Monthly Archives: April 2018

Why I love Jen Sincero…..

This is the queen of Badassery, who wrote these great books:

About five years ago, I found her and took a course with her. Because of that, I wrote these two books:

I got to meet her last night in Philly with my extra-special niece. And Jen  met my daughter in Dublin, Ireland. I love her because she brings family together to be Badassi ( I made that plural up!). 

Ain’t love grand…………

“You Just have to Laugh……………”

©2018 Cathy Sikorski

 

 

 

Clean Up, Clean Up, Everybody, Everywhere…….

I have been trying to give you wonderful readers important information about aging, healthcare, and caregiving. It just hasn’t been that humorous, now has it?

Let’s change it up. Just for laughs.

My Mom has bravely embraced her new Smart Phone. But, oh the journey. Almost on a daily basis, she struggles with re-learning how to delete messages, listen to messages, text a message, delete texts and just answer the damn phone.

What’s fascinating about this…and I notice it with my other friends ‘of a certain age’, is that she is obsessed with “cleaning out” her phone. There can be no messages in the inbox. No texts hanging around when she has ended the conversation. No emails that offensively fill up her mailbox when she must make room for more email that may arrive at any moment. I usually have to stop her from doing what this guy is doing.

 

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I’ve tried to explain that those texts and emails can stay there as long as she needs them. If she wants to look at a text later, share it with someone, or just remember what someone texted her, there is no need to clean up five minutes after the conversation ends.

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This is the deal….you clean up your mess. You clean up after yourself. You make your bed. You wash the dirty dishes. You do not leave them in the sink for someone else. You vacuum, dust, and tidy up every day, all the time. You do this because you never know who may show up at your door, or what emergency may ensue and someone will be unexpectedly in your lair. And you do it with an Entemann’s cake on hand, just in case.

Your phone is no different. God forbid someone sees that you have 15 messages in your queue. You have 42 unread emails. You have not cleaned up your mess. Anyone can pick up your phone and see what an absolute slob you are. A disgrace.

I, myself, often have 1500 messages floating around in my email. This drives many people insane. But not me. I don’t care. I really don’t. Then again, I’m cleaning up at 11:00 PM for my cleaning lady, who bravely shows up tomorrow. Maybe I’d be better if this guy were coming.

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On top of all this, while my mom is riding next to me in my car, feeling quite smug since we tidied up her phone, I catch her looking through the camera lens of the phone, just to see what is in the hole.

 

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Yeah, I caught you.

“You Just have to Laugh……”

©2018 Cathy Sikorski

And You Thought “Mooning” Went Out With Hot Rods…………

In the beginning of 2017, Medicare implemented the new Medicare Outpatient Observation Notice which seems to have the same effect as the old ‘mooning’ we think about from American Grafitti.

You see, MOONing in Medicare (sounds like a love song from Cole Porter, doesn’t it?) means that within 36 hours of entering a hospital, if you will not be admitted, but only kept under  “observation,” they must inform you with a written explanation.  This is the form, if you’d like to see it!

MOON FORM

The problem with this form is the unintended consequences it might have for you, if you are on Medicare, or your loved one, if you are a caregiver for someone who is on Medicare.

If a patient is placed under observation, typically in the Emergency Room, and is never formally “admitted” to the hospital, Part A hospitalization of Medicare does not pay. In other words, you are paying as an outpatient.  For a quick trip to the ER (is there such a thing?) that’s no big deal. After all, the Part A deductible is $1340.00 so you may not even spend that much if you’re only there a few hours.

However, if you are there a few days, and you stay on observation, it is likely that you will start racking up fairly high medical costs with co-pays for every service you are getting. Not to mention any drugs, that likely will not be covered by your Part D while you are in the hospital. It’s complicated, scary and could be costly.

The worst result could be that you are sent to rehabilitation, and because you never met the “admitted to the hospital for 3 days” requirement to have Medicare pay for at least 20 days in that rehabilitation center, you are now responsible for a significant bill coming out of that rehabilitation center. This has happened to people to the tune of thousands of dollars.

So what can you do?

This advice comes directly from this AARP article, which oddly was written before MOON became a regulation and before the MOON form existed. So I have added two of my own suggestions at the end:

Medicare: Inpatient or Outpatient?

