SAVVY SENIOR
A guide to finding affordable dental care  

 

Oct. 28, 2014

Jim Miller


Q: I had dental insurance through my work for many years but lost it when I retired. Where can retirees find affordable dental care?

A: Finding affordable dental care can be challenging for seniors living on a tight budget. Most retirees lose their dental insurance after leaving the workplace, and original Medicare does not cover cleaning, fillings or dentures. While there’s no one solution to affordable dental care there are a number of options that can help cut your costs. Here’s where to look.

 

Medicare Advantage

While original Medicare (Part A and B) and Medicare supplemental policies do not cover routine dental care, there are some Medicare Advantage (Part C) plans that do. Many of these plans, which are sold through private insurance companies, cover dental care along with eye care, hearing and prescription drugs, in addition to all of your hospital and medical insurance. If you’re eligible for Medicare, see medicare.gov/find-a-plan to look for Advantage plans in your area that covers dental care.
 

Dental discounts

Another way you can reduce your dental care expenses is to join a dental discount network. How this works is you pay an annual membership fee - around $80 to $200 a year - in exchange for 10 to 60 percent discounts on service and treatments from participating dentists. To find a network, go to DentalPlans.com (or 888-632-5353) where you can search for plans and participating dentists by zip code, as well as get a breakdown of the discounts offered.

Another option that’s currently available only in the southern California area is Brighter.com. They provide users free access to a network of dentists offering up to 50 percent discounts on all services.

 

Dental schools

Dental school clinics offer savings opportunities too. All 65 accredited dental schools in the U.S. offer affordable care provided by dental students who are overseen by their professors. You can expect to pay about half of what a traditional dentist would charge and still receive excellent, well-supervised care.

Another option is to check with local colleges that offer dental hygiene programs. For training purposes, many programs provide teeth cleanings by their students for a fraction of what you’d pay at a dentist’s office.

To search for nearby dental schools or dental hygiene programs visit ada.org/dentalschools.

 

Veterans benefits

If you’re a veteran enrolled in the VA health care program, or are a beneficiary of the Civilian Health and Medical Program (CHAMPVA), the VA is now offering a dental insurance program that gives you the option to buy dental insurance through Delta Dental and MetLife at a reduced cost.

The VA also provides free dental care to vets who have dental problems resulting from service. To learn more about these options, visit va.gov/dental or call 877-222-8387.

 

Low income options

If you’re low income, there are various programs and clinics that provide dental care at a reduced rate or for free. To look for options in your area contact your state dental director (see astdd.org), or your state or local dental society (ebusiness.ada.org/mystate.aspx).

You may also be able to get discounted or free dental care at one of the federally funded HRSA health centers (findahealthcenter.hrsa.gov, 877-464-4772), or at a privately funded free clinic (nafcclinics.org).

Also check with the Dental Lifeline Network (dentallifeline.org, 888-471-6334) which provides free dental care for low-income elderly and disabled; Remote Area Medical (ramusa.org) which offers free health, eye and dental care to people in select locations; and Indian Health Service (ihs.gov), which provides free dental care to American Indians and Alaska Natives who are members of a federally recognized Indian tribe.

Also see toothwisdom.org, a website created by Oral Health America that will help you locate low-cost dental care.





How Medicare covers outpatient mental health services 
  
Oct. 21, 2014

Q: Does Medicare cover outpatient counseling or therapy sessions for seniors? Since retiring, my husband has really struggled with depression and needs to get some help. What can you tell us?

Inquiring Senior
 

A: Yes, Medicare recently upgraded its coverage of outpatient mental health services to help beneficiaries with depression and other needs. Here’s how it works.

If you have original Medicare, your Part B coverage will pay 80 percent (after you’ve met your $147 Part B deductible) for a variety of counseling and therapy services that are provided outside a hospital, like individual and group therapy, family counseling and more. They also cover services for treatment of beneficiaries who struggle with inappropriate alcohol and drug use.

You or your supplemental insurance is responsible for the remaining 20 percent coinsurance. 

Medicare also gives your husband the option of getting treatment through a variety of mental health professionals such as psychiatrists, psychologists, clinical social workers and clinical nurse specialists.

It’s also important to understand that if your husband decides to see a non-medical doctor (such as psychologists or a clinical social worker), you’ll need to make sure that he or she is Medicare-certified and takes assignment, which means they accept Medicare’s approved amount as full payment. If they don’t, Medicare will not pay for the services.

