Every once in a while even a caregiver needs help…..choose wisely!
It Ain’t Gettin’ Any Easier!
Pretty much every day, I am alarmed by little stories I find by scanning information about Elder issues.
My new friend Joanne Giardini-Russell, a true Medicare Guru, wrote an article this week about one of her clients who continued to go to work up to age 71. That, in itself, wasn’t a big surprise to me. If 60 is the new 40, working to age 70 or older, is bound to happen more and more. Many of us actually like working. Sure, many must keep working, and that is another article, for sure. But many people do work well into their 70’s and even 80’s. And those same hard-working people are often horrified about seemingly innocuous decisions they made (or didn’t make, by omission) and how they have placed themselves or their spouse into true fear of imminent destitution. Because of runaway health care costs.
You see, this guy’s venial sin was working too long and not retiring…..his mortal sin was not getting good information about how this affected his health insurance….more specifically Medicare. Suffice it to say that Joanne is trying to help this couple who have blown through more than $30,000…YES, THAT IS THIRTY THOUSAND DOLLARS…. of their own money, even though he had group insurance at work.
I don’t know this unfortunate couple’s story. But my guess is, they were not educated at work, they did not know how to use Medicare to their advantage at age 65, they did not take advantage of all the options at work for short-term disability and long-term disability, even if it required a contribution, and so on.
Those of us in this field are trying hard to get everyone to see the advantage of advanced planning instead of crisis planning. We are trying to work with your Financial Advisors, your HR people at work, and quite frankly, anyone else who will listen, including you.
Find us. Ask us to come to your work and speak. Ask us questions on the internet machine!
Buy our books, yeah I said it. But let me ask you a question, if anyone could have saved thirty dollars, three thousand dollars, or thirty thousand dollars, by buying a book for fifteen dollars, would that be worth it? Yes, my friends, I think it would. #WhoMovedMyTeeth?
There is tons of good information out there. But you must find the experts, read things, ask questions and take action. Now is the time if you are a Baby Boomer, now is the time if your parents are in their 50’s and 60’s.
Oh, and to you Millennials and Gen-Xers….it’s never too late!
“You Just Have to…… Get Your Sh%$#@# Together…..and then you can Laugh all the way to the bank!”
Joanne doesn’t even know I’m telling you about her….so she will see this when you do. If If you have any inkling that you want to discuss what you should do about signing up for Medicare:
Check out my friend Joanne at :
Boomer Health Group
Joanne Giardini-Russell, Medicare Guru
http://www.boomerhealthgroup.com/
Hot Fun In the Summertime…..
Yay! It’s summer…..
If you are a Baby Boomer, or a baby, or anyone…..it’s summer and you want to take a vacation! But guess what?!? People get sick on vacation, too!
I attended a Medicare seminar with my Mom the other day…and that is so another story…but one little-unnoticed tidbit stood out for me….Medicare won’t pay for your vacation illness, sort of.
Did you ever notice that everything we need to care about in aging is ‘sort of?’ I sort of have a knee problem; Insurance sort of covers that; Eggs are sort of good for you; You sort of shouldn’t drink with that medication. I digress, sort of.
We finally reach the age where we want to travel, travel, travel and there’s a big ol’ mousetrap in the middle of it. You will be entering a Rube Goldberg universe of obstacles if you don’t prepare.
If you go on vacation with Medicare all by itself and don’t take any of its friends…nope, no good, won’t pay if you trip on the gangplank of the water taxi in Venice, or puke your way through the Galapagos Islands. Certain Medigap policies will cover you for 80% of the cost in your first two months of travel. Medicare Advantage might cover some aspects of an emergency, sort of.
So it’s all kinda’ sorta’. You want to have a vacation and not just in the summer. You want to travel for fun and fun and more fun, while you’re healthy and can pay for it. C’mon universe…I earned this!
So what can you do?
- Call your insurance provider and ask…Do you cover travel? Domestically and abroad? Believe it or not, some Medicare Advantage will not cover you from state-to-state, so if you’re a snowbird….yikes! Check it out.
