Health Insurance Tips for Traveling Abroad

How does health insurance and Medicare cover health care outside the U.S.? My husband and I have a trip abroad planned this fall and would like to find out if we should buy extra insurance. What can you tell us?

Great question! No one likes to think about health problems while on vacation, but medical emergencies happen, and your regular insurance may not cover your care when you are traveling abroad. To avoid any expensive surprises, here are some tips to help make sure you are covered.

Know What is Covered

Your first step is to contact your health insurer to find out exactly what your plan covers when you are traveling abroad. If you have health coverage through an employer, the Health Insurance Marketplace or a private insurance company, the level of coverage can vary widely depending on your policy.

If your plan does provide coverage abroad ask about the specifics, such as whether the plan includes coverage for emergency evacuations to the U.S. and pre-existing medical conditions. You should also find out what your out-of-pocket costs will be if you need medical care while you are away.

If you or your husband have original Medicare, it does not provide coverage outside the U.S., except in certain circumstances - for instance, on a cruise ship within six hours of the U.S. Some coverage is built in if you have one of the Medigap supplemental plans (C, D, F, G, M, N) that pay 80% of bills for emergency care as long as it is during the first 60 days of the trip abroad. There is also a $250 annual deductible plus a lifetime limit of $50,000 for foreign travel emergency care.

If you happen to have a Medicare Advantage plan, your coverage outside the U.S. will depend on the plan. Some plans offer emergency care coverage while others do not. You will need to check your plan for details.

Buy Extra Protection

If your policy does not provide health coverage outside the U.S. or if the coverage is limited with high out-of-pocket costs, you can purchase a travel medical insurance policy to cover you or supplement what your insurer will not cover.

To shop and compare plans, visit sites like InsureMyTrip.com or SquareMouth.com to give you a general idea of what travel medical insurance cost. A couple in their sixties planning a two-week trip to Europe, for example, could get a $50,000 medical coverage limit and $100,000 for a medical evacuation for around $100 or higher.

You also need to know that most travel medical plans do not cover costs related to pre-existing health conditions. If you or your husband has a pre-existing condition that might require medical care, choose a comprehensive travel policy, which typically covers medical care, medical evacuation, trip cancellation, trip interruption and baggage loss, and then add a pre-existing-condition waiver.

Finding Care

If you get sick or injured during your trip, call your travel insurer who can recommend local care options. For extra help, consider joining the International Association for Medical Assistance to Travelers, which provides its members access to a worldwide network of physicians who speak English and have agreed to affordable prearranged fees. Membership is free. Also visit Step.State.gov to enroll your trip with the nearest U.S. Embassy or Consulate. They can also offer health care referrals.

Reimbursement

If you do have travel medical insurance and you receive medical care while traveling abroad, you will probably be required to file a claim and show medical records outlining the care you received and receipts. Make sure you get copies of the receipts so you can get reimbursed when you get home.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

Youth Foundation offers grant cycle

The Washington County Youth Foundation has been steadily working to be ready for the start of this year’s fall grant cycle. The Youth Foundation offers grants for youth directed community service projects.

Judy Johnson, Executive Director of the Foundation, commented, “The Youth Foundation has been offering a grant cycle since 2002. They have funded many youth-directed community service projects. It is so exciting to see youth and adults working together for the betterment of Washington County.”

Applications are available on-line at www.wccf.biz and are due by October 8, 2018, 3:00pm in the Foundation Office. The grant awards will be announced in November. For more information, you can call the Washington County Community Foundation office at 883-7334.

The mission of the Washington County Community Foundation is to engage people, build resources and strengthen our community. For more information, visit www.wccf.biz

Which Flu Shot is Right for You?

I've been reading that there are a bunch of different flu vaccines this flu season. Which flu shot is right for me?

It wasn't that long ago that if you wanted to protect yourself from the flu, you would simply get a flu shot. These days, however, there are numerous flu vaccine options to choose from and picking the right one may feel a bit overwhelming. To help you decide which flu vaccine is right for you, you need to consider your health, age and personal preferences.

Flu Shot Options

Every year, the Centers for Disease Control and Prevention (CDC) recommends that everyone six months of age and older get a seasonal flu shot. This recommendation is especially important for seniors who are at higher risk of developing serious flu-related complications. Each year, the flu puts more than 200,000 people in the hospital and kills an average of 24,000 people. Eighty to ninety percent of those who die from flu-complications are seniors. Here is a summary of the different vaccine options available:

Standard flu vaccines: If you want to keep things basic, consider getting vaccinated with the standard (trivalent) flu shot, which has been around for more than 40 years and protects against three different strains of flu viruses. This year's version protects against two A strains (H1N1 and H3N2) and one influenza B virus.

