Insurance For Over 65

Serving Georgia, Alabama, and Florida

Greg Nicholaides

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How To Overcome Fear When Donating Blood

Heart Healthy Tips – Feb. 24, 2020

While none of us typically enjoy getting blood taken, there are many people out there who genuinely fear needles. If you’re one of these people, don’t worry, you are far from alone. This fear is one of the top 10 rated fears in the United States, with 50 million Americans suffering from an extreme fear of needles. This intense anxiety can disrupt both important medical procedures and routine health maintenance. Not only is it a huge deterrent for getting your annual flu shot, which is critically important for preventing the spread of influenza, but it can also discourage people from donating blood.

The anxieties that we feel about needles often don’t match up with the reality of the situation. Getting blood drawn or getting a shot is minimally painful and under the right sanitary circumstances, generally very safe. The issue has to do with mental attitudes surrounding the event. The needles used to draw blood are usually only 16- or 17-gauge needles, which are not wide enough in diameter to cause you any severe pain or bodily harm. Learning the importance behind blood donation and how to better prepare can help make it less intimidating in the future.

Why You Should Donate Blood

Donating blood is an important part of our established medical system and it saves countless lives. Hundreds to thousands of patients need blood each day in both regular and emergency transfusions. Approximately 36,000 units of blood are needed every day for these transfusions, and banks aren’t building the stockpile that they need for patient security. Blood donations are a vital source of life for many people including cancer patients, accident victims, post-operation patients, and many more.

Furthermore, donating blood not only saves lives, but it also has tangible benefits for the donor. Donating blood can actually improve the viscosity of your blood and improve overall cardiovascular health.

How to Prepare for Your Donation

Even if you cannot seem to manage your anxiety about needles, there are some things that you can do to make the process easier. One of the most important things you can do is to properly prepare your body with a few simple steps:

  • Make sure that you get plenty of sleep the evening before
  • Eat a balanced meal before you go and a snack right afterward
  • Avoid fatty foods due to the fat deposits that can build up in your blood
  • Drink plenty of water to hydrate your veins and prevent passing out

When you get to the actual facility, try to do everything you can to calm your nerves. Try closing your eyes to avoid catching sight of the needle and its insertion. Additionally, nurses say that talking through the insertion can distract patients enough to skirt major anxiety.

Spreading the Love

Overall, blood donation provides an important resource to those in need, and regular donations should be praised. While blood donation has many benefits, it’s still important for everyone to stay up to date on their doctors’ visits to keep track of their cardiovascular health! Regular visits to the cardiologist and a heart-healthy lifestyle are strongly encouraged. Check out our blog for tips or schedule a visit with one of our qualified doctors today!

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You Can Fight a Denied Medicare Advantage Claim

By ELEANOR LAISE, Senior Editor

Kiplinger’s Retirement Report – Feb. 2020

If a Medicare Advantage plan denies you coverage for medically necessary care, don’t take it lying down. File an appeal, and your odds are good that the plan will overturn its decision.

That’s the message for consumers in a recent government report examining service and payment denials in Medicare Advantage plans, which are offered by private insurers and often combine basic Medicare benefits with drug, dental and vision coverage in a single package.

Looking at appeals filed by Advantage enrollees and health care providers between 2014 and 2016, the U.S. Department of Health and Human Services’ Office of Inspector General found that plans overturned 75% of their own denials.

“The high number of overturned denials raises concerns that some Medicare Advantage beneficiaries and providers were initially denied services and payments that should have been provided,” the report says. To make matters worse, enrollees and providers appeal only 1% of denials, the Inspector General found, suggesting that some beneficiaries may be going without needed services or paying out of pocket for care.

And for patients, plan denials may have even broader repercussions. “If a provider is denied payment, they may be more reticent to provide certain services” in the future, says Leslie Fried, senior director at the National Council on Aging’s Center for Benefits Access.

Inappropriate denials are a growing concern as the number of Medicare Advantage plan beneficiaries soars. Advantage plans had 21 million enrollees in 2018, up from 8 million in 2007. As the government gives Advantage plans added flexibility, such as allowing them to offer supplemental benefits not covered by traditional Medicare, that number is likely to grow. But unlike traditional Medicare beneficiaries, Advantage plan enrollees looking to limit their costs must stay within their plan’s network of providers and may need referrals to see specialists.

