Health & Fitness
Fill ‘Gaps’ with Supplemental Insurance | Print |  E-mail
Thursday, 09 April 2015 13:54

By David Sayen • Special to the Times

Medicare helps to pay for a wide variety of health services, from flu shots to hospital stays to hospice care. But it doesn’t cover everything. And it doesn’t cover all your out-of-pocket costs.

Many services covered by Medicare require co-payments, coinsurance and deductibles. You can purchase supplemental insurance to cover these “gaps” in Medicare. Such insurance is called Medigap. Some policies cover benefits that Medicare doesn’t, like emergency care in a foreign country.

If you have Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health services. Then your Medigap policy pays its share.

You have to pay for Medigap yourself, and it’s sold through private insurance companies. You can buy it only if you have traditional Medicare, not Medicare Advantage, which is managed care provided by private insurers.

Every Medigap policy has to follow federal and state laws designed to protect you. Medigap insurance companies can sell you only a “standardized” Medigap policy identified in most states by the letters A through D, F through G and K through N. Each standardized policy must offer the same basic benefits, no matter which company sells it.

So, beware when you’re shopping for a Medigap policy: Cost is usually the only difference between Medigap policies with the same letter sold by different companies.

And, there can be significant differences in how much various insurers charge for exactly the same coverage.

These are some costs that Medigap policies often cover:

•Medicare Part A (hospital) coinsurance and hospital costs for up to 365 days after Medicare benefits run out;

• Medicare Part B (medical) coinsurance or co-pays;

• Blood (first three pints);

• Part A hospice care coinsurance or co-pays;

• Skilled nursing facility coinsurance;

• Part A and Part B deductibles.

Medigap policies generally don’t cover long-term care (like care in a nursing home), vision or dental, hearing aids, eyeglasses and private duty nursing.

The best time to buy a Medigap policy is during your six-month Medigap open enrollment period, because you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the month you both turn 65 and are enrolled in Medicare Part B, and once it’s over, you can’t get it again.

Medigap insurance companies are generally allowed to use medical underwriting to decide whether to accept your application and how much to charge you for the Medigap policy. However, if you apply during your Medigap open enrollment period, you can buy any Medigap policy the company sells, even if you have health problems, for the same price as people with good health.

Some other points to keep in mind:

• You must have Medicare Part A and Part B to buy a Medigap policy;

• A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you must each buy a separate policy;

• You pay the private insurer a monthly premium for your Medigap policy, in addition to the monthly Part B premium that you pay to Medicare;

• Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium.

David Sayen is Medicare’s regional administrator for California. You can get answers to your Medicare questions by calling 1-800-633-4227.

 
Is TMJ Cause of Your Headaches? | Print |  E-mail
Thursday, 26 March 2015 14:17

032615h1Nearly everyone on occasion experiences a throbbing headache that interferes with concentration at work or school, or saps the joy from the day.

But sometimes the source of that headache can be surprising. For many people, the pain that emanates from the head can be traced back to their teeth, their bite relationship and the alignment of the lower jaw.

“Pain doesn’t happen randomly or because of bad luck,” says Dr. Fred Abeles. “There’s a cause and effect to almost everything in the human body.”

With many headaches, Abeles says, the cause is the temporomandibular joint, or TMJ, the place at the front of the ear where the lower jaw and the temporal bone on the side of the head meet.

Sometimes, the bite and the lower jaw are out of alignment, putting additional strain on muscles, which leads to the headaches. And, for many, TMJ headaches aren’t going away because people try to mask pain with medication rather than correct the underlying cause.

But how do you know a headache is caused by TMJ? Abeles says these are some of the warning signs.

• Your jaw clicks or pops. Any joint in your body should work silently and seamlessly. If your jaw clicks or pops when you open or close it, it’s a clear sign that the lower half of the joint is not in the proper position. Even if the popping and clicking doesn’t produce pain, the muscles that have to support and stabilize the joint become fatigued and will produce pain.

• Your bite feels off. The TMJ is the only joint in the human body that has 28 teeth stuck between the opening and closing motion of the joint to complicate things. Every other joint is completely controlled by muscles, and the position of the joint, its movement and range of motion are mediated by muscle.

The TMJ’s position is dictated by where our teeth come together in our bite. So, if your bite feels off or your teeth don’t fit together well, there’s a good chance your TMJ joints are off, too.

