Medicare covers some home health services

Posted on February 2, 2012 by Darrell Fryer

Great article I saw in the OC Regsiter on Feb 1, 2012 to help answer a common question I get from people who think Medicare will cover their Long Term Care needs. It’s by DAVID SAVEN
Medicare covers a variety of heath care services that you can receive in the comfort and privacy of your home. These include intermittent skilled nursing care, physical therapy, speech-language pathology services, and occupational therapy.

Such services once were available only at a hospital or doctor’s office. But they’re just as effective, more convenient and usually less expensive when you get them in your home.

If you get your Medicare benefits through a Medicare Advantage health plan (instead of original Medicare), check with the plan for details about how it provides home health benefits.

To be eligible for home health services, you must be under a doctor’s care and receive your services under a plan of care established and reviewed regularly by a physician. He or she also needs to certify that you need one or more home health services.

In addition, you must be homebound and have a doctor’s certification to that effect. (Being homebound means leaving your home isn’t recommended because of your condition, or your condition keeps you from leaving without using a wheelchair or walker, or getting help from another person.) Also, you must get your services from a home health agency that is Medicare-approved.

If you meet the criteria, Medicare pays for covered home health services for as long as you’re eligible and your doctor certifies that you need them.

Skilled nursing services are covered when they’re given on a part-time or intermittent basis. In order for Medicare to cover such care, it must be necessary and ordered by your doctor for your specific condition. You must not need full-time nursing care.

Skilled nursing services are given by either a registered nurse or a licensed practical nurse under an RN’s supervision. Nurses provide direct care and teach you and your caregivers about your care. Examples of skilled nursing care include giving IV drugs, shots or tube feedings; changing dressings; and teaching about prescription drugs or diabetes care. Any service that could be done safely by a nonmedical person (or by yourself) without the supervision of a nurse, isn’t skilled nursing care.

Physical therapy, occupational therapy and speech-language pathology services have to be specific, safe and effective treatments for your condition.

Before your home health care begins, the home health agency should tell you how much of your bill Medicare will pay. The agency should also tell you if any items or services they give you aren’t covered by Medicare, and how much you’ll have to pay for them. This should be explained by both talking with you and in writing. The agency should give you a notice called the Home Health Advance Beneficiary Notice (HHABN) before giving you services and supplies that Medicare doesn’t cover.

What isn’t covered? Some examples:
24-hour-a-day care at home. Meals delivered to your home.
Homemaker services like shopping, cleaning and laundry (when this is the only care you need, and when these services aren’t related to your plan of care).

Personal care given by home health aides like bathing, dressing and using the bathroom (when this is the only care you need).

If your doctor decides you need home health care, you can choose from among the Medicare-certified agencies in your area. (However, Medicare Advantage plans may require that you get home health services only from agencies they contract with.)

One good way to look for a home health agency is by using Medicare’s “Home Health Compare” web tool, at medicare.gov/HHCompare. This tool lets you compare home health agencies by the types of services they offer and the quality of care they provide.

For more details on Medicare’s home health benefit, please read our booklet “Medicare and Home Health Care.” It’s online at medicare.gov/publications /pubs/pdf/10969.pdf.

Posted in Auto Insurance, Capistrano Health Insurance, Disability, Health Insurance, Life Insurance, Long Term Care, Medicare Insurance | Tagged | Leave a comment

The Latest Update on Obamacare

Posted on September 20, 2011 by Darrell Fryer

From John Nelson, President of Warner Pacific who’s company is a General Agency that helps Agents with healthcare issues, quotes, and placing health insurance. He is actively involved with the process of Obamacare and talks to many people in Washington regarding the healthcare challenges we all face as Americans.  It’s one of the best non-partisan viewpoints and understanding of what is going on now. The reading is long, but very informative on what is going on, that I couldn’t stop.

From John: The legal challenges against the PPACA (Obamacare), I will attempt to articulate what I think might happen. My discussion will be limited to certain aspects of the bill – primarily with regard to the individual mandate and the question over severability. So I will be excluding a fair amount. Remember, PPACA is over 2,700 pages long and affects virtually every aspect of healthcare delivery and its related financing (the insurance component) including Medicare, Medicaid and private insurers. It even deals with student loans. Also, my discussion will be limited primarily to one challenge to the law – the one that involved dozens of states suing the federal government in a Florida court.