“Medicare Advantage plans are committed to providing quality, affordable and appropriate care to patients,” says Cathryn Donaldson, a spokesperson for America’s Health Insurance Plans, a health insurance industry group. A denial, she says, “can often be a request for additional information for the claim, or a move to an alternative treatment that’s more effective.”

Dealing With a Medicare Denial

It’s critical for Advantage plan beneficiaries to read their denial notices, understand their rights to appeal and file appeals promptly, patient advocates say.

But the denial notices that plans send to enrollees aren’t always clear, says Fred Riccardi, vice president of client services at the Medicare Rights Center. In 2015, audits by the Centers for Medicare and Medicaid Services (CMS) found that 45% of Advantage plans sent denial letters with incomplete or incorrect information, according to the Inspector General’s report.

Follow the instructions on the denial notice to make your appeal. Ask your doctor to write a letter explaining why you need the care. And understand the timeline to make your claim. Advantage enrollees have only 60 days from the date of the denial notice to file an appeal with the plan, compared with 120 days for traditional Medicare beneficiaries. The plan must then make a decision within 30 days if it’s denying a service that you haven’t yet received, or 60 days if it’s refusing to pay for a service that you already received. If your health could be harmed by waiting for the standard appeals process to play out, request an expedited appeal, which requires a decision within 72 hours.

If the plan rejects your initial appeal, your claim will be automatically forwarded to an independent entity for review. And if your appeal is rejected there, you still have up to three more levels of appeal.

Helping Hands

The appeals process can be overwhelming, particularly for patients who are sick or frail. Find expert assistance through these resources:

State health insurance assistance programs. To find your local program, go to shiptacenter.org or call 877-839-2675.

Medicare Rights Center. An advocacy group for Medicare beneficiaries. Go to medicarerights.org or call 800-333-4114.

Legal aid programs. Find legal services in your area at eldercare.acl.gov or call 800-677-1116.

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Why Refined Carbs and Sugar are so Bad for Your Health

By Lawrence Robinson, Jeanne Segal, Ph.D., and Robert Segal, M.A. – June 2019

They’re the comfort foods we most often crave: pasta, fries, pizza, white bread, sugary desserts. But here’s how choosing healthier carbs can improve your health and waistline.

Refined or simple carbohydrates include sugars and refined grains that have been stripped of all bran, fiber, and nutrients. These include white bread, pizza dough, pasta, pastries, white flour, white rice, sweet desserts, and many breakfast cereals. They digest quickly and their high glycemic index causes unhealthy spikes in blood sugar levels. They can also cause fluctuations in mood and energy and a build-up of fat, especially around your waistline.

When you eat refined carbs, your bloodstream is flooded with sugar which triggers a surge of insulin to clear the sugar from your blood. All this insulin can leave you feeling hungry soon after a meal, often craving more sugary carbs. This can cause you to overeat, put on weight, and over time lead to insulin resistance and type-2 diabetes. Diets high in refined carbs and sugar have also been linked to high blood pressure, heart disease, obesity, hyperactivity, mood disorders, and even suicide in teenagers.

For many of us, cutting back on sugary treats and overcoming our carb cravings can seem like a daunting task. As well as being present in obvious foods such as sugary snacks, desserts, and candies, sugar is also hidden in much of the processed food we eat – from soda, coffee and fruit drinks to bread, pasta sauce, and frozen dinners. But cutting back on these diet saboteurs doesn’t mean feeling unsatisfied or never enjoying comfort food again. The key is to choose the right carbs. Complex carbs such as vegetables, whole grains, and naturally sweet fruit digest slower, resulting in stable blood sugar and less fat accumulation.

By focusing on whole foods and complex, unrefined carbs, you can reduce your intake of sugar and refined carbs, keep your blood sugar stable, maintain a healthy weight, and still find ways to satisfy your sweet tooth. You’ll not only feel healthier and more energetic, you could also shed that stubborn belly fat so many of us struggle with.

