single national health insurance program for all U.S. residents. (Sen. Sanders, S.1804; Rep. Ellison, H.R. 676); Three proposals would create a new public plan option, based on Medicare, that would be offered to individuals and some or all employers through the Affordable Care Act marketplace. (The Choice Act

by Rep. Schakowsky, H.R. 635, and Sen. Whitehouse, S. 194); The Medicare-X Choice Act by Sen. Bennett, S. 1970, and Rep. Higgins, H.R.4094; and the Choose Medicare Act by Sen. Merkley, S. 2708 and Rep. Richmond, H.R. 6117); Two proposals would create a Medicare buy-in option for older individuals not yet eligible for the current Medicare program. (Sen. Stabenow, S. 1742; Rep. Higgins, H.R. 3748); and One proposal would create a Medicaid buy-in option that states can elect to offer to individuals through the ACA marketplace. (Sen Schatz, S. 2001 and Rep. Luján, H.R. 4129). Read the KFF issue brief for more information about each of these proposals.

New Medicare Advantage and Part D Plan Landscape Reveals Challenges Ahead In late September, the Centers for Medicare & Medicaid Services (CMS)—the federal agency that oversees the Medicare program—released an overviewof the upcoming year in Medicare Advantage (MA) and the Part D prescription drug program. Among the notable inclusions, CMS expects more people to join MA plans than ever before, shows a sharp increase in the number of plans available, and reveals the number of plans that will offer expanded supplemental benefits. In 2018, approximately one third of all people with Medicare were enrolled in MA plans. Determining whether MA is the right choice for any beneficiary’s individual circumstances can be a very complicated decision, and we remain concerned that many people with Medicare do not have easy access to all of the tools and information they need

to make those decisions. Previous research has made clear that people with Medicare often do not end up in the best plan for their needs, which can mean they spend more than they should or may even face having to switch doctors to stay in the plan’s network. Unfortunately, this difficulty will be worse due to the proliferation of MA plans and the new, complicated offerings that people will need to wade through. The CMS overview shows an increase from 3,100 MA plans offered nationally to 3,700, with over 91% of beneficiaries having to choose between 10 or more plans. In addition, CMS is allowing MA plans new flexibilities to offer certain supplemental benefits. While we support increasing the benefits people with Medicare receive from the

program, CMS has not provided enough guidance to ensure these benefits are explained thoroughly to people who might choose to enroll. We predict that many beneficiaries and their families will be confused by the number of options and will not get the proper support to make the best choice for their circumstances. One valuable resource is the State Health Insurance Assistance Program (SHIP). Each state or territory has a SHIP where beneficiaries can receive unbiased, on-on-one counseling to help them choose the best options. There is also good news in the overview: MA and Part D plan premiums have gone down slightly and access to both types of plans will be widespread. This means that beneficiaries who would benefit from these offerings will have access to

them. But premiums going down is not the whole story. Many people with Medicare struggle to afford their out-ofpocket costs, especially for their needed medications. We urge CMS to ensure that people with Medicare have access to the best tools and information to make important decisions about their coverage options.

Read the 2019 Medicare Advantage and Part D Prescription Drug Program Landscape. Find your local SHIP. Read more about our concerns with CMS guidance for MA and Part D plans.

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 riarajap@hotmail.com • http://www.facebook.com/groups/354516807278/