• You have pain around your forehead, temples, back of head or radiating down your neck. Ninety percent of pain comes from muscle. If your muscles are not functioning well because of fatigue from supporting one or both of your TMJ joints in an improper position, they produce pain. It’s much like when you exercise or work hard and feel muscle pain later. The only difference is that TMJ is more subtle and chronic.

• You have forward head posture. Our heads are supposed to be centered over our shoulders. If yours is in front of your shoulders when you are upright, you have “forward head posture.” That relates to your bite and your airway. The human head weighs about eight to 10 pounds. The farther forward it is off the center axis, the more strain it places on neck muscles and vertebrae.

• You snore. Snoring is a red flag that respiration during sleep is disturbed, Abeles says. Several factors can lead to snoring, but one of the most important is the position of the lower jaw, he says. If your lower jaw is a little too far back, then the tongue is farther back as well.

“If the tongue is slightly farther back than optimal, it vibrates against our soft palate, closes off our airway and we snore,” Dr. Abeles says. The snoring doesn’t cause the headache, he says, but it could be a sign the lower jaw is too far back. As a result, the muscles that support the jaw in an improper position produce the headache pain.

 

 
Navigators Help Guide Breast Cancer Patients through Treatment Options | Print |  E-mail
Thursday, 26 March 2015 14:07

032615h2Receiving a diagnosis of breast cancer has to be one of the most life-altering events a woman can experience.

The diagnosis plunges each woman into a new world, filled with medical lingo and urgent decisions, along with the very normal responses of shock and fear.

One small ray of hope: a Breast Cancer Navigator is standing by to guide them. In hospitals that employ navigators, their job is to literally help the patient navigate the choppy waters of breast cancer treatment.

“Breast cancer navigators provide not only education and support, but also can serve as a counselor, care coordinator, case manager, researcher, advocate and friend,” says Joyce McCullen, a navigator with Eden Medical Center in Castro Valley.

Navigation services are provided free of charge to patients. All that is required is to ask for the service. Most patients first encounter the navigator when they receive a diagnosis of breast cancer. The navigator helps the woman understand just what this diagnosis means. During this initial phase, patients may not even know what questions to ask or whom to ask.

What does a navigator do?

Navigators are part of the patient’s cancer care team, working with physicians and other medical professionals. They help the patient and family:

• Understand the diagnosis

• Explore treatment options

• Prepare for surgical and non-surgical treatments like chemotherapy

• Understand how to manage at home during recovery from surgery, chemotherapy and/or radiation treatments

• Keep track of medical appointments

• Evaluate clinical trial opportunities

• Manage financial issues related to care

• Consider nutritional support during treatment

• Learn about support groups and other community resources for cancer patients

• Recover after treatment has ended

Navigators are valuable as the patient moves through treatment — however long that takes. Patients are often seeing their original primary care physician and also a surgeon as well as a medical oncologist for chemotherapy and/or a radiation oncologist for radiation treatment.

Navigators don’t deal only with the medical aspect of care. Depending on their needs and what type of support system they might — or might not — have at home, navigators can step in.

One important role is making the patients aware of support groups and other services that address the practical and emotional aspects of dealing with cancer.

The bond that can form between the cancer patient and nurse navigator is appreciated by both parties. “It is a beautiful blend of education and clinical practice. Patients feel cared for in a way that surpasses many traditional medical care interactions,” said McCullen. “It is a gift to work with these women. They have opened my eyes to true living and inspire me every day.”

 

 
You Can Reduce the Risk of Birth Defects | Print |  E-mail
Thursday, 12 March 2015 15:34

031215hEvery 4-1/2 minutes in the U.S., a baby is born with a birth defect leading to hospital-related economic costs that exceed $2.6 billion annually. But the risk of birth defects can be decreased.

The Problem

Many women are unaware that prescription opioid-based medications such as codeine, oxycodone, hydrocodone and morphine, used to treat severe pain, may increase the risk for serious birth defects of the brain, spine, abdominal wall and heart, as well as preterm birth when taken during pregnancy. They can also cause babies to suffer withdrawal when born.

Since half of all pregnancies are unplanned, women may be prescribed opioid-based pain medications before they know they’re pregnant. More than one-fourth of privately insured women of childbearing age fill prescriptions for opioid-based painkillers, according to the CDC.