Alternatively, for additional protection, you should consider the quadrivalent flu vaccine, which protects against four types of influenza — the same three strains as the standard trivalent flu shot, plus an additional B-strain virus.

Senior specific vaccines: If you are age 65 or older and want extra protection, you should consider the Fluzone High-Dose or FLUAD. The Fluzone High-Dose has four times the amount of antigen as a regular flu shot, while the FLUAD contains an added adjuvant ingredient called MF59. Both vaccines provide a stronger immune response for better protection.

Egg allergy vaccines: If you are allergic to eggs, your flu shot options are Flucelvax or FluBlok. Neither of these vaccines uses chicken eggs in their manufacturing process.

Fear of needle vaccines: If you are afraid of needles and between the ages of 18 and 64, your options are the Fluzone Intradermal or AFLURIA vaccine.

The Fluzone intradermal flu shot uses a tiny 1/16-inch long micro-needle to inject the vaccine just under the skin, rather than deeper in the muscle like a standard flu shot. The AFLURIA vaccine is administered by a jet injector, which is a medical device that uses a high-pressure, narrow stream of fluid to penetrate the skin instead of a needle.

You should also know that if you are a Medicare beneficiary, Part B covers all flu vaccinations. If you have private health insurance, you will need to check with your plan to see which vaccines are covered.

Pneumonia Vaccines

Other important vaccinations the CDC recommends to seniors, especially this time of year, are the pneumococcal vaccines for pneumonia. Around 1 million Americans are hospitalized with pneumonia each year and about 50,000 people die from it.

The CDC recommends that all seniors, age 65 or older, receive two vaccinations —Prevnar 13 and Pneumovax 23. Both vaccines, which are administered just once at different times, work in different ways to provide maximum protection.

If you have not received any pneumococcal vaccine, you should get the Prevnar 13 first, followed by Pneumovax 23 six to 12 months later. Medicare Part B covers both vaccines, if they are taken at least one year apart.

To locate a vaccination site that offers both flu and pneumonia shots, visit Vaccines.gov and type in your zip code.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

Choosing a Continuing-Care Retirement Community

an you give me some tips on picking an all-inclusive residential retirement community that offers independent housing, along with assisted living and nursing care? My husband and I are looking to downsize and simplify, but we want our next move to be our last.

If you want your next move to be your final one, an all-inclusive retirement community — also known as a continuing-care retirement community (CCRC) — is a great option to consider.

CCRCs are different from other types of senior housing because they provide all levels of housing, services and care in one convenient location. While they vary greatly in appearance and services, most CCRCs offer apartments or single-family homes for active independent seniors. They also offer onsite assisted living for seniors who require help with basic living tasks like bathing, dressing or going to the bathroom and nursing home care for residents who are in declining health.

CCRCs also provide a bevy of resort-style amenities and services that include community dining halls, exercise facilities, housekeeping and transportation, as well as many social and recreational activities. Be aware that these services often come at a hefty price. Most communities have entry fees that range from the low to mid-six figures plus ongoing monthly fees that can range from around $2,000 to over $4,000 depending on the facility, services and the contract option you choose.

With more than 2,000 CCRCs in operation throughout the U.S., finding a facility that fits your lifestyle, needs and budget will require some legwork. Here are some steps to help you proceed.

Make a list: Start by calling the Area Agency on Aging (call 800-677-1116 for contact information) in the area you want to live for a list of CCRCs.

Call the facilities: Once you have located a few local facilities, call them to find out if they have any vacancies, what they charge and if they provide the types of services you want or need.

Take a tour: Many CCRCs encourage potential residents to stay overnight and have a few meals in their dining hall. During your visit, notice the upkeep of the facility and talk to the current residents to see how they like living there. Also, check out the assisted living and nursing facilities and find out how decisions are made to move residents from one level of care to another.

To learn more about a particular facility, call the state long-term care ombudsman (see LTCombudsman.org) who can tell you whether the assisted living and nursing care services within the CCRC have had any complaints or other problems. You can also use Medicare's nursing home compare tool at Medicare.gov/nursinghomecompare.

Review contracts and fees: Most CCRCs offer three types of contracts: Type A, or life-care contracts, which have the highest entry fee but cover all levels of long-term care as needed; Type B, or modified contracts, which have lower entry fees but limit long-term care services in the initial fee; and Type C, or fee-for-service contracts, which offer the lowest entrance fees but require you to pay extra for long-term care if you need it.