Drugmakers Funnel Millions To Lawmakers; A Few Dozen Get $100,000-Plus Before the midterm elections heated up, dozens of drugmakers had already poured about $12 million into the war chests of hundreds of members of Congress. Since the beginning of last year, 34 lawmakers have each received more than $100,000 from pharmaceutical companies. Two of those — Reps. Greg Walden of Oregon, a key Republican committee chairman, and Kevin McCarthy of California, the House Republican majority leader — each received more than $200,000, a new Kaiser Health News database shows. As voters prepare to go to the polls, they can use a new database, “Pharma Cash to Congress,” tracking up to 10 years of pharmaceutical company contributions to any or all members of Congress, illuminating drugmakers’ efforts to influence legislation. The drug industry ranks among lawmakers’ most generous patrons. In the past decade, Congress has received $79 million from 68 pharma political action committees, or PACs, run by employees of companies that make drugs treating everything from cancer to erectile dysfunction. Drugmakers’ campaign contributions have reached record-breaking levels in recent years as skyrocketing drug prices have become a hot-button political issue. By June 30, 52 PACs funded by pharmaceutical companies and their trade organizations had given about $12 million to members of Congress for this election cycle. It is unclear whether drugmakers will top their previous 10-year record of $16 million, given during the 2016 election season. While PAC contributions to candidates are limited, a larger donation frequently accompanies individual contributions from the company’s executives and other employees. It also sends a clear message to the recipient, campaign finance experts say, one they may remember when lobbyists come calling: There’s more where that came from. The KHN analysis shows that pharmaceutical companies tend to play the field, giving to a wide swath of lawmakers on both sides of the aisle….Read More

VIEW THE SAMPLE CHARTS BELOW

See more charts and information:  Who’s giving the most.  Spending By 14 Drugmakers On Patient Advocacy Vs. Lobbing

 Pharma Cash To Congress  Lawmakers: Filled & Refilled  Drugmakers: Dispensing Dollars

Methodology Kaiser Health News uses campaign finance reports from the Federal Election Commission (FEC) to track donations from political action committees (PACs) registered with the FEC by pharmaceutical companies. Totals include donations to the principal campaign committees and leadership PACs for current members of Congress. We include only donations to members for election cycles in which they hold office (even if they weren’t in office for the full cycle, in the case of special elections). Donations are assigned to the quarter in which they were given, regardless of when they are reported by the receiving committee or PAC. Exact amounts can change as amendments and refunds are reported; KHN will update the analysis quarterly. Occasionally, refunds are reported in a different cycle from the original contribution, resulting in a negative total for the cycle….Read More KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation. Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 riarajap@hotmail.com • http://www.facebook.com/groups/354516807278/


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Dementia And Guns: When Should Doctors Broach The Topic? Some patients refuse to answer. Many doctors don’t ask. As the number of Americans with dementia rises, health professionals are grappling with when and how to pose the question: “Do you have guns at home?” While gun violence data is scarce, a Kaiser Health News investigation with PBS NewsHour published in June uncovered over 100 cases across the U.S. since 2012 in which people with dementia used guns to kill themselves or others. The shooters often acted during bouts of confusion, paranoia, delusion or aggression — common symptoms of dementia.

Tragically they shot spouses, children and caregivers. Yet health care providers across the country say they have not received enough guidance on whether, when and how to counsel families on gun safety. Dr. Altaf Saadi, a neurologist at UCLA who has been practicing medicine for five years, said the KHN article revealed a “blind spot” in her clinical practice. After reading it, she looked up the American Academy of Neurology’s advice on treating dementia patients. Its guidelines suggest doctors

consider asking about “access to firearms or other weapons” during a safety screen — but they don’t say what to do if a patient does have guns. Amid a dearth of national gun safety data, there are no scientific standards for when a health care provider should discuss gun access for people with cognitive impairment or at what point in dementia’s progression a person becomes unfit to handle a gun. Most doctors don’t ask about firearms, research has found. In a 2014 study, 58 per cent of internists surveyed reported

never asking whether patients have guns at home. “One of the biggest mistakes that doctors make is not thinking about gun access,” said Dr. Colleen Christmas, a geriatric primary care doctor at Johns Hopkins School of Medicine and member of the American Neurological Association. Firearms are the most common method of suicide among seniors, she noted. Christmas said she asks every incoming patient about access to firearms, in the same nonjudgmental tone that she asks about seat belts, and “I find the conversation goes quite smoothly.”...Read More

