Archive for December, 2016

Share of Cost, Making Medicare Enrollment Clear and Simple

Saturday, Dec. 31st 2016 6:29 AM

The enrollment process for Medicare has not been updated for over 50 years when Medicare began. As a result 3/4 of a million Americans are paying a lifetime late enrollment penalty on their Medicare Part B premiums that is sometimes 30% or more of the current premium amount. In the past, most people who qualified for Social Security benefits at 65 years of age, were also then automatically enrolled into Medicare (as 65 is the general age of Medicare eligibility). Yet, now people born between 1948-1960 don’t qualify for full Social Security benefits until ages 66 to 67. (Full retirement age for people born in 1960 or later is 67). Also, more people are working longer and actively delaying the collection of their Social Security benefits. This means more and more people are no longer automatically enrolled in Medicare when turning 65. Yet, the federal government has no a formal notification system to let these people know about their Medicare eligibility, how and when to enroll and the financial consequences for not enrolling when first eligible.

The Beneficiary Enrollment Notification and Eligibility Simplification Act (BENES) Act (S.3236 and H.R. 5772) simplifies the Part B enrollment process through reforms and required statutory changes. This is the culmination of several years of work in which California Health Advocates (CHA) and other national consumer groups have worked with the Centers for Medicare and Medicaid Services, sent numerous other sign-on letters, and discussed remedies for the disconnect between Social Security benefits and eligibility for Medicare and other enrollment problems. This legislation is the end result and we urge you to support its success.

Below is a summary of the BENES Act of 2016 by the Medicare Rights Center. Here is also a section-by-section summary of the Act (HR5772).

MEDICARE ENROLLMENT SHOULD NOT BE A GAMBLE

THE BENES ACT (S.3236/H.R. 5772) OFFERS NEEDED SOLUTIONS

The laws underpinning Part B enrollment have not been revisited in over 50 years, since Medicare was first established. As a result, today nearly 750,000 Americans are paying a statutory lifetime late enrollment penalty, often 30% or more of their monthly Part B premium. Why? Because while people with Social Security benefits are automatically enrolled in Medicare, an increasing number of Americans are working longer, delaying retirement, and deferring Social Security. With fewer people automatically enrolled—and 10,000 Baby Boomers aging into Medicare each day—more people new to Medicare must actively enroll in Part B. Unfortunately, many such individuals fail to do so properly.

Different enrollment rules apply to those without coverage, with employer-based coverage, with retiree coverage, with COBRA coverage, and now with Marketplace coverage. The rules are so complicated that even the most sophisticated Human Resources (HR) departments struggle to follow them. Many retirees and people with disabilities who are paying for private coverage learn only after medical treatment that their insurance is “secondary” to Medicare and that relying on their insurance, instead of Part B, creates a “gap”—which can cost hundreds of thousands of dollars out-of-pocket.

Clear and simple advice to those approaching eligibility could help address the problem, but today the federal government provides no notification to people nearing Medicare eligibility that must actively enroll about when and how to do so. For those who make an honest mistake, an opaque process—known as equitable relief—requires them to prove they received erroneous advice from a federal official—a standard virtually impossible to meet. Championed by Congressmen Raul Ruiz (D-CA) and Patrick Meehan (R-PA) and Senators Bob Casey (D-PA) and Chuck Schumer (D-NY), the bipartisan, bicameral Beneficiary Enrollment Notification and Eligibility Simplification Act (BENES) Act (S.3236 and H.R. 5772) modernizes and simplifies the Part B enrollment process through a series of reforms that require statutory changes.

THE BENES ACT:

Increases Notification and Education. The BENES Act will create a pathway for the Department of Health and Human Services (HHS), Social Security Administration (SSA), and Internal Revenue Service (IRS) to work together and notify individuals approaching eligibility about enrollment rules and how other insurance works with Medicare.

Eliminates Coverage Gaps during Enrollment Periods. The BENES Act guarantees that people with Medicare do not experience a break in critical coverage. Specifically, the bill will fix coverage gaps in the 5th, 6th a person’s Initial Enrollment Period (IEP) and in the General Enrollment Period (GEP).

Updates Avenues for Relief. Current law provides no standardized process for those seeking equitable relief for failing to enroll in Medicare. Many beneficiaries are obliged to pay a lifetime Part B premium penalty or experience gaps in coverage as a result of misinformation by a trusted source. Consequently, the BENES Act will make the criteria for equitable relief requests more flexible.

PLEASE CO-SPONSOR THE BENES ACT TO MODERNIZE PART B ENROLLMENT LAWS AND ENSURE PEOPLE WITH MEDICARE ARE GETTING THE COVERAGE THEY DESERVE.

 

Posted on Saturday, Dec. 31st 2016 6:29 AM | by Share of Cost | in Social Security | No Comments »

Share of Cost, Difference Between Mouth Rinse and Mouthwash

Thursday, Dec. 29th 2016 3:13 PM

Many people thing mouth rinse and mouthwash are the same, but that would be wrong.

Mouthwash: Mouthwash is used to help freshen your breath.