  • Ask about your status each day you are in the hospital, as it can be changed (from inpatient to observation, or vice versa) at any time.
  • Ask the hospital doctor to reconsider your case or refer it to the hospital committee that decides status.
  • Ask your own doctor whether observation status is justified. If not, ask him or her to call the hospital to explain the medical reasons why you should be admitted as an inpatient.
  • If, after discharge, you need rehab or other kinds of continuing care but learn that Medicare won’t cover your stay in a skilled nursing facility, ask your doctor whether you qualify for similar care at home through Medicare’s home health care benefit, or for Medicare-covered care in a rehabilitation hospital.
  • If you go to a skilled nursing facility and have to pay for it yourself, you can try formally appealing Medicare’s decision. When you receive your quarterly Medicare Summary Notice, make a copy and highlight the facility’s charge. Send this to the address provided on the notice with a letter saying you want to appeal Medicare’s decision of noncoverage on the basis that you should have been classified as an inpatient during your hospital stay and not placed under observation. If this is denied, you can go to a higher level of appeal, following instructions on the denial letter.

Additionally,

  •         You can refuse to sign the form. All that does is make the hospital sign it, and make them a bit testy. But it signifies that you do not accept this and hopefully is evidence on Appeal that you were trying to fight the observation status.
  • You can take your patient home. I am not recommending this, especially if the whole reason you are fighting ‘observation status’ is because your patient is very sick and you are certain they will end up in the hospital, a rehab center, or a skilled nursing facility after this event. But one of the problems with Medicare is that they penalize hospitals for re-admissions. So discussing the possibility that you might take your loved one home, that might force a re-admission, may move them to admit your loved one.

Sometimes this feels like the “Art of War,” when dealing with healthcare issues. Being forewarned is being forearmed, as they say. Seems like anything is better than being MOONED!

“You Just have to Laugh…..”

©2018 Cathy Sikorski

ALMOST EVERYONE IS FALLING FOR THIS NEW MEDICARE CARD SCAM! PROTECT MOM!

This is so important, that I scrapped my blog for today, for this. And since it is Friday afternoon, I’m going to repeat it again early next week. Please, for the love of God, tell your parents, your Seniors,  your neighbors, your friends,  even your enemies and maybe your pets…… that bad, bad people are scamming those with Medicare about their new cards.  THEY ARE FREE and NO ONE WILL CALL YOU ABOUT THEM:

NEW CARDS MEDICARE FRAUD ALERT: YOUR NEW CARD IS FREE!

Don’t Pay Those Medical Bills.

Yes, I said it. Countless times I have run into weary-worn caregivers who are frustrated by the overwhelming cost of care. According to AARP, out-of-pocket (OOP) costs for caregivers can be upwards of twenty percent of a caregiver’s income.

https://www.aarp.org/caregiving/financial-legal/info-2017/out-of-pocket-cost-report.html

And this is only getting worse.

I often find that clients of mine or even those I’m caring for are quick to pay any medical bill that comes to their mailbox. I encourage you to STOP that right now. We in caregiving and Elder healthcare know that there are many documents that come to our door that say: ‘This is Not a Bill.” And yet it looks like a bill, it sounds like a bill and it often has wording that indicates, “your share of expenses.” I’m sure you’ve found, as I have, that with my mother’s generation:”If it’s a bill, you pay it.” Even if it just ‘looks’ like a bill, many seniors will pay it, just to get it off their plate and to do the right thing.

Unquestionably, we should not pay something that says, “This is Not a Bill.” I’ve been able to either take those away, sneak them out of the house, or train my caregivees not to pay them. That has made a significant in-road into this problem. But it is the real bills that can cost you more than you know.

I tell the tale of a bill I received for my brother-in-law from the hospital for $4500.00, after his death. He had excellent health insurance and was ill for many months prior to his death, so this bill seemed far too exorbitant based on what I knew about his insurance. Every month for a year, I received this bill. Every two or three months, after I called to inquire if they had submitted it correctly to insurance, if they had processed the bill, or if they had calculated all the insurance discounts, they would tell me to wait as the bill was still in process. But they continued to send me the bill, even though they were waiting for payment.

I could have paid that bill ten times before it was properly processed. The actual final bill was $0.00. Yes, zero dollars and zero cents. Just try getting back $4500.00 you’ve overpaid because you were hasty to ‘pay’ a bill. And as I alluded to at the beginning of this article, often caregivers pay these bills out of their own pocket. Don’t do that either, if you can help it, ever. That discussion is for another day.

But for now, when you receive a bill, make sure it is correct. Make sure it has been processed both by Medicare and your Medigap policy, if you have one. Make sure you have received all your proper discounts. Don’t ever be afraid to call and question a bill. Never be afraid to wait, just wait and see if the bill has been processed properly. You can and will save yourself money, frustration and maybe even some heartburn.

Then perhaps you can have the last laugh!

“You Just have to Laugh……….”

©2018 Cathy Sikorski