Hidden Drugs And Danger Lurk In Over-The-Counter Supplements, Study Finds Everyone has seen the ads or the products on the shelves. A dietary supplement that promises to make consumers skinny, without dieting or exercise. Or the one that will bulk them up and turn them into the envy of other weightlifters at the gym. Not to mention the one to make them perform better in the bedroom. Their labels say they are safe and all-natural. But are they? Many of these products contain unapproved and unregulated pharmaceutically active ingredients, according to a study published Friday in

JAMA Network Open. The authors wrote that the substances represent “a serious public health concern.” Researchers from the California Department of Public Health found that, from 2007 to 2016, 776 products marketed as dietary supplements contained hidden active ingredients that are unsafe or unstudied. Among them, dapoxetine, an antidepressant that is not approved in the United States;

and sibutramine, which was included in some weight -loss supplements but was banned from the U.S. market in 2010 because of cardiovascular risks. “It’s mind-boggling to imagine what’s happening here,” said Dr. Pieter Cohen, an associate professor of medicine at the Cambridge Health Alliance in Massachusetts. Cohen wasn’t involved in the study but wrote a commentarypublished

alongside the research. The California researchers based their findings on an analysis of a Food and Drug Administration database that identifies “tainted” supplements. “The study lays a foundation for ongoing enforcement work in this area, by the FDA and other partner agencies, to curb the illegal manufacture, importation, distribution, and sales of adulterated dietary supplements,” CDPH spokesman Corey Egel said in an email….Read More

No Kids? Who Will Care for You as You Age? PREPARING FOR OUR golden years in middle age is usually focused on fattening a 401(k), keeping up with the hottest ranked retirement cities and thinking about how we might adapt a home for aging in place. But are you giving much thought to who’ll take care of you when your health, mobility and independence decline?

If you have kids, you may feel some security knowing there’s a readymade shortlist of people who might look after you – although it’s not a guarantee they’ll be able to help. But a growing number of people are heading into old age without any children to put on the list of potential caregivers. In 2016, nearly 15 percent of

women ages 40-44 hadn’t given birth and were childless, up from 10 percent in 1976, according to the U.S. Census Bureau. A 2013 report from AARP projects that by 2040, about 21 percent of the older, disabled population will be childless. Lisa Mayfield isn’t surprised by the numbers. Mayfield is an

aging life care manager, also known as a geriatric care manager, a type of elder care professional who offers guidance and coordination of care for older adults. “I would say a third of our clients fit this category of not having children,” says Mayfield, president-elect of the Aging Life Care Association….Read More

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How does Medicare cover mental health services? Dear Marci, I am new to Medicare. I have been receiving treatment for depression and anxiety for several years, and have gotten treatment in both inpatient and outpatient settings. Will these services be covered under Medicare? How much will they cost?Beau (Baton Rouge, LA ) Dear Beau, Medicare covers medically necessary mental health care— services and programs that are intended to help diagnose and treat mental health conditions. If you have Original Medicare, Part A covers inpatient mental health services that you receive in either a psychiatric hospital (a hospital that only treats mental health patients) or a general hospital. Your provider should determine which hospital setting you need. If you receive care in a psychiatric hospital, Medicare covers up to 190 days of inpatient care in your lifetime. If you have used your lifetime days but need additional mental health care, Medicare may cover your additional inpatient care at a

general hospital. Be aware that you will have the same out-of-pocket costs with Original Medicare whether you receive care in a general or psychiatric hospital:  The Part A deductible: Before Medicare covers the cost of inpatient care, you have to meet the deductible for the benefit period. In 2018, the deductible is $1,340.  Days 1-60: After you meet the deductible, Medicare pays in full for the first 60 days of your care.  Days 61-90: Medicare pays part of the cost, and you are responsible for a daily coinsurance. In 2018, the coinsurance is $335.  Lifetime reserve days: For up to 60 lifetime reserve days, Medicare pays part of the cost, and you are responsible for a daily coinsurance. The coinsurance in 2018 is $670. Medicare Part B covers outpatient mental health care, including the following services:  Individual and group therapy