The not-so-sweet link between sugar and belly fat

A lot of belly fat surrounds the abdominal organs and liver and is closely linked to insulin resistance and an increased risk of diabetes. Calories obtained from fructose (found in sugary beverages such as soda, energy and sports drinks, coffee drinks, and processed foods like doughnuts, muffins, cereal, candy, and granola bars) are more likely to add weight around your abdomen. Cutting back on sugary foods can mean a slimmer waistline as well as a lower risk of diabetes.

Good carbs vs. bad carbs

Carbohydrates are one of your body’s main sources of energy. Health organizations such as the U.S. Department of Health and Human Services recommend that 45 to 65 percent of your daily calories should come from carbohydrates. However, the majority of these should be from complex, unrefined carbs rather than refined carbs (including starches such as potatoes and corn).

Unlike simple carbs, complex carbohydrates are digested slowly, causing a gradual rise in blood sugar. They’re usually high in nutrients and fiber, which can help prevent serious disease, aid with weight-loss, and improve your energy levels. In general, “good” carbohydrates have a lower glycemic load and can even help guard against type 2 diabetes and cardiovascular problems in the future.

Good carbs include:

Unrefined whole grains – whole wheat or multigrain bread, brown rice, barley, quinoa, bran cereal, oatmeal

Non-starchy vegetables – spinach, green beans, Brussels sprouts, celery, tomatoes

Legumes – kidney beans, baked beans, peas, lentils

Nuts – peanuts, cashews, walnuts

Fruit – apples, berries, citrus fruit, bananas, pears

Switching to good carbs

While there are many health benefits to switching from refined to complex carbs, you don’t have to consign yourself to never again eating French fries or a slice of white bread. After all, when you ban certain foods, it’s natural to crave those foods even more. Instead, make refined carbs and sugary foods an occasional indulgence rather than a regular part of your diet. As you reduce your intake of these unhealthy foods, you’ll likely find yourself craving them less and less.

Added sugar is just empty calories

Your body gets all the sugar it needs from that naturally occurring in food – fructose in fruit or lactose in milk, for example. All the sugar added to processed food offers no nutritional value – but just means a lot of empty calories that can sabotage any healthy diet, contribute to weight gain, and increase your risk for serious health problems.

Again, it’s unrealistic to try to eliminate all sugar and empty calories from your diet. The American Heart Association recommends limiting the amount of added sugars you consume to no more than 100 calories per day (about 6 teaspoons or 24 grams of sugar) for women and 150 calories per day (9 teaspoons or 36 grams) for men. If that still sounds like a lot, it’s worth remembering that a 12-ounce soda contains up to 10 teaspoons of added sugar—some shakes and sweetened coffee drinks even more. The average American currently consumes 19.5 teaspoons (82 grams) of added sugar each day, often without realizing it. By becoming more aware of the sugar in your diet, you can cut down to the recommended levels and make a huge difference to the way you look, think, and feel.

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Health Spending is Likely to Grow by 5.4% per Year Through 2028. Here’s Why

By Paige Minemyer

Mar 24, 2020

The Centers for Medicare & Medicaid Services has released its annual health spending estimates.

National health spending is likely to grow by 5.4% per year over the next decade, according to new estimates from the Centers for Medicare & Medicaid Services (CMS). 

CMS’ Office of the Actuary released its annual predictions on national health expenditures Tuesday, and the agency projects health spending will account for 19.7% of the gross domestic product by 2028. 

Price growth is likely to accelerate, the actuary said, with a 2.4% growth rate due in large part to faster growth in healthcare workers’ wages. 

“As it has over the past several decades, health spending is expected to grow, on average, more rapidly than the rest of the economy in each year of the projection period through 2028 and to consume an increasingly larger share of GDP,” the actuaries wrote.

The largest source of the growing spending will be Medicare, according to the report, as baby boomers continue to age into the program in large numbers. The federal government’s share of healthcare spending is set to increase from 28% in 2018 to 31% in 2028.