Medicare will, however, pay for the services of Medicare-certified medical doctors (such as psychiatrists) who do not take assignment, but these doctors can charge you up to 15 percent above Medicare’s approved amount in addition to the 20 percent coinsurance, which you will be responsible for.

To locate a mental health care professional in your area that accepts Medicare assignment, use Medicare’s online Physician Compare tool. Just go to medicare.gov/physiciancompare and type in your zip code, or city and state, then type in the type of profession you want locate, like “psychiatry” or “clinical psychologist” in the “What are you searching for?” box. You can also get this information by calling Medicare at 800-633-4227.

 

Medicare Advantage

If you and your husband get your Medicare benefits through a private Medicare Advantage plan, they too must cover the same services as original Medicare but they will likely require him to see an in-network provider. You’ll need to contact your plan directly for the details.

 

Additional coverage

In addition to the outpatient mental health services, you should also know that Medicare covers yearly depression screenings that must be done in a primary care doctor’s office or primary care clinic that can assure appropriate diagnosis, treatment and follow-up. Annual depression screenings are covered 100 percent.

Medicare will also cover almost all medications used to treat mental health conditions under the Part D prescription drug benefit. If your husband is prescribed an antidepressant or some other medication for his condition, and he has a Part D plan, you should call his plan to confirm coverage or you can search the plans formulary (the list of medications they cover) on their website.

For more detailed information, call Medicare at 800-633-4227 and request a copy of publication #10184 “Medicare & Your Mental Health Benefits,” or you can read it online at medicare.gov/publications/pubs/pdf/10184.pdf.

 

 

What to consider when choosing a walk-in bathtub
Oct. 14, 2014


Q: I’m interested in getting a walk-in bathtub for my wife that’s easy for her to get into and out of, but could use some assistance. Can you offer any consumer tips?

A: A walk-in bathtub is a great option for seniors with mobility problems who have trouble getting in and out of a traditional tub. But with so many options available today, choosing one can be challenging. Here are a few tips that can help.

 

Bathtub basics

Walk-in bathtubs are specialty products that have a watertight, hinged door built into the side of the tub that provides a much lower threshold to step over (usually 3 to 7 inches) versus a standard tub that’s around 15 inches.

In addition to the low threshold, most walk-in tubs also have a built-in seat, grab bars, anti-slip floors and a handheld showerhead. And many higher-end models offer therapeutic spa-like features that are great for seniors with arthritis and other ailments.

The kind of walk-in tub you choose will depend on the size and layout of your bathroom, your wife’s needs and preferences, and your budget. Prices for a good walk-in tub typically run between $3,000 and $10,000 installed. Here are some other things you should know.

Quality check: The best walk-in bathtubs on the market today are made in the USA. Also, make sure the company you choose has a lifetime “leak-proof” door seal warranty and lengthy warranties on both the tub and the operating system.

Tub size: While walk-in bathtubs vary in shape and size, most models have high-walls (three feet or higher), are 26 to 32 inches wide, and will fit into the same 60-inch long space as your standard tub without having to reconfigure the room. If the walk-in tub doesn’t quite fit your old bathtub space, extension kits are available to ensure a good fit.

Door options: Most walk-in tubs have an inward opening door, but if your wife uses a wheelchair or is a large person, an outward opening door may be a better option because they’re easier to enter and exit. But, be aware that because these doors swing out, they require more bathroom space.

One other style to consider is the “rising-wall” bathtub made by Kohler, which sits about two feet off the ground and has a side panel that slides up and down. These tubs can be entered from a seated position, which makes it a nice option for wheelchair users.

Tub type: Most companies offer several different types of walk-in tubs. The most basic type is a soaker tub, or you can get a therapeutic tub that offers either whirlpool water jets or bubble massage air jets, or a combination of the two.

Fast fill and drain: One drawback to using a walk-in bathtub is that the bather must sit in the tub as it fills and drains, which can make for a chilly experience. To help with this, choose a tub that has fast-filling faucets and pump-assisted drainage systems, which significantly speeds up the process.