You also need to find out what yearly price increases you can expect. You should also inquire as to how much of your entry fee is refundable if you move or die and what happens if you outlive your financial resources.

Research the CCRC: Find out who owns the facility, get a copy of their most recently audited financial statement and a copy of their contract and review these with your lawyer or financial advisor. You should also request information regarding their occupancy rate. Unless it is a newer community filling up, occupancy below 85% could be a red flag that the facility is having financial or management problems.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

Travel to Nashville for a Gaylord Country Christmas with WCCF

Washington County Community Foundation is sponsoring a trip to Music City, USA, Nashville, Tennessee, December 12-14, 2018. The trip will depart from the Learning Center/YMCA parking lot the morning of December 12^th for a short trip to Nashville, TN. You will stay at the famed Gaylord Opryland Hotel, always an exquisite stay. The Country Christmas Package includes tickets to Fantasy in Ice – an exhibit of carvings, sculptures, and holiday theme displays – all made of ice. Later that evening, you will enjoy a Christmas Dinner Show featuring Trace Adkins.

Day 2 of the trip includes tickets to ride on the Delta River Flatboat and the evening will be spent attending a live holiday performance at the Grand Ole Opry.

The last day of the trip will start at Opry Mills to finish up some last minute Christmas shopping. Following lunch, you will depart Nashville to head home to Salem. The bus will arrive in the evening.

The trip not only includes hotel and transportation, but it also includes tickets for the attractions listed above. The cost for the trip is $649.00 per person for double occupancy, $819.00 per person for single occupancy, and $579.00 per person for triple occupancy. There is a $200.00 deposit due at time of sign-up and the balance is due by October 11^th.

For more information about the trip or to make a reservation, please contact WCCF at 812-883-7334. Join Washington County Community Foundation in getting to know your neighbors and your community in a fun, adventurous way.

Washington County Community Foundation is a nonprofit public charity established in 1993 to serve donors, award grants, and provide leadership to improve Washington County forever

Could You Have COPD?

I have struggled with some shortness of breath for the past five years or so. I just thought I was getting older and out of shape, but a friend recently mentioned I may have COPD. What can you tell me about this?

Chronic Obstructive Pulmonary Disease (COPD) is a serious lung disease that, over time, makes it hard to breathe. COPD is used to describe a variety of lung diseases, including, emphysema and chronic bronchitis. An estimated 24 million people have COPD today, but about half do not realize it.

Many people mistake shortness of breath as a normal part of aging or a result of being out of shape, but that is not necessarily the case. COPD develops slowly, so symptoms may not be obvious until damage has occurred. Common symptoms include an ongoing cough, a cough that produces a lot of mucus, shortness of breath (especially during physical activity), wheezing and chest tightness.

Those most at risk are smokers, former smokers over the age of 40 and people who have had long-term exposure to other lung irritants like secondhand smoke, air pollution, chemical fumes and dust. Additionally, alpha-1-antitrypsin deficiency, a rare genetic condition known as AAT deficiency, can increase the risk of developing COPD.

If you are experiencing any of the aforementioned symptoms, you need to get tested by your doctor. Spirometry is a simple breathing test that your doctor can use to tell if you have COPD and, if so, how severe it is. Early screening can also identify COPD before major loss of lung function occurs.

Unfortunately, there is no cure for COPD. However, if you do indeed have COPD, you need to know that there are things you can do to help manage symptoms and protect your lungs from further damage, including:

Quit smoking: If you smoke, the best thing you can do to prevent more damage to your lungs is to quit. To get help, the National Cancer Institute offers a number of smoking cessation resources at smokefree.gov or call 1-800-QUIT-NOW. You can also ask your doctor about prescription anti-smoking drugs that can help reduce nicotine cravings.

Avoid air pollutants: Stay away from things that could irritate your lungs like dust, allergens and strong fumes. Also, to help improve your air quality at home, you can remove dust-collecting clutter, keep carpets clean, run an exhaust fan when using smelly cleaning products, bug sprays or paint, ban smoking indoors and keep windows closed when outdoor air pollution is high (see airnow.gov for daily air-quality reports).

Guard against flu: The flu can cause serious problems for people who have COPD, so you should get a flu shot every fall and wash and sanitize your hands frequently to avoid getting sick. You can also ask your doctor about getting the pneumococcal immunizations for protection against pneumonia.

Take prescribed medications: Bronchodilators (taken with an inhaler) are commonly used for COPD. They help relax the airway muscles to make breathing easier. Depending on how severe your condition, you may need a short-acting version to use only when symptoms occur or a long-acting prescription for daily use. Inhaled steroids may also help decrease inflammation, reduce mucus and prevent flare-ups.