The actuary projects Medicare spending will increase by 7.6% per year on average as enrollment growth far outstrips other programs. Medicare enrollment is expected to grow by 2.5% over the next decade, compared with 1.1% growth in Medicaid and 0.4% in private insurance.

The growth in Medicare enrollment – and accompanying spending – will offset a projected increase in the national uninsured rate over the next 10 years, according to the actuary.  CMS estimates that the insured rate will decline from 90.6% in 2018 to 89.4% in 2028.

A business line that could see significant spending boosts in the coming decade is prescription drugs, with spending expected to accelerate on average 5.4% per year as both price and utilization increase. However, the actuary said that increase will be largely on the back of higher spending among people with private coverage, especially in the latter half of the decade.

By 2024, the actuary estimates that drug spending in commercial plans will grow on average 5% per year, up from 3.7% in 2021 through 2023.

“Policymakers and other stakeholders will undoubtedly continue to monitor these trends and their implications for the health sector, federal and state budgets, and the economy as a whole,” the actuaries wrote.

Greg Says believes these healthcare spending trends should encourage an increased reliance on adequate insurance protection from the ever-increasing costs for healthcare.

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Does Diet Soda Increase Your Risk Of A Stroke?

The Link Between Artificial Sweeteners and Cardiovascular Events

Back in the early 60s, as scientific evidence began to mount regarding the detrimental health effects of excessive sugar consumption, Coca-Cola and other major soda companies began to release diet soda alternatives. The first diet sodas were sweetened by artificial sweeteners known as cyclamates, which are now banned in the United States. Now the five “non-nutritive” artificial sweeteners used in diet soda production are saccharin, acesulfame, aspartame, neotame, and sucralose.

When you’re trying to cut down on sugar consumption or lose weight, doctors will often tell you that the best place to start is by cutting soda out of your diet. After all, one 12-ounce can of Coca-Cola contains a whopping 39 grams of sugar, which is the equivalent of about 3.5 donuts. Yikes!

Although these synthetic substances were originally created to provide soda-drinkers with a healthier, more diet-friendly alternative, studies suggest that consumption of artificially sweetened diet soft drinks may be causing more harm than the regular versions.

Studies Linking Artificial Sweeteners to Negative Health Outcomes

Recent studies are investigating the effects of frequent consumption of artificially sweetened diet beverages with negative health outcomes like stroke, dementia and even type 2 diabetes. While diet sodas aren’t loaded with the same amounts of unhealthy sugars and corn syrup that are in regular pop, their artificial chemicals have a known effect on brain function and heart health. Multiple studies have been conducted to investigate the association between the consumption of artificially sweetened diet drinks like Diet Coke, and the results suggest staying away from regular sodas and diet sodas altogether.

A published paper from the Boston University School of Medicine suggests that people who consume a large quantity of artificially sweetened soft drinks may be up to three times more likely to suffer from a stroke or dementia.

As part of the population-based Women’s Health Initiative, a recent study examined the causes of illness and death in postmenopausal women for 12 years. The women were ages 50-79 years old with no history of diabetes or heart disease, who drank two or more artificially sweetened, 12-ounce beverages per day. The study found that those women had increased their risk of clot-based stroke and heart attack by as much as 31% compared to women who drank less than one artificially sweetened beverage per week.

Alternatives to Soda: Water, Water, Water!

So, what is worse for health, drinking regular sodas or diet alternatives? The simple solution is to simply cut out both sugary soda drinks and diet soda altogether, and just drink water or other low-sugar alternatives. While this may seem easier said than done, the countless benefits of drinking water regularly are quite motivating.  Drinking water helps you lose weight, keeps you energized, fights stress, regulates body temperature, boosts skin health, and supports healthy digestion. The list of water’s benefits goes on and on.

If you are trying to reduce your intake of sugary drinks, here are a few heart-healthy recommendations to make water a little more exciting. Your heart and your body will thank you!

  • Try sparkling water with zero sugar or additives, like La Croix, which gives you that zingy soda feeling without the negative side effects.
  • Infuse water with fresh fruits to give it a naturally sweetened flavor.
  • Drink unsweetened iced teas and add lemon or mint for an extra kick.