Where to shop: While there are many companies that make, sell and install walk-in bathtubs, some of the best in the industry are Safe Step (www.safesteptub.com, 800-346-6616), Premier (www.premiercarebathing.com, 800-934-7614), American Standard (www.americanstandard.com, 866-423-0800) and Jacuzzi (www.jacuzzi.com, 800-288-4002). Many big box retailers like Lowes, Home Depot and Sears sell walk-in bathtubs too.

Unfortunately, Medicare does not cover walk-in bathtubs, but many companies offer financing with monthly payment plans.

To get started, contact a few companies who will send a local dealer to your home to assess your bathroom, and give you product options and estimates for free.

 


 

How to check up on your hospital
Oct. 7, 2014


Q: What resources can you recommend for researching hospitals? I need to get a knee replacement next year, and want to find a good, safe hospital to have it done in.

A: Most people don’t give much thought when it comes to choosing a hospital, but selecting the right one can be as important as the doctor you choose. Here are some tips and resources to help you research and check up on your area hospitals.

 

Hospital shopping

While you may not always have the opportunity to choose your hospital, especially in the case of an emergency, having a planned procedure can offer you a variety of choices.

When shopping for a hospital, the most important criterion is to find one that has a strong department in your area of need. A facility that excels in coronary bypass surgery, for example, may not be the best choice for a knee replacement. Research shows that patients tend to have better results when they’re treated in hospitals that have extensive experience with their specific condition.

In order to choose a hospital that’s best for you, it is important to discuss your concerns and alternatives with the doctor who is treating you. Some doctors may be affiliated with several hospitals from which you can choose. Or, if you’ve yet to select a doctor, finding a top hospital that has expertise with your condition can help you determine which physician to actually choose.

Another important reason to do some research is the all too frequent occurrence of hospital infections, which kill around 75,000 people in the U.S. each year. So checking your hospital’s infection rates and cleanliness procedures is also a wise move.

 

Researching tools

Today, there are a number of online resources that provide hospital safety and performance data to help you research and compare facilities. Because hospitals are such complex places, it’s wise to get information from a variety of sources. Here is a summary of some top guides.

Hospital Compare (medicare.gov/hospitalcompare): Operated by the Centers for Medicare and Medicaid Services, this free tool lets you compare general quality of care, as well as care for many medical conditions and surgical procedures in more than 4,000 U.S. hospitals.

Consumer Reports Hospital Rankings (consumerreports.org/hospitalratings): If you don’t mind spending a few dollars ($7 for one month or $30 per year), Consumer Reports ranks 4,500 hospitals in all 50 states plus Washington D.C. and Puerto Rico. The reliable resource provides information on up to 34 performance and safety measures.

U.S. News & World Report (usnews.com/best-hospitals): This online publishing resource identifies the best hospitals for 16 specialties, and provides rankings by metro area and by specialty for free.

Healthgrades (healthgrades.com): A private, for-profit organization, they provide free hospital ratings on patient safety and medical procedures, and scores hospitals using a 5-star scale. 

The Commonwealth Fund (whynotthebest.org): This is a private foundation that provides free performance data on all U.S. hospitals.

The Joint Commission (qualitycheck.org): This is a not-for-profit organization that accredits and certifies more than 20,500 health care organizations and programs in the U.S. Hospitals receive a checkmark for each set of measures they have met. But there’s no way to tell whether a hospital is stronger in one area over another.

Hospital Inspections (hospitalinspections.org): Established by the Association of Health Care Journalist, this focuses on violations and inspection reports.

The Leapfrog Group (hospitalsafetyscore.org): This national, not-for-profit organization grades hospitals on their overall performance in keeping patients safe. Use your city, state or ZIP code to search more than 2,500 hospitals.

VA Hospital Compare (www.hospitalcompare.va.gov): If you’re a veteran, you can research and compare VA medical centers here.

 

 

Burial and Memorial Benefits Available to Veterans
Sept. 30, 2014


Dear Savvy Senior,

Does the Veterans Administration provide any special funeral services or benefits to old veterans? My father is a 90-year-old World War II veteran with late stage Alzheimer’s, so I’m looking into funeral options and would like to know what the VA may provide.

Planning Ahead

 

Dear Planning,

Yes, the Veterans Administration offers a number of burial and memorial benefits to veterans if their discharge from the military was under conditions other than dishonorable – which will need to be verified. To do this, you’ll need a copy of your dad’s DD Form 214 “Certificate of Release or Discharge from Active Duty,” which you can request online at archives.gov/veterans.