Expert Opinions

“This highlights the importance of promoting safer alternative treatments, when available, for women of reproductive age.  We must do what we can to protect babies from exposure to opioids,” said Dr. Coleen Boyle, Director of CDC’s National Center on Birth Defects.

“If you are using an opioid painkiller, you should also be practicing effective birth control,” advises Dr. José Cordero, a pediatrician and member of the Board at the March of Dimes. “If you decide to get pregnant or do become pregnant, tell your health care provider about all the medications you are taking right away. You may be able to switch to a safer alternative.”

Dr. Cordero urges physicians and other prescribers not to write prescriptions for opioid-based painkillers for female patients who may become pregnant without a discussion of the risks and safer alternatives.

Learn More

Further information is at www.cdc.gov/treatingfortwo, www.cdc.gov/pregnancy/meds/treatingfortwo/features/opioid.html, www.marchofdimes.org and www.nacersano.org.

— North American Precis Synd. Inc.

CAPTION: By not taking certain prescription painkillers, mothers may protect their babies from birth defects.


 
Colon Care for Life: Get Your Screening | Print |  E-mail
Thursday, 12 March 2015 15:32

By Wei-Fang Ko, M.D. • Special to the Times

Colon cancer is one of the most treatable cancers when detected early. Yet, according to the American Cancer Society, half of people age 50 and older who should be screened for colon cancer are not.

March is National Colorectal Cancer Awareness Month and an opportunity to learn more about keeping your colon healthy.

Many people tend to put off colon cancer screening, but the significant health benefits make the process very worthwhile. With regular testing, thousands of lives could be saved each year.

What is colon cancer?

Colon cancer usually develops slowly in the large bowel or colon. Often, it begins when environmental or genetic changes cause the growth of abnormal tissue or a polyp. Most of this tissue begins as polyps, or noncancerous tumors, that grow on the inner lining of the colon. If not removed promptly, some of these polyps can become cancerous.

Why screening is important

There are many screening tests — talk with your doctor to determine your risk and which screening test might be best for you.

Most people with an average risk for colon cancer should be screened at age 50. A colonoscopy is one screening option that your doctor may recommend, usually once every 10 years. During this screening, doctors examine the entire length of the colon to detect polyps or early-stage cancers.

Regular colonoscopy screenings for the detection and removal of polyps can reduce a person’s risk of developing colon cancer by up to 90 percent. And, the detection of early-stage cancers increases the chance of a successful treatment outcome.

Preparation

To see the colon lining clearly, your doctor will prescribe a strong laxative for you to drink to clean out your colon. Preparing for your colonoscopy can take one to two days depending on what your doctor recommends.

Depending on the method of preparation, patients should not eat solid foods for 24 hours prior to the procedure, but they can have clear liquids, such as water, tea, apple juice and clear bouillon.

What to Expect in the GI Lab

During a colonoscopy, most patients receive a sedative. Those receiving conscious sedation are closely monitored. Although they can hear and follow instructions, many do not remember the 30-minute screening. Patients should expect to spend 2-3 hours total at the GI lab.

To examine the colon, your doctor will insert a thin, flexible colonoscope and move it gently through your colon. A chip in the tip of the scope transmits images to a computer screen while fiber bundles provide light so your doctor can check for polyps.

You may feel a little pressure on your abdomen as your doctor manipulates the scope, but most patients remember feeling very little at all. Doctors can immediately remove any polyps and take tissue samples during the colonoscopy.

Dr. Wei-Fang Ko is a board-certified gastroenterologist and affiliated with Eden Medical Center.


 
Heimlich Heroes Teach Kids How to Respond | Print |  E-mail
Thursday, 26 February 2015 14:48

022615hThree siblings sit in their kitchen enjoying a bedtime snack of sliced oranges. One of them accidently takes too big a bite and suddenly his face is red and he can’t breathe. A routine activity has turned into a choking emergency.

Without a second thought, an older sibling wraps his arms around his brother and performs the Heimlich maneuver. The orange slice is dislodged. Oxygen is restored. They all can sleep soundly.

“It happened too fast for me to be nervous,” Louis Fritz of Walton, Kentucky, says of his heroic act.

Thankfully, Fritz was able to recognize the signs of choking and perform the Heimlich maneuver with confidence — saving his younger brother’s life. He learned about the Heimlich maneuver from reading a hospital poster a few years prior.

“I had never actually practiced the Heimlich maneuver before I had to use it on my brother,” reflects Fritz, “I think it’s important for all kids to be trained because you never know when you might need to save someone from choking.”