- Do you pay for airlifting? Getting me home from the Machu Picchu where I fell climbing the Stairs of Death on Wayna Picchu cause I forgot I wasn’t a Millennial? Do you?
- How do I file a claim for unexpected medical expenses when I get home?
- What if my preexisting condition requires some unexpected medical care while I’m traveling, do you cover that? Presumably, if you have a preexisting condition, your health insurance carrier already knows that.
But what can you do that’s best?
Dig down deep in your heart and your pocketbook and buy travel insurance. Make sure it covers all these possibilities. Because the truth of the matter is, it’s a few extra hundred dollars. If you’re paying thousands to take a glorious trip, don’t be cheap or chintzy now. Rest assured, you will probably not use it. And then thank your lucky stars, if you need it.
Bon Voyage! Love ya’, mean it!
“You Just have to Laugh…..”
©2018 Cathy Sikorski
Maybe we get by with a little help…………..
I was inspired by a Republican.
I know, you didn’t really expect that from me. I don’t do politics here, and this isn’t that.
My friend Dave likes to tease me about being a bleeding-heart liberal. But it’s truly all in fun and we do have sane, respectful conversations.
But Dave blew me away yesterday. We were at a lovely birthday party where he greeted me with “welcome to the Republican convention!” then with true pleasantries put aside, he told me he is volunteering at a local food bank.
For the entire summer and perhaps beyond, he will spend several hours a week at a local food bank. I don’t do that, do you? And he still works parttime.
I asked him how he felt about this experience two weeks in.
His biggest take away so far is that he had no idea how truly desperate so many people are, especially in his area, whiech is fairly affluent.
And that’s it right there, isn’t it?
He had no idea. Those of us who are fortunate enough to lead lives of relative prosperity have no idea. I include myself in that. As much as I like to believe I have the heart and soul of well-oiled liberal thoughts. I still, often, have no idea of the deep-down-and-dirty reality of other peoples’ struggles.
There are many ways to go with this. But for now, I’d just like to say. Maybe we could all volunteer for a day, an hour, a week, a month, a summer and see what enlightenment brings. I’m looking into it, how ’bout you? Let’s all just get a real idea. And then maybe we can come up with some workable ideas that all of us can get on board with.
We can, I know we can.
Not Just Laughing now, but not crying either….looking for a way to come together.
©2018 Cathy Sikorski
Just Tell the Truth………..
I took a friend in for some out-patient surgery. Her anesthesiologist told her that she was only going to have a sedative, like the one you get for a colonoscopy. In other words, it would not be general anesthesia. He explained that the difference. General anesthesia relaxes all the muscles, whereas the sedative just makes you sleepy. The good news is she asked to be extra-sleepy and he was totally down with that.
When I was finally allowed back to help my friend get dressed, hear her discharge instructions and get her in the wheelchair to go home, I could see that she was quite a bit loopy. She couldn’t remember everything the doctor had said. She couldn’t remember exactly why her tongue was like sandpaper. And she was uncertain of her discharge instructions.
All of which was fine, because that’s why I was there. I came as her ‘person.’ It’s pretty much standard that you bring your person to surgery with you. In fact, I highly recommend in all my seminars that you take someone with you to every serious doctor’s appointment, lawyer’s appointment, and financial advisor. Four ears are always better than two.
You absolutely must take a driver to the hospital with you when you are having any kind of sedative. You must. And yet…..
Our discharge nurse told us the tale of how some people try to pretend that their ‘person’ is coming, just not at the moment. I get that. We had to be at the hospital at 6:30 AM. Not many people want to get up in the dark to take someone to the hospital. Maybe you have a tag-team of players. You got your ‘early-riser’ and you got your ‘picker-upper.’ That’s fine. Just so long as someone is there to hear the instructions and take you home, get your meds and put you to bed.
But apparently, there is an underground of people who drive themselves, or get an Uber, or somehow show up alone. They give the intake nurse a fake phone number of their ‘picker-upper,’ and go in and get that surgery. regardless of how they are getting home.
Our nurse said she gets fake phone numbers, lies about family or friends coming, lies about where their car is when the wheelchair is at the door, lies about even where they are going to go after surgery.