Here’s a rundown of some of the different benefits that are available to veterans that die a non-service related death.

 

National and State Cemetery Benefits

If your dad is eligible, and wants to be buried in one of the 131 national or 93 state VA cemeteries (see www.cem.va.gov/cem/cems/listcem.asp for a list) the VA benefits provided at no cost to the family include a gravesite; opening and closing of the grave; perpetual gravesite care; a government headstone or marker; a United States burial flag that can be used to drape the casket or accompany the urn (after the funeral service, the flag is given to the next-of-kin as a keepsake); and a Presidential memorial certificate, which is an engraved paper certificate signed by the current President expressing the country’s grateful recognition of the veteran’s service.

National cemetery burial benefits are also available to spouses and dependents of veterans.

If your dad is cremated, his remains will be buried or inurned in the same manner as casketed remains.

Funeral or cremation arrangements and costs are not, however, taken care of by the VA. They are the responsibility of the veteran’s family.

 

Private Cemetery Benefits

If your dad is going to be buried in a private cemetery, the benefits available include a free government headstone or marker, or a medallion that can be affixed to an existing privately purchased headstone or marker; a burial flag; and a Presidential memorial certificate.

Funeral or cremation arrangements and costs are again the responsibility of the family, and there are no benefits offered to spouses and dependents that are buried in private cemeteries.

 

Military Funeral Honors

Another popular benefit available to all eligible veterans buried in either a national or private cemetery is a military funeral honors ceremony. This includes folding and presenting the U.S. burial flag to the veteran’s survivors and the playing of Taps, performed by two or more uniformed military members.

The funeral provider you choose will be able to assist you with all VA burial requests. Depending on what you want, certain forms may need to be completed which are always better to be done in advance. For a complete rundown of burial and memorial benefits, eligibility details and required forms, visit www.cem.va.gov or call 800-827-1000.

 

Burial Allowances

In addition to the many burial benefits, some veterans may also qualify for a $734 burial and funeral expense allowance (if hospitalized by VA at time of death), or $300 (if not hospitalized by VA at time of death), and a $734 plot-interment allowance to those who choose to be buried in a private cemetery. To find out if your dad is eligible, see benefits.va.gov/benefits/factsheets/burials/burial.pdf.

To apply for burial allowances, you’ll need to fill out VA Form 21-530 “Application for Burial Benefits.” You need to attach a copy of your dad’s discharge document (DD 214 or equivalent), death certificate, funeral and burial bills. They should show that you have paid them in full. You may download the form at va.gov/vaforms.

 


Vaccination Options Available to Seniors this Flu Season 
  
Sept. 23, 2014


Dear Savvy Senior,

I understand that there are several types of flu vaccines being offered to seniors this flu season. What can you tell me about them?

Cautious Senior

 

Dear Cautious,

Depending on your health, age and personal preference, there’s a buffet of flu shots available to seniors this flu season, along with two vaccinations for pneumonia that you should consider getting too.

                                                                                         

Flu Shots Options

Just as they do every year, the Centers for Disease Control and Prevention (CDC) recommends a seasonal flu shot to almost everyone, but it’s especially important for seniors who are at higher risk of developing serious flu-related complications. The flu puts more than 200,000 people in the hospital each year and kills around 24,000 – 90 percent of whom are seniors. Here’s the rundown of the different options:
 

Standard (trivalent) flu shot: This tried-and-true shot that’s been around for more than 30 years protects against three strains of influenza. This year’s version protects against the two common A strains (H1N1 and H3N2), and one influenza B virus.

Quadrivalent flu shot: This vaccine, which was introduced last year, protects against four types of influenza – the same three strains as the standard flu shot, plus an additional B-strain virus.

High-dose flu shot: Designed specifically for seniors, age 65 and older, this vaccine, called the Fluzone High-Dose, has four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protection. But, be aware that the high-dose option may also be more likely to cause side effects, including headache, muscle aches and fever.

Intradermal flu shot: If you don’t like needles, the intradermal shot is a nice option because it uses a tiny 1/16-inch long micro-needle to inject the vaccine just under the skin, rather than deeper in the muscle like standard flu shots. This trivalent vaccine is recommended only to those ages 18 to 64.