Choking is the fifth-leading cause of accidental death in the United States. Over the years, the Heimlich maneuver has saved an estimated 50,000 U.S. lives, and thousands more worldwide.

Although most people don’t consider themselves heroic, one organization is passionately working to teach people that anyone can be a “Heimlich Hero.”

Heimlich Heroes is a free interactive program designed for children ages seven and up. By the end of their basic one-hour training, students are taught how to recognize the signs of choking, minimize or eliminate the risk of choking and properly perform the Heimlich maneuver.

Over 4,000 people across 22 states have been trained or have registered with Heimlich Heroes for training… free of charge.

The Heimlich Heroes training kit includes an instructional video, learning materials for students based on their ages and the Heidi or Hank training doll. These 42-inch dolls feature an internal diaphragm, lungs and a windpipe. The dolls’ plastic mouths expel a peanut-sized foam cushion when the maneuver is performed correctly.

Practicing the maneuver on a doll helps children learn the approximate amount of pressure they need to exert and it builds confidence in performing it. When faced with a choking emergency, trained children are then ready to spring into action and save a life.

Although the basic training session only lasts an hour, extended lessons that align with the Common Core curriculum are available for school use.

Heimlich Heroes is specifically designed to help children, teachers, sitters, parents and other youth leaders become equipped to handle a choking emergency and prevent needless deaths. Training is simple, free and easily accessible.

To access free training materials and learn how to bring Heimlich Heroes to your school or organization, visit www.heimlichheroes.com/anyone.

CAPTION: Practicing the Heimlich maneuver on a doll helps children learn the approximate amount of pressure they need to exert and it builds confidence in performing it.


 
‘Get to Know Your Thyroid’ Tonight at Carlton Plaza | Print |  E-mail
Thursday, 26 February 2015 14:46

022615h2By Farnoosh Farrokhi, M.D. • Special to the Times

Goiter is simply an abnormal enlargement of the thyroid gland, a butterfly-shaped gland at the base of the neck. The thyroid gland makes two main hormones which regulate body metabolism. The pituitary gland in the brain controls the function of thyroid by making a hormone known as thyroid-stimulating hormone (TSH).

Causes of Goiter

The most common cause of goiter worldwide is a lack of iodine in the diet. In the United States, where the use of iodized salt is common, a goiter is more often caused by an over- or under-active thyroid, or by lumps that develop in the gland itself.

“Hashimoto’s thyroiditis” is one of the causes of under-active thyroid which can result in goiter. This is an autoimmune condition in which there is destruction of the thyroid gland by one’s own immune system, rendering the gland unable to make enough hormones. The brain senses the low thyroid hormone level and secretes more TSH to stimulate the thyroid. This stimulation causes the thyroid to grow and produce goiter.

Another common cause of goiter is “Graves’ disease” which causes an over-active thyroid. In this condition, one’s immune system produces a protein that stimulates the thyroid gland to enlarge and produce more hormones.

Occasionally, thyroid function is normal but goiter is caused by large lumps on the thyroid gland. These lumps are called “nodules.” Unlike the other goiters, the cause of this type of goiter is not well understood.

Symptoms

Not all goiters cause symptoms. If they are large enough, they may cause a tight feeling in the throat, coughing, hoarseness, and difficulty swallowing and breathing.

Diagnosis

Diagnosis can be made by physical exam or thyroid ultrasound. Once diagnosed, thyroid function tests should be checked to determine if the thyroid is functioning normally, or if it is under- or over-active.

Treatment

Treatment options depend on the cause of the goiter. If the goiter is due to Hashimoto’s Thyroiditis, thyroid hormone supplements should be given as a daily pill. This treatment will restore thyroid hormone levels to normal, but does not usually make the goiter go completely away.

If the cause of goiter is an over-active thyroid, treatment with medications and radioactive iodine usually leads to a decrease or disappearance of the goiter. In cases with normal thyroid function, small goiters usually do not need treatment, but for large goiters with compressive symptoms, surgical removal might be suggested.

Farnoosh Farrokhi, M.D. will be presenting a free talk, “Get to Know Your Thyroid” at 6 p.m. tonight, Feb. 26, at Carlton Plaza, 1000 E. 14th St., in San Leandro. Call 510-869-6737 to reserve your seat.