 Substance abuse treatment  Tests to make sure you are getting the right care  Occupational therapy  Activity therapies such as art, dance, or music therapy  Training and education (such as training on how to inject a needed medication or education about your condition)  Family counseling to help with your treatment  Laboratory tests  Prescription drugs that you cannot administer yourself, such as injections that a doctor must give you.  An annual depression screening that you receive in a primary care setting. Speak to your doctor or primary care provider for more information.  The depression screening is considered a preventive service, and Medicare covers depression screenings at 100% of the Medicare-approved amount. Original Medicare covers these outpatient mental health services

(with the exception of the annual depression screening) at 80% of the Medicare-approved amount. This means that as long as you receive services from a provider who accepts assignment (meaning they accept Medicare’s approved amount as full payment for a service), you will pay a 20% coinsurance after you meet your Part B deductible. Medicare Part B also covers partial hospitalization for mental health treatment for people who meet coverage requirements. Partial hospitalization programs provide care that is more intensive than other forms of mental health care, but less intensive than inpatient care. If you have a Medicare Advantage Plan, your plan must cover the same inpatient and outpatient mental health services as Original Medicare, but they may impose different rules, restrictions, and costs. If you need information about a plan’s costs and coverage rules, or if you are experiencing problems, contact your Medicare Advantage Plan. -Marci

What is the average age for COPD? It may be harder for cells to repair themselves as the body ages, and this may play a role in the development of chronic obstructive pulmonary disease, otherwise known as COPD. Younger people are still at risk, but increasing age may mean more lung damage and exposure to risk factors, and so a higher risk. COPD is a collection of chronic lung disorders that usually develop after years of lung damage. Age does appear to be a factor with COPD because of this, and older people may be more at risk than those who are younger. Diagnosing COPD early is critical because treatment focuses on slowing the

progression of the disease. Many risk factors are preventable and can delay the onset. What is the typical age of onset for COPD? According to the National Heart, Lung, and Blood Institute, COPD most often occurs in people more than 40 years of age who smoke or have done so earlier in life. Other risk factors, such as long-term exposure to chemicals, may also play a role. COPD typically builds up over time, and so the longer someone exposes themselves to potential lung damage, the more likely it is that they might

develop COPD. The lungs of people who are younger may recover from potential irritants faster than those of people who are older. Also, lung damage may not be enough to cause symptoms, as COPD typically takes years to produce noticeable signs. COPD in younger people The progressive nature of COPD may make it less likely for a young person to develop it, but it is still possible. Risk factors may not have built up enough to cause COPD, but people in high-risk groups, such as those who smoke heavily or who work in polluted environments, should still be

aware of the risks they could be exposing themselves to and take steps to avoid them. Genetic factors A genetic condition called AAT (alpha-1 antitrypsin) deficiency increases the risk of developing COPD at any age. According to the National Heart, Lung, and Blood Institute, up to 100,000 people in the U.S. may have AAT deficiency. AAT deficiency makes it difficult for the body to respond to damage in the lungs, which could lead to people with the deficiency developing COPD faster than others….Read More

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3 myths about the flu shot you need to stop believing  It's flu season - and it's time to bunk some enduring flu shot myths.  Young, healthy people and pregnant women should still get the vaccine.  Getting the shot won't make you sick. Hate getting the flu? Then you should get the flu shot. Actually, according to the Centers for Disease Control and Prevention (CDC), everyone 6 months and older should get a flu shot, so long as they're not allergic to any of its ingredients. Most importantly, you shouldn't let myths about the shot keep you from getting vaccinated. INSIDER spoke with Dr. Malcolm Thaler of New York City's One Medical to debunk a few of the enduring myths that seem to crop up every flu season. Here are three you can ditch for good. MYTH: If you're young and healthy, you don't need to get the flu shot "Yes, a young healthy person is less likely than an elderly person or someone who has chronic disease to end up with serious complications from the flu, but the disease is miserable