To locate a vaccination site that offers these flu shots, visit vaccines.gov and type in your ZIP code. You’ll also be happy to know that if you’re a Medicare beneficiary, Part B will cover 100 percent of the costs of any flu shot, as long as your doctor, health clinic or pharmacy agrees not to charge you more than Medicare pays. Private health insurers are also required to cover standard flu shots, however, you’ll need to check with your provider to see if they cover the other vaccination options.

 

Pneumonia Vaccines

The other important vaccinations the CDC recommends to seniors, especially this time of year, are the pneumococcal vaccines for pneumonia. An estimated 900,000 people in the U.S. get pneumococcal pneumonia each year, and it kills around 5,000. 

This year, the CDC is recommending that all seniors 65 or older get two separate vaccines, which is a change of decades-old advice. The vaccines are Prevnar 13 and Pneumovax 23. Previously, only Pneumovax 23 was recommended for seniors.

Both vaccines, which are administered just once, work in different ways to provide maximum protection.

If you haven’t yet received any pneumococcal vaccine you should get the Prevnar 13 first, followed by Pneumovax 23 six to 12 months later. But, if you’ve already been vaccinated with Pneumovax 23 you should get Prevnar 13 at least one year later.

Medicare currently covers only one pneumococcal vaccine per older adult. If you’re paying out of pocket, you can expect to pay around $50 to $85 for Pneumovax 23, and around $120 to $150 for the Prevnar 13.

 

Wandering solutions for Alzheimer’s caregivers 
Sept. 16, 2014



Q: My mother, who lives with me, has Alzheimer’s disease and I worry about her wandering away. What tips can you recommend to help me protect her?

A: According to the Alzheimer’s Association, about 60 percent of people who suffer from dementia wander at some point. For caregivers, this can be frightening because many of those who wander off end up confused and lost, even in their own neighborhood, and are unable to communicate who they are or where they live. But there are things you can do to guard against this and protect your loved one.

 

Wandering prevention

For starters, to help reduce your mom’s tendency to wander, keep her occupied and involved in familiar daily activities such as preparing dinner or folding the laundry. It’s also important to encourage daily exercise and limit daytime napping to reduce nighttime restlessness.

There are also a number of simple home modifications you can make to keep her from wandering away. Some possible solutions include: adding an extra lock on the top or bottom of the exterior doors out of the line of sight; install child-proof door knobs or levers; place a full-length mirror, or put a “STOP” or “Do Not Enter” sign on the doors you don’t want her going through; or get a signal device or motion sensor that lets you know when the door is opened. See alzstore.com for a variety of product solutions. And, be sure you hide the car keys to keep her from driving.

It’s also a good idea to alert your neighbors that your mom may wander so they can keep an eye out, and have on hand a recent picture to show around the neighborhood or to the police if she does get lost.

 

Wandering services

If you want some added protection in case she does wander off, there are a number services you can turn to for help, like the MedicAlert + Safe Return program (medicalert.org/safereturn).

This service comes with a personalized ID bracelet that will have your mom’s medical information engraved on it, along with her membership number and the toll-free MedicAlert emergency phone number.

If she goes missing, you would call 911 and report it to the local police department who would begin a search, and then report it to MedicAlert. Or, a Good Samaritan or police officer may find her, call the MedicAlert number, to get her back home safely.

Another option that could help, depending on where you live, is a radio frequency locater service like SafetyNet and Project Lifesaver, which are offered by some local law enforcement agencies.

With these services, your mother would wear a wristband that contains a radio transmitter that emits tracking signals. If she goes missing, you would contact the local authorities who would send out rescue personnel who will use their tracking equipment to locate her. Visit safetynetbylojack.com and projectlifesaver.org to see if these services are available in your community.

 

GPS tracking

There are also a number of GPS tracking devices that can help you keep tabs on your mom. With these products, she would carry or wear a small GPS tracker that would notify you or other caregivers via text message or email if she were to wander beyond a pre-established area, and would let you know exactly where to find her if she did.

To find GPS trackers, consider the PocketFinder (pocketfinder.com) or the Alzheimer’s Association Comfort Zone (alz.org/comfortzone). Or, if you have concerns that your mother wouldn’t wear a GPS device or would take it off, there’s the GPS SmartSole (gpssmartsole.com), which is an insole with an embedded GPS device.

For more wandering prevention tips and solutions, visit the Alzheimer’s Association Safety Center at alz.org/safety and This Caring Home at thiscaringhome.org.