Dr. Farrokhi is a board-certified endocrinologist and is affiliated with Eden Medical Center.


 
Weight-loss Myths Debunked | Print |  E-mail
Thursday, 12 February 2015 15:02

021215hMore than a third of adults in the United States, 35.1 percent, are obese, according to the Centers for Disease Control. Nearly 70 percent are at least overweight, and obesity in adolescents has quadrupled in the past three decades.

“Most of us know we’re facing a national health crisis, yet diets for millions of Americans continue to be based in heavily processed foods,” says Dr. Eleazar Kadile, who specializes in treating patients with obesity and associated chronic disease.

Poor attitudes and lack of understanding contribute significantly to this national crisis which contributes to our national healthcare difficulties, says Dr. Kadile. He debunks these five myths about being overweight and obese.

It’s your fault that you’re fat: Obesity is caused by complex imbalances within a person’s body and their environment. Some imbalances are exacerbated by poor dietary choices based on bad dietary information, personal history and psychological patterns.

Together, the physiological, psychological, social and environmental causes of the disease of obesity create a predicament that obese people are drawn into and unable to get out of.

Obese people are among the fat and happy: Large people can be masters at suppressing the indignities they suffer in society. The obese often have to pay first-class fares since cheaper seats for transportation are designed for thinner people. Most advertisements employ beautiful people who are thin, and rarely attractive actors who are larger.

National campaigns to battle obesity do not focus on the factors beyond diet and exercise that keep people overweight. Obese patients also spend an average of nearly $1,500 more each year on medical care than other Americans.

• Obese and overweight people just need the right diet. There’s no shortage of diets promoted by beautiful people who promise amazing results. If only overweight people eat what they eat, then they’ll be beautiful, too. But that’s just not true.

What and how one eats is just a part of an excessive body mass index (BMI) level. Other important factors to achieving a healthy BMI include good information regarding one’s health, sustained motivation to change, continuous learning, vigilance and an ability to be extremely honest.

Food is not an obese individual’s friend; exercise is. Eat less; exercise more; lose weight — those have been the commandments in the religion of weight loss. But most obese people have tried this and it hasn’t worked. More than being a source of pleasure, comfort and survival, food is medicine.

“Sometimes, you need to eat fat — the right kind — in order to burn fat. And, many exercises can actually harm an obese person,” says Dr. Kalide. “You can’t impose cookie-cutter solutions to this complex problem and expect them to work.”

Fat people need to “just do it” — lose weight. This attitude is not based in reality; it’s an over-simplistic response to a frustrating problem.

“Morbidly obese patients need plenty of preparation,” he says. “When a patient comes to me, I go through a rigorous list of questions regarding medical and family history. I ask about eating, sleeping and activity patterns, as well as medical conditions, emotional patterns, stress histories, good times and bad times, etc. I also have them go through an extensive battery of medical tests. That’s the effective and safe way of doing it.”

In other words, “just do it” just doesn’t cover it.

CAPTION: It takes more than just eating less and exercising more to maintain a healthy weight.


 
Is It a Heart Attack or Just Stress? | Print |  E-mail
Thursday, 12 February 2015 15:00

You’ve had a stressful day at work — you’re late with an assignment, your email box is overflowing — and, at home, the kids aren’t making things any easier.

And now you need to get dinner on the table. You suddenly notice your heart is pounding, you can’t catch your breath and you feel lightheaded.

Is it a panic attack — or a heart attack?

Heart disease in the East Bay

Although sometimes thought of as a “man’s disease,” heart disease kills around the same number of women and men each year in the United States. Even if you have no symptoms, you may still be at risk. Almost two-thirds of women who die suddenly of heart disease have no previous symptoms.

“Chest pain is a common symptom of a heart attack,” says East Bay interventional cardiologist, Robert Greene, M.D., who practices at Alta Bates Summit Medical Center. “Unlike men, women tend to experience more subtle heart attack symptoms, like nausea, jaw/back pain, fatigue and shortness of breath.”

What causes heart attacks?

“Myocardial infarction, or a heart attack, occurs when the blood flow to the heart is blocked,” explains Dr. Greene. “This blockage is caused when fat and cholesterol — known as plaque — buildup in the vessels that supply blood to the heart. Most heart attacks happen when a blood clot forms on the plaque and cuts off the blood supply to the heart.”