enough as it is," Thaler said. "You're doing yourself a great service by getting the vaccine and protecting those folks around you as well. You're reducing the transmission of the disease." Even if you don't feel like you want the flu shot for yourself, consider getting it to protect the more vulnerable people you interact with. Each year,thousands of Americans still die because of flu-related complications, accor ding to the CDC. During the 2017-2018 flu season, for example, an estimated 80,000 people died from the flu - the highest death toll in more than 40 years. MYTH: Getting the flu shot will make you sick The flu vaccine does not contain live flu virus, so it can't actually infect you, according to Thaler. "There's nothing alive in it," Thaler said. "It can make your arm a little bit sore, but beyond that [you might] just feel a little off for about 24 hours - a little achy and not quite right. That's just your immune system getting

charged up. That's the extent of it." You might think the shot makes you sick if you come down with something shortly after receiving the vaccine. But you probably caught totally different infection the flu shot wasn't designed to prevent. And just because those two things happened in a similar time frame, Thaler said, doesn't mean they're connected. "We're giving [the shot] in the fall - that's when people start to get colds and acute bronchitis and things of that sort. People like to make associations between fall illnesses and getting the flu shot and it's just incorrect." MYTH: Pregnant women shouldn't get the flu shot In fall 2017, a study reported a link between firsttrimester flu shots and miscarriages in pregnant women. But experts say all expecting moms should still get the vaccine anyway. "[The vaccine is] safe for all three trimesters, and it protects not only mom but it protects the baby for up to 6 months after he

or she has been born," Thaler said. (That's really important, since the CDC says that babies shouldn't get flu shots until they're at least 6 months old.) The American College of Obstetricians and Gynecologists (ACOG) even released a statement about the miscarriage study, saying that all pregnant women should still get the flu shot. For one thing, the study didn't prove that the shot causes miscarriages - it only identified a very slight link between them. That's distinction is important in science: Just because two things are linked, doesn't mean one caused the other. Plus, it's just a single study, and no single study erases all the existing evidence that flu shots are safe for all pregnant women. Finally - as the ACOG noted in its statement - pregnant women are more likely to die because of the flu than the average person. The vaccine's benefits easily outweigh other worries. Not sure where to get a flu shot? Use this tool from the CDC to find a location in your zip code.

How do hearing and sight influence cognitive decline? Previous research suggested that hearing loss and abnormalities in the eye are tied to memory loss and a higher Alzheimer's risk. New evidence now indicates that addressing hearing and sight problems can slow down cognitive decline. Existing studies have pointed out that there is a link between the quality of a person's hearing and their eye health and their exposure to cognitive decline. For instance, one such study covered on Medical News Today suggested that poor hearing may correlate with a poor memory. Another one proposed that we could detect Alzheimer's disease by looking for tell-tale

abnormalities in a person's eyes. Now, two new papers — each based on studies conducted by the same scientists from the University of Manchester in the United Kingdom — look at the evidence indicating that treating hearing loss and eyesight problems can slow down the development of cognitive decline. One of the papers, published in the journal PLOS One, shows that people who have had surgery for cataract — which is condition that can lead to vision loss in the absence of a surgical

intervention — have a slower cognitive decline rate. The other paper, which is published in the Journal of the American Geriatrics Society, has reported similar findings about people who wear hearing aids. "Age is one of the most important factors implicated in cognitive decline," states Dr. Asri Maharani, one of the studies' authors. Dr. Asri Maharani: "We find that hearing and vision interventions may slow it down and perhaps prevent some cases of dementia, which is exciting — though we can't say

yet that this is a causal relationship." "But the beauty of this study is that we're comparing the progress of the same individuals over time," she notes. Cataract surgery and hearing aids do help In both of these studies, the researchers assessed the rate of cognitive decline by evaluating the participants' episodic memory using word recall tests. The scientists then compared the rates of cognitive function impairment before and after the participants started wearing hearing aids or underwent cataract surgery….Read More

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RI ARA October 21, 2018 E-Newsletter  
RI ARA October 21, 2018 E-Newsletter  
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