For more information, visit the COPD Foundation at copdfoundation.org or call the COPD information line at 866-316-2673.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

Published August 17, 2018

How People Can Find Clinical Trials

What can you tell me about clinical trials and how to go about finding one?

Each year, hundreds of thousands of Americans participate in clinical trials in hopes of gaining access to the latest, and possibly greatest (but not yet on the market) treatments for various types of illnesses. Clinical trials can vary greatly in what they are designed to do, so be careful to choose one that actually benefits you. Here is what you should know along with some tips for locating a clinical trial near you.

Clinical Trials

A clinical trial is a test or research study of a drug, device or medical procedure using people as the trial subjects. These trials — sponsored by drug companies, doctors, hospitals or the federal government — are conducted to learn whether a new treatment is safe and effective. These new treatments are also unproven, so there may be some risk involved.

All clinical trials have certain eligibility criteria (age, gender, health status, etc.) that you must meet in order to be accepted. Before taking part in a trial, you will be asked to sign an informed consent agreement. You can also leave a study at any time.

Find a Trial

Every year, there are more than 100,000 clinical trials conducted in the U.S. You can find them by asking your doctor, who may be monitoring trials in his or her specialty. You can also look for them on your own at ClinicalTrials.gov. This website, sponsored by the National Institutes of Health, contains a comprehensive database of federally and privately supported clinical studies in the U.S. and abroad on a wide range of diseases and conditions. The website includes information about each trial's purpose, who may participate, locations and phone numbers.

If you want some help finding the right trial, try ResearchMatch, a web-based resource created by Vanderbilt University that connects willing patients with researchers of clinical trials. Alternatively, check out the Center for Information and Study on Clinical Research Participation. This organization will conduct a thorough clinical trials search for you and mail or email you the results within a week or two. Call 877-633-4376 for assistance. Those with dementia and their caregivers can also locate clinical trials at the Alzheimer's Association TrialMatch.

Things to Know

Before deciding to participate in a trial, you need to first discuss it with your doctor to make sure it is appropriate for you. Then, schedule an appointment with the study's medical team and ask a variety of questions, such as:

What is the purpose of the study and can it improve my condition?
What are the risks?
What kinds of tests and treatments does the study involve, and how often and where are they performed?
Is the experimental treatment in the study being compared with a standard treatment or a placebo?
Who is paying for the study? Will I have any costs, and if so, will my insurance plan or Medicare cover the rest?
What if something goes wrong during or after the trial and I need extra medical care? Who will cover those costs?

For more information on clinical trials for older adults visit the National Institute on Aging at nia.nih.gov/health/clinical-trials. This website has many informative articles including one titled "Questions to Ask Before Participating in a Clinical Trial."

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

Published August 10, 2018

The Consequences of Dying Without a Will

What will happen to my money and possessions if I die without a will?

If you pass away without a will, what happens to your assets will be determined by the laws of your state of residence. Every state has intestacy laws in place to distribute property and assets to a deceased person's closest relatives when there is no will or trust. These laws vary from state-to-state.

Here is a general (not state-specific) breakdown of what can happen to a person's assets, depending on whom they leave behind.

Married with children : When a married person with children passes away without a will, property, investments and financial accounts that are "jointly owned" with a right of survivorship automatically go to the surviving co-owner (typically a spouse or child) without going through probate, which is the legal process that distributes a deceased person's assets.

For all other property or individual financial accounts, the laws of most states award one-third or one-half to the surviving spouse, while the rest goes to the children.

Married with no children or grandchildren : Some states award the entire estate to the surviving spouse, or everything up to a certain amount (for example, the first $100,000). Some states award only one-third to one-half of the decedent's separately owned assets to the surviving spouse, with the remainder generally going to the deceased person's parents, or if the parents are dead, to brothers and sisters.

Jointly owned property, investments, financial accounts, or community property automatically goes to the surviving co-owner.

Single with children : State laws provide that the entire estate goes to the children, in equal shares. If an adult child of the decedent has died, then that child's children (the decedent's grandchildren) will receive a distribution from the decedent's estate.

Single with no children or grandchildren : In this situation, most state laws favor the deceased person's parents. If both parents are deceased, many states divide the property among the brothers and sisters, or if they are not living, their children (i.e., the deceased's nieces and nephews). If there are no nieces and nephews, it goes to the next of kin. If there are no family members living, then the state takes the property.

Make a Will

To ensure your assets go to those you want to receive them, you need to create a will. If you have a simple estate and an uncomplicated family situation, there are several good, low-cost, do-it-yourself resources that can help.