If only there was a nose indicator.
She thinks that it’s because people may be private, or stubborn, or just that they don’t want to inconvenience anyone. I told her, I thought all of that is likely true.
But there’s also another possibility. Some people really don’t have a ‘person.’ They just don’t. So if you have a person. Or you can choose a person from column A or column B. Please do two things. Please don’t be dumb and go it alone…chose a person. You need them. You need them for information, for remembering and for your safety as well as for the safety of every single person trying to get home that day. Just be honest.
And two……….be ever so grateful you have a person. And maybe you can offer to be a person someday.
“You Just have to Laugh……and be a person.”
©2018 Cathy Sikorski
This is a test of my patience and WordPress
Don’t Pay Those Medical Bills…..Part Deux
I’m back…..and boy do I have a story for you!
I try so hard to let you all know the important things going on in caregiving both legally and practically. It’s so difficult for us to stay abreast of all this crazy, complex information. And yet, I too, fall prey to the insidious actions of those who would undermine all of us.
I did the one thing, the one thing I tell all of you not to do. Okay, I didn’t actually do it, but I sat side-by-side with my husband and watched him do the ONE THING I TELL ALL OF YOU NOT TO DO.
Here’s the tale:
My husband was having a routine colonoscopy. He hates that I share personal information, but in this case, it’s critical that you know exactly that. For your protection, he’s allowing me to reveal he has routine medical care. Yes, he’s that great.
The day before the procedure, my husband gets a call from the hospital. They tell him that they have called our insurance and he will have to pay a $1,190 co-pay. Yes, that is One Thousand One hundred Ninety Dollars.
This seemed really odd to me. Routine care is always covered. But I will admit that even with relatively good health insurance, we have been paying larger and larger sums every year for co-pays, deductibles, and God-forbid, out-of-network costs.
Since the hospital said they checked with our insurance and this would be our co-pay, we took the checkbook to the hospital.
Now, I bitched about this to anyone who would listen.
“Can you believe this? Almost $1200 for a CO-PAY for a ROUTINE COLONOSCOPY? No wonder people get cancer! No wonder they won’t get routine tests! That’s a mortgage payment for lots of people! That’s a car payment! Hell, that’s a mortgage payment AND a car payment for most people!
I was hopping mad. We are fortunate that we could pay, but it’s not without a big “OUCH.” I also know that there are many, many people who absolutely cannot afford $1200 out of nowhere for a ROUTINE PREVENTATIVE MEDICAL PROCEDURE. Yes, I’m yelling. Yes, I’m using exclamation points. I was pissed.
When we got to the hospital, the clerk asked how much did we want to put down on our colonoscopy. Like it was a car, a house, or some nice furniture. Because they were not taking him back there for those great drugs until we made some kind of a downpayment. For God’s sake. We just don’t want cancer….which clearly we probably wouldn’t be able to pay for either.
But I sat there, speechless, as my husband wrote a check for $1,190.
And then I got the EOB. That ‘s the Explanation of Benefits. I read every one, just to make sure our medical bills were processed and to see how much of a bill I can expect.
Guess what? The EOB for my husband’s colonoscopy showed that it was a routine procedure and we did not owe anything. Not because we owed a co-pay or a deductible that we paid in advance…but because WE DIDN’T OWE ANYTHING.
Yep. We called the hospital and the billing department said: “Oh, that’s just an estimate that they give you, they don’t really know what you will owe. We will return all your money. But you need to wait at least two weeks.”
My husband is the calm one in this house. Thank God, because they would only discuss this with him. If I had a crowbar, a siren, or a hammer that phone call would have gone so very differently.
P.S. My husband would not have checked the EOB….and I feel very certain that $1190 would have disappeared forever.
Soooooooooooooo……DO NOT PAY THOSE MEDICAL BILLS…………….JUST WAIT. I wrote the book on it and still had to be reminded the hard way.
“You Just have to Laugh……..and take your own advice……”
©2018 Cathy Sikorski
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.
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.
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.
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.
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!
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