Tips for a healthy heart

“Catch heart disease before symptoms begin,” warns Dr. Greene. “Have your cholesterol and blood pressure levels checked regularly beginning at age 45.”

• Maintain a healthy weight

• Eat five servings of fruit and veggies each day

• Exercise regularly (at least 30 min., five times a week)

• Quit smoking

• Manage stress

“Walking 20-30 minutes each day can reduce your heart attack risk more than drugs or surgery,” adds Dr. Greene. “And don’t forget about reducing stress.”

It’s easy for a woman to ignore the signs of a heart attack, because they are so similar to the symptoms of a panic attack: stress/fatigue, a rapid heartbeat and shortness of breath.

 

 
Measle Cases Hit Alameda County | Print |  E-mail
Thursday, 29 January 2015 13:08

012915hBy Amy Sylvestri • San Leandro Times

Five cases of measles have been discovered in Alameda County, four of which have been traced to the recent outbreak of the disease at Disneyland.

A total of 73 confirmed cases of measles have been reported statewide — five Alameda County cases, two in Santa Clara County, and the rest in Southern California.

The outbreak appears to be stemming from unvaccinated individuals, according to Sherri Willis, spokeswoman for the Alameda County Public Health Department.

Willis says that 82 percent of the cases statewide have occurred in people who have not been vaccinated against measles.

Measles is a highly contagious viral disease which begins with a fever, followed by a cough, runny nose, pink-eye and rash – the rash is often on the face near the hairline and behind the ears. Infected individuals are usually contagious from about four days before the rash appears to four days afterwards, according to state health officials.

The disease spreads rapidly at theme parks, shopping malls and other places where large numbers of people congregate.

Dr. Jeff Leinen, a physician with Sutter Alameda County, says that it’s a numbers game: the more people who are vaccinated, the safer in general the population is from infection.

“As long as there are about 92 percent of people vaccinated, there won’t generally be enough susceptible individuals in the area for it to move through the population,” said Leinen. “Even if you are sick and coughing, there will be enough protected individuals around that passing it along will be rare. The trouble comes when the percentage of immunized individuals dips.”

Leinen said that whether people aren’t being immunized because they are unable to for financial reasons or because they deliberately chose to be anti-vaccination for themselves and their children, the public is now seeing the consequences.

Most infants cannot have the measles vaccine until they are six months to a year old. That means Disneyland should be off the list for vacation spots for people with small babies and the unvaccinated in general.

“If you are planning to visit and have a baby that is too young for the vaccine, don’t go,” said Willis. “And what we are beginning to see now, is that measles are in the community.”

Willis said the county will not release the exact cities of residence of the people infected due to privacy concerns, but that the five individuals range in age from children to adults and that they are not in the same family.

In the Alameda County cases, two people were totally unvaccinated and one was under vaccinated. In the 1970s and 1980s, only one measles shot was required, now doctors recommend two.

“The important thing now is that people be aware of their vaccination status,” said Willis. “If you have only had one shot, you may need a booster. This vaccine is 99 percent effective in two doses, which is more than many other vaccines.”

Of the 73 cases statewide, 82 percent of them occured in people who have not been vaccinated against measles.

PHOTO COURTESY OF U.S. Army Corps of Engineers, Carol E. Davis


 
Get Help Paying Medicare Costs | Print |  E-mail
Thursday, 29 January 2015 13:07

By David Sayen • Special to the Times

Did you know that you may be able to get help from your state to pay your Medicare premiums?

State-based Medicare Savings Programs also may pay Medicare Part A (hospital insurance) and Part B (medical insurance) deductibles, coinsurance, and copayments.

If you have income from working, you may qualify for these programs even if your income is higher than the income limits listed below. There are four kinds of Medicare Savings Programs:

• Qualified Medicare Beneficiary (QMB) Program — Helps pay for your Part A and/or Part B premiums, deductibles, coinsurance, and copayments.

• Specified Low-Income Medicare Beneficiary (SLMB) Program — Helps pay your Part B premiums only.

• Qualifying Individual (QI) Program — Helps pay your Part B premiums only. You must apply each year for QI benefits and the applications are granted on a first-come, first-served basis, with priority given to people who got QI benefits the previous year. (You can’t get QI benefits if you qualify for Medicaid).

• Qualified Disabled and Working Individuals (QDWI) Program — Helps pay your Part A premiums only. You may qualify for this program if you have a disability and are working.