Mouth Rinse: An antiseptic mouth rinse, however, will actually help to reduce the bacterial load found in plaque. By using mouth rinse it will help prevents plaque build-up more than just brushing and flossing alone.

Posted on Thursday, Dec. 29th 2016 3:13 PM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Brush Your Teeth Twice a Day

Tuesday, Dec. 27th 2016 6:11 AM

Removes Plague Build Up

Teeth decay when bacteria and plaque are allowed to build up in the mouth and eat away. Plaque that is not removed with thorough daily brushing and cleaning between teeth can eventually harden into calculus or tartar.   Brushing removes plaque from the tooth surfaces. Brushing your teeth with fluoride toothpaste is your best bet when it comes to keeping your teeth in tip-top shape.   Brush your teeth twice a day, with a soft-bristled brush. Brushing your teeth twice a day can save you hundreds of dollars–sometimes thousands–in dental work.

Posted on Tuesday, Dec. 27th 2016 6:11 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Genomics study points to origins of pollen allergens

Sunday, Dec. 25th 2016 6:00 AM

A joint University of Adelaide-Shanghai Jiao Tong University study has provided the first broad picture of the evolution and possible functions in the plant of pollen allergens.

Published in the journal Plant Physiology, the researchers believe their work may help with medical research into the reduction or prevention of allergic diseases such as asthma and allergic rhinitis (hay fever).

Posted on Sunday, Dec. 25th 2016 6:00 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Flossing

Friday, Dec. 23rd 2016 6:50 AM

Flossing is fundamental part of your at home dental habit in order to keep your teeth and gums clean. However you only get the benefits of flossing when you do it right. Snapping and popping your way through the process probably does more harm than good, causing friction on tissue and damage at the gum line. Instead, use about two inches of floss between your fingers, unroll a fresh section of floss for each tooth, and keep the floss tight against your tooth to break up plaque while leaving your gums in good shape.

Posted on Friday, Dec. 23rd 2016 6:50 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Brushing Your Teeth

Wednesday, Dec. 21st 2016 6:58 AM

A way to avoid having expensive dental visits is by having good at home dental habits. One of the first dental care habits we think of is brushing our teeth. Brushing our teeth once a day is good, but the American Dental Association says to brush twice a day. Use a soft-bristled toothbrush and a fluoride toothpaste. By brushing twice daily, it helps to prevents plaque from forming in the first place and disrupts any plaque that has already started to form. When brushing your teeth you want to make sure you get to all the areas of your mouth with your toothbrush, including teeth, gums, tongue, and the insides of your cheeks. In general, the process should take about 2 minutes.

 

Posted on Wednesday, Dec. 21st 2016 6:58 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Cleaning Between Your Teeth

Monday, Dec. 19th 2016 6:07 AM

If you are only brushing your teeth you are only doing half the job. Cleaning between your teeth every day can have a crucial impact on your oral health, that is why it is important to make sure and floss daily.   If you have a tough time reaching certain parts of your mouth to floss, ask your dentist about interdental brushes, floss aides, or water or air-flossing devices.

Posted on Monday, Dec. 19th 2016 6:07 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Does insurance cover the cost of sealants?

Saturday, Dec. 17th 2016 6:06 AM

Dental insurance will often cover the cost of dental sealants; however, this is dependent on the level of insurance you purchased.  Insurance benefits for sealant procedures have increased considerably, especially as companies start to realize that sealants are a proven preventive technique. You should check with your insurance company about coverage though and with your dentist to see how much they will cost.  Before you take up insurance on teeth, talk with your insurance agent as to if cover is provided for teeth sealant application.

Posted on Saturday, Dec. 17th 2016 6:06 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, CHA Launches New Website Making Medicare Accessible for Californians

Thursday, Dec. 15th 2016 6:16 AM

“Making Medicare understandable and accessible in a friendly, feel-good way” is one of the goals of the newly launched website for California Health Advocates (CHA). “With close to 1,000 pages of quality and reliable Medicare information for consumers and professionals, we strive for a site that is both welcoming and easy for people to get their questions answered and equipped with helpful resources,” said Tatiana Fassieux, Board Chair for California Health Advocates.

CHA’s new website (cahealthadvocates.org) serves beneficiaries, their families and caregivers, and professionals

Posted on Thursday, Dec. 15th 2016 6:16 AM | by Share of Cost | in Social Security | No Comments »

Share of Cost, Should Children Get Dental Sealants?

Tuesday, Dec. 13th 2016 2:56 PM

Children should receive sealants on permanent molars as soon as they erupt (about ages 6 and 12 years).  Children with unmet dental needs suffer the daily distraction of chronic toothaches, the acute and searing pain of dental abscesses, disfigured smile, dysfunctional speech, and difficulty eating.  Children with dental decay who lack access to dental care are often not brought to seek care until decay is severe.