If you need assistance or if you have a complicated financial situation, blended family or have considerable assets, you should hire an attorney. An experienced attorney can make sure you cover all your bases, which can help avoid family confusion and squabbles after you are gone. Costs will vary depending on where you reside, but you can expect to pay anywhere between $200 and $1,000 for a will.

The National Academy of Elder Law Attorney and the National Association of Estate Planners and Councils are good resources that have online directories to help you find someone in your area. If money is tight, check with your state's bar association to find low-cost legal help in your area. Or call the Eldercare Locator at 800-677-1116 for a referral.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

Published August 3, 2018

How Medicare Covers Diabetes

How well does Medicare cover diabetes? I am 66 years old and was recently told by my doctor that I have pre-diabetes. If it progresses to full-fledged diabetes what can I expect from Medicare?

Medicare provides a wide range of coverage to help beneficiaries who have diabetes, as well as those who are at risk of getting it — but they do not cover everything. Here is a breakdown of what Medicare covers when it comes to diabetes services and supplies along with some other tips that can help you save money.

Screenings: If you have pre-diabetes or some other health conditions that put you at risk of getting diabetes — such as high blood pressure, high cholesterol and triglycerides, being overweight, or having a family history of diabetes — Medicare Part B (medical insurance) will pay 100% of the cost of up to two diabetes screenings every year.

Doctor's services: If you are a Medicare beneficiary, Medicare will pay 80% of the cost of all doctor's office visits that are related to diabetes after you have met this year's $183 (for 2018) Part B deductible.

Prevention program: Just launched in April, the Medicare Diabetes Prevention Program provides lifestyle change programs offered by health professionals to help you prevent diabetes. This is available for free to all Part B beneficiaries who have pre-diabetes.

Self-management: If you have diabetes, Medicare covers 80% of the cost of self-management training to teach you how to successfully manage your diabetes.

Supplies and medications: After you have met your deductible, Medicare Part B covers 80% of the cost of glucose monitors, test strips (100 per month if you use insulin, or 33 per month if you do not), lancets, external insulin pumps and insulin (if you use a pump).

If, however, you inject insulin with a syringe, Medicare's Part D prescription drug benefit will help pay your insulin costs and the supplies needed to inject it — if you have a plan. Part D plans also cover most other diabetes medications too. You will need to check your plan for specific coverage details.

Nutrition therapy: Medicare will pick up the entire tab for medical nutrition therapy, which teaches you how to adjust your diet so you can better manage your condition. You will need a doctor's referral to get this service.

Foot care: Foot problems are common among diabetics. Medicare covers 80% of foot exams every six months for individuals with diabetes-related nerve damage. They will also help pay for therapeutic shoes or inserts prescribed by a podiatrist.

Eye exams: Because diabetes increases the risks of getting glaucoma and diabetic retinopathy, 80% of dilated medical eye exams are covered each year, but eye refractions for glasses are not.

For more information, see "Medicare's Coverage of Diabetes Supplies & Services" online booklet at Medicare.gov/Pubs/pdf/11022-Medicare-Diabetes-Coverage.pdf.

Other Insurance

If you have a Medicare supplemental (Medigap) policy, it may pay some of the costs that Medicare does not cover. Call your plan's benefits administrator for more information.

If you are in a Medicare Advantage plan (like an HMO or PPO), your plan must give you at least the same diabetes coverage as original Medicare does, but it may have different rules. You should check your policy for details.

Financial Assistance

If your income is low and you cannot afford your Medicare out-of-pocket costs, you may be able to get help through Medicare Savings Programs. To find out if you qualify or to apply, contact your state Medicaid program.

Also, find out if you are eligible for "Extra Help" which helps Medicare Part D beneficiaries with their medication expenses. Visit SSA.gov/prescriptionhelp or call Social Security (800-772-1213) to learn more.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

Published July 27, 2018

WCCF offering $40,000.00 in Fall Grant Cycle

Grants for the WCCF Fall Grant Cycle are issued from the Washington County Community Foundation’s Touch Tomorrow funds and are made possible by the generous donors of the Foundation. The total amount available for this grant cycle is $40,000.00.

Grant applications for the fall grant cycle are available at the WCCF office located on Shelby Street in the Learning Center complex or by emailing program.officer@wccf.biz. The Washington County Community Foundation is currently accepting applications. The application deadline will be 3:30pm, September 13, 2018. For more information, you may call Judy Johnson or Lindsey Wade-Swift at the Foundation office. The number is 883-7334.