If you qualify for a QMB, SLMB, or QI program, you automatically qualify to get Extra Help paying for your Medicare prescription drug coverage (Part D) plan.

If you answer yes to the questions below, call your State Medicaid office to see if you qualify for a Medicare Savings Program:

(1)Do you have, or are you eligible for, Medicare Part A?

(2)Is your income for 2014 at, or below, the income limits listed below?

(3)Do you have limited resources, below the limits below?

The amounts that follow may increase in 2015. But it’s important to call or fill out an application if you think you could qualify for savings even if your monthly income or resources are higher than the amounts listed here.

QMB Program: Individual  = $993; Married couple = $1,331

SLMB Program: Individual = $1,187; Married couple = $1,593

QI Program: Individual = $1,333; Married couple = $1,790

QDWI Program: Individual = $3,975; Married couple = $5,329

Resource limits for the QMB, SLMB, and QI programs are $7,160 for one person and $10,750 for a married couple. Resource limits for the QDWI program are $4,000 for one person and $6,000 for a married couple.

Countable resources include money in a checking or savings account, stocks, and bonds, but don’t include your home, one car, a burial plot, up to $1,500 for burial expenses if you have put that money aside, furniture, and other household and personal items.

David Sayen is Medicare’s regional administrator for California. Call 1-800-633-4227.


 
Reset Your Internal Clock | Print |  E-mail
Thursday, 15 January 2015 15:32

By adjusting your circadian rhythm you can better the chances of a good night’s sleep

011515hBy Mark Underwood • Special to the Times

Have you ever wondered why you tend to wake up at the same time without an alarm clock, fall asleep about the same time or get hungry about the same hour each day?

The answer is due to your circadian rhythm or biological clock found deep in the brain. Our amazing clocks are highly intertwined with physiological and behavioral processes. They routinely manage our 24-hour sleep/wake cycle with brain wave activity, hormone production and cell regeneration.

But our internal clocks don’t adjust well to new routines.

Biological clocks have a profound effect on when we go to sleep, eat and wake, but also on mental and physical health.

The inner workings of our clocks are high-tech machines. One good example is the daily night-time routine. As night falls the clock is in high operational mode as it begins to slow the body for sleep, lowering body temperature, and releasing the hormone melatonin that makes us feel sleepy.

The clock is “programmed” to react to light and darkness and the daily departure of the sun — essential for our bodies to function throughout a busy day.

Creatures of habit

Our internal clocks keep us on track. Without the intricate balance, we’d have jet lag more often than not. Sluggishness, insomnia, lost appetite, and an awful feeling of being “out of it,” are natural consequences of jet lag, a frequent discomfort of travelers.

When you travel across time zones and it’s 10 p.m. back home, your internal clock will have you wanting to go to bed no matter what the local time is, even if it’s noon locally.

Even though our clocks do not adapt well to interruptions in daily routines, our circadian rhythm can be reset, making good sleep possible.

There are many situations when our clocks may be out of sync with daily life. If you go to bed much later than usual, take a different job that requires you to work at night, or act as a personal caregiver to a friend which results in interrupted patterns of sleep, you’ll probably have problems adjusting your circadian rhythm.

People who have chronic sleep problems have a weaker defense system against pathogens that cause illness, such as the common cold. To make matters worse, it is known that poor sleep can lead to overeating. While it is not exactly understood, the body uses rest to “recharge” the body. Hormones such as leptin, which control appetite, may be affected.

Clock reset tips

What can you do if you are one of millions who work late at night or sometimes disrupt your circadian rhythm?

• Decrease caffeine and alcohol intake before bedtime.

• Work on reducing stress. We all have stress, but it is the single major factor to poor sleep and long-term health problems.

• Find structured ways to relax. Yoga is a good example.

• Eat a healthy, well-balanced diet and drink plenty of water.

• Exercise regularly, but if you’re exercising too close to bedtime, you might be confusing your internal clock with this nightly activity.

• If you need to sleep in the daytime, it is very important to shut out light to trigger light/dark cycles. Adjust your room’s environment if your room is too hot or loud. Studies have shown that very dark (pitch black), cool rooms are the most “sleepable.” If you live near traffic, invest in ear plugs.

• Upgrade your mattress for a more comfortable, good night’s sleep.

Mark Underwood is a neuroscience researcher, president and co-founder of Quincy Bioscience, a biotech company located in Madison, Wisconsin.


 

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