Children are not stigmatized by being singled out during the screening and sealing process.  Children need dental sealants applied again when new molars emerge, usually around twelve years of age.  Children should get sealants on their permanent molars as soon as the teeth come in  before decay attacks the teeth.  Children who would benefit most from sealants include those with existing pits and fissures that may develop cavities or those with risk factors for cavities.  Children with sealants still should: Brush twice a day with a pea-size amount of fluoride toothpaste.

 

Posted on Tuesday, Dec. 13th 2016 2:56 PM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Simple, sensitive, and cost-effective assays for analyzing fragile X

Sunday, Dec. 11th 2016 7:00 AM

Tests useful for preclinical and clinical research on a genetic mutation related to autism and intellectual disability may become more available, reports The Journal of Molecular Diagnostics.

Fragile X syndrome, the most common heritable cause of intellectual disability and a frequent cause of autism, is characterized by abnormalities of the FMR1 gene that are difficult to analyze. Preclinical studies of Fragile X and the Fragile X””related disorders are hampered by the lack of low-cost and sensitive yet simple methods. National Institutes of Health (NIH) researchers have now developed a set of assays that are robust, cheap enough for routine research use, and may be suitable for initial patient screening, according to a new report in The Journal of Molecular Diagnostics.

Posted on Sunday, Dec. 11th 2016 7:00 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, How Much Do Dental Sealants Costs?

Friday, Dec. 9th 2016 6:37 AM

Treatment is cost effective because sealing a tooth costs less than filling one.  The cost of dental sealants can range from approximately $25 to $50 per tooth.  Of course, this may be a small price to pay compared to the discomfort and cost associated with dental procedures that may become necessary if your teeth remain unprotected.

The cost of dental sealants varies with location and practice, but is considered inexpensive compared to repairs and fillings.  Dental sealants have been proven a safe and cost-efficient dental procedure.  Sealants cost less than getting a single cavity filled.

Posted on Friday, Dec. 9th 2016 6:37 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Gaining Coverage Through Medicaid Or Private Insurance Increased Prescription Use And Lowered Out-Of-Pocket Spending

Wednesday, Dec. 7th 2016 12:30 PM

A growing body of literature describes how the Affordable Care Act (ACA) has expanded health insurance coverage. What is less well known is how these coverage gains have affected populations that are at risk for high health spending. To investigate this issue, we used prescription transaction data for a panel of 6.7 million prescription drug users to compare changes in coverage, prescription fills, plan spending, and out-of-pocket spending before and after the implementation of the ACA’s coverage expansion. We found a 30 percent reduction in the proportion of this population that was uninsured in 2014 compared to 2013. Uninsured people who gained private coverage filled, on average, 28 percent more prescriptions and had 29 percent less out-of-pocket spending per prescription in 2014 compared to 2013. Those who gained Medicaid coverage had larger increases in fill rates (79 percent) and reductions in out-of-pocket spending per prescription (58 percent). People who gained coverage who had at least one of the chronic conditions detailed in our study saw larger decreases in out-of-pocket spending compared to those who did not have at least one condition. These results demonstrate that by reducing financial barriers to care, the ACA has increased treatment rates while reducing out-of-pocket spending, particularly for people with chronic conditions.

Posted on Wednesday, Dec. 7th 2016 12:30 PM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Dental Visits

Monday, Dec. 5th 2016 6:35 AM

Even though most people know that regular dental check ups are important part of our oral health care, roughly 50% of adults in the United States still do not see a dentist on a yearly basis. The main reasons for that is do to  “dentist-phobia,” finances, or just plain neglect. If you are part of the 50% that is prone to ditching the dentist, keep in mind that by having regular trips to the dentist your dentist can catch problems such as tooth decay, gum disease, trauma, or cancer at an early stage when they are treatable and treatments are more affordable.

Posted on Monday, Dec. 5th 2016 6:35 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, What are Dental Sealants?

Saturday, Dec. 3rd 2016 6:33 AM

Dental sealants are thin plastic coatings that are applied to the grooves on the chewing surfaces of the back teeth to protect them from tooth decay.  Dental sealants are effective in preventing dental caries in the occlusal (chewing) and other pitted and fissured surfaces of the teeth.  Dental sealants were assessed in permanent molars (occlusal and buccal surfaces in lower molars and occlusal and lingual surfaces in upper molars), premolars (occlusal surface), and upper lateral incisors (lingual surface).

Dental sealants are highly effective in preventing dental caries that occur on the surfaces of teeth that have pits and fissures.  Dental sealants are usually applied in a dentist’s office.  Dental sealants last for 4-5 years and can easily be reapplied by your dentist when they do wear off.  Dental sealants represent one of the greatest, but least known advances, of modern dentistry.

 

Posted on Saturday, Dec. 3rd 2016 6:33 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, New opioid as effective as morphine, without the side effects

Thursday, Dec. 1st 2016 5:00 AM

Opioids are among the most commonly prescribed painkillers in the United States, and they are also the deadliest; each day, 78 Americans die from an opioid overdose. Now, scientists have developed a safer form of the drug, which they say could reduce the number of overdoses and combat addiction.

Posted on Thursday, Dec. 1st 2016 5:00 AM | by Share of Cost | in Share of Cost | No Comments »