 


Ergonomic tools that can ease gardening pains 
Sept. 9, 2014


Q: Are brand-name medications better than generic, and if not, why is there such a price difference? Also, how can I find out which medicines are available in generic form.
 

A: No. Brand-name medications are not better, safer or more effective than their generic alternative because they’re virtually the same.

To gain approval from the U.S. Food and Drug Administration (FDA), generic drugs are required to the same active ingredient, strength, dosage form and route of administration as their brand-name counterpart. The generic manufacturer must also demonstrate that people absorb the drug at the same rate.

The only difference between a brand-name drug and its generic is the name (generics are usually called by their chemical name), shape and color of the drug (U.S. trademark laws don’t allow generics to look exactly like the their brand-name counterparts) and price. Generic drugs are often 10 to 30 percent cheaper when they first become available, but by the end of the first year the price can drop in half. And by the second and third year it can drop 70 to 90 percent.

 

Cost difference

The reason generic drugs are so much cheaper is because their manufacturers don’t have the hefty start-up costs that the original creators of the drug do. When a pharmaceutical company creates a new drug, it spends millions of dollars on the research, development and clinical testing phase. Then, if it gets FDA approval, it has to turn around and spend even more money to market the drug to the health care industry and the public.

The total cost can rise into the hundreds of millions by the time the drug is in the hands of consumers.

In an effort to recoup their investment, the brand-name drug makers charge a premium price, and are given a 20-year patent protection, which means that no other company can make or sell the drug during that period of time.

After those 20 years are up, however, other companies can apply to the FDA to sell generic versions. But because generic manufacturers don’t have the same research, development and marketing costs, they can sell their product much cheaper.

Also, once generic drugs are approved, there’s greater competition, which drives the price down. Today, nearly 8 in 10 prescriptions filled in the United States are for generic, which saves U.S. consumers around $3 billion every week.

 

New generics

You should also know that in 2014 and 2015, patents on a wide variety of popular brand-name drugs will expire and become available in generic, including Celebrex, Copaxone, Actonel, Nexium, Exforge, Cymbalta, Lunesta, Avodart, Abilify, Evista, Maxalt, Maxalt MPT, Micardis, Micardis HCT, Reneagel, Twynata and Xeloda.

For more information, Community Catalyst, a national, nonprofit consumer advocacy organization provides a list on their website of the top 50 brand-name drugs and the dates they should become available as generics. Go to communitycatalyst.org, and type “Drugs Going Generic 2014 - 2015” in their search bar to find it.

You can also find out if a brand-name drug has a generic alternative by simply asking your doctor or pharmacist. Or, visit GoodRX.com, a Web tool that provides prices on brand-name drugs and their generic alternatives (if available) at virtually every pharmacy in the U.S. so you can find the best deals in your area.





 

How to recognize and handle senior gambling problems   
Sept. 2, 2014


Q: How can you know when someone has a gambling problem? Since my father passed away a couple years ago, my 76-year-old mother spends a lot of time at an Indian casino near her house playing slot machines.

A: It's a great question. Problem gambling among seniors is definitely on the rise. Seniors have time and money on their hands, and the influx of casinos across the country have made access to gambling much more convenient. Here’s what you should know, along with some tips and resources that can help your mom if she does indeed have a problem.

 

Problem gambling

For most older adults, gambling is simply a fun recreational activity, but for those who become addicted to it, it can be a devastating disease that can financially wipe them out.

There are a number of reasons why seniors can be vulnerable to gambling problems. For starters, seniors are often catered to by casinos with free bus transportation, free or discounted meals, special rewards and other prizes as a way to entice them.

In addition, many seniors use gambling as a way to distract or escape feelings of loneliness, depression, sadness, or even a chronic health condition. Some may have financial problems they are seeking to overcome. And some may have cognitive impairment that interferes with their ability to make sound decisions.

Adding to the problem is that many seniors may not understand addiction, making them less likely to identify a gambling problem. Or they may be confused or embarrassed that they can’t control their urges to gamble and reluctant to seek help because they think that at their age, they should know better. And even if they recognize that they have a problem, they may not know that help is available or where to get it.

You should also know that while there are many gambling options for people to get hooked on today, casino slot machines are far and away the most popular among seniors. Slot machines are much more addictive then the old machines of yesteryear with spinning lemons, cherries and melons. Many of today’s slot machines offer intense sensory stimulation with large video screens, music and vibrating, ergonomic chairs.

 

Find help

How can you know if your mom has a gambling problem? Gamblers Anonymous offers a 20 question online test at gamblersanonymous.org that your mom can take to help determine if she has a problem. In the meantime, here are some questions you can ask to help evaluate her situation.

Is she preoccupied with gambling, constantly talking about it, or planning to gamble versus doing her normal activities?

Is she gambling more and more money to get the same level of excitement?

Is she using her retirement funds or other savings to gamble, or is she pawning or selling personal items to get money to gamble with?

Has she lost control to the point that she can’t she set a limit of time and money to spend in the casino, and stick to it?

Does she become uncomfortable, angry or lie when you ask her about her gambling activities?

If your mom answers yes to any of these questions, she may have a problem. To find help contact the National Council on Problem Gambling (www.ncpgambling.org), a non-profit organization that operates a 24-hour national hotline at 800-522-4700. They can direct you to resources in your area, including counselors who have been trained through the National Certified Gambler Counseling Program.

 





How to get a Medicare covered power scooter or wheelchair   
August 19, 2014


Q: What’s the process for getting Medicare to pay for an electric mobility scooter or power wheelchair? My 76-year-old mother has arthritis in her knees and hips, and has a difficult time getting around anymore.
 

A: Getting an electric-powered mobility scooter or wheelchair for your mom that’s covered by original Medicare starts with a visit to her doctor’s office. If eligible, Medicare will pay 80 percent of the cost, after she meets her $147 Part B deductible. She will be responsible for the remaining 20 percent. Here’s a breakdown of how it works.
 

Make an appointment

Your first step is to call your mom’s doctor and schedule a Medicare required, face-to-face mobility evaluation, to determine her need for a power wheelchair or scooter. For your mom to be eligible, she’ll need to meet all of the following conditions:

- Her health condition makes moving around her home very difficult, even with the help of a cane, walker or manual wheelchair.

- She has significant problems performing activities of daily living like bathing, dressing, getting in or out of a bed or chair, or using the bathroom.

- She is able to safely operate, and get on and off the scooter or wheelchair, or have someone with her who is always available to help her safely use the device.

If eligible, your mom’s doctor will determine what kind of mobility equipment she’ll need based on her condition, usability in her home, and ability to operate it.

It’s also important to know that Medicare coverage is dependent on your mom needing a scooter or wheelchair in her home. If her claim is based on needing it outside her home, it will be denied as not medically necessary, because the wheelchair or scooter will be considered as a leisure item.

 

Where to shop

If the doctor determines your mom needs a power scooter or wheelchair, he or she will fill out a written order or certificate of medical necessity (CMN) form for her. Once she gets that, she’ll need to take it to a Medicare approved supplier within 45 days. If your mother happens to live in one of Medicare’s competitive bidding areas, you’ll need to get her device from specific suppliers approved by Medicare. To find approved suppliers and competitive bidding suppliers in your area, visit medicare.gov/supplier or call 800-633-4227.

Once you choose an approved supplier, they will send a representative to assess your mom’s home measuring her doorways, thresholds and overall space to ensure she gets the appropriate mobility device.

 

Financial assistance

If your mom has a Medicare supplemental policy, it may pick up some, or all of the 20 percent cost of the scooter or wheelchair that’s not covered by Medicare. If, however, she doesn’t have supplemental insurance, and can’t afford the 20 percent, she may be able to get help through Medicare Savings Programs. Call your local Medicaid office for eligibility information.

Or, if you find that your mom is not eligible for a Medicare covered scooter or wheelchair, and she can’t afford to purchase one, renting can be a much cheaper short-term solution. Talk to a supplier about this option.

For more information, call Medicare at 800-633-4227 and request a copy of publication #11046 “Medicare’s Wheelchair and Scooter Benefit,” or you can read it online at medicare.gov/publications/pubs/pdf/11046.pdf.

 

Medicare advantage

If your mom happens to have a Medicare Advantage plan (like an HMO or PPO), she’ll need to call her plan to find out the specific steps she needs to take to get a wheelchair or scooter. Many Advantage plans may have specific suppliers within the plan’s network they’ll require her to use.

 

 

 

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