There are a number of other legal challenges against the federal government that might lead another observer to draw a different conclusion on how these challenges will ultimately pan out down the road. But given the clout and importance of the states, many observers including myself have been particularly interested in that one. Before I address what I think might happen with the Supreme Court, I think it is important to understand the status of the States’ lawsuit and how they got here. So I will be first explaining why the states sued the federal government, how the court ruled and the subsequent action by a district appeals court.

The Reason the States Sued the Feds

The primary reason over two dozen states and other parties (the plaintiffs) sued the federal government is because of the individual mandate. They simply do not think that the federal government has the authority to mandate citizens to buy health insurance. The states believe that the decision about whether or not to compel someone to buy insurance is theirs to make and not the federal government’s. By the way, this is why folks aren’t challenging the likes of Massachusetts which has a similar mandate in place. Massachusetts has the authority as a state to do this.

In more technical terms, the states believe that the federal government via the PPACA is stretching what’s known as the “Commerce Clause” beyond what it was designed to do and is an overreach of power by the federal government. It all harkens back to our history and the compromises that came together to form our nation. The federal government has powers but so do the states. The original 13 individual states wanted to retain a certain amount of autonomy when they formed the union. So there are powers unique to the federal government and there are powers unique to the states. The Commerce Clause was created about a hundred years ago and has evolved over time. It was created to address the question of which governmental entity has the power of regulating business when business is transacted across state lines. For example, let’s say that California has the authority to regulate the California Widget Makers. Colorado has the authority to regulate the Colorado Widget Makers, too. But the way they regulate their Widget Makers is different than how California regulates its Widget Makers. The regulations are different and were promulgated out of the customs and needs of the unique populations. Let’s now assume that Joe’s California based widget company has decided to expand its customer base beyond California and into Colorado. Which regulations apply to Joe? Colorado or California’s?

The Commerce Clause exists, in part, because it answers this question and creates consistency for the likes of Joe because he only has to play by one set of rules and not two. Back to PPACA. So the law mandates that people will have to buy individual coverage starting in 2014. The states are saying “no, whether or not they should be forced to buy coverage is our call, not yours.” The feds are saying it’s their call because a persons decision about whether to obtain or go without coverage transcends state lines and affects everyone throughout the country. The states disagree. But how they’re saying no via their lawsuit in Florida is interesting because their argument is based on this: The Commerce Clause only applies to those people who are engaged in commerce. Those who choose not to buy a product are therefore not involved in commerce and the mandate, therefore, should not apply to them. They say the feds cannot force people out of inactivity into activity. The feds counter by saying that because of regulations that compel hospitals to care for people regardless of whether they have coverage or not, that while someone may appear to be inactive, they’re really not because they’ll eventually need care, they will get it and the rest of us will end up footing the bill via cost shifting (keep in mind that about 20% of our commercial premiums are a direct result of doctors and hospitals charging carriers more to make up for the lack of payments they’re getting from the feds and the uncompensated care they’re giving to folks who don’t have any coverage).

In their lawsuit, the states also asked that if the court agreed with them about the individual mandate, that the whole law should be thrown out and ruled unconstitutional. The basis of their argument is that there is no severability clause anywhere in the 2,700 plus pages of the law. A severability clause basically enables the bulk of the law to survive even if a portion of it is thrown out. These clauses are typical in business contracts (such as agent agreements). But there isn’t one in PPACA and the states said that it should be thrown out if the mandate goes down.

How the Florida Court Ruled

The Florida Court agreed with the states on both counts. Basically, the court said that the government cannot compel people to engage in an activity like buying health insurance. That authority is left to the states. And they agreed that this portion of PPACA was not severable and, therefore, the whole thing is unconstitutional. The court’s rationale here was interesting, I thought.

The reality is that Congress passes a lot of laws that do not include a severability clause. And yet many of those laws remain in place after the court has ruled against certain provisions of them because severability is implied. The courts, not wanting to thwart the will of the people via their elected representatives know that throwing out every single law because of problems with certain sections would create a logjam in government and nothing would get done. So the courts prefer not to do this. But judges don’t automatically assume severability. They go back to and research any documentation they can get their hands on to determine whether or not lawmakers intended to include severability in the legislation. And that’s just what the Florida judge did with the PPACA.

So what did he find? He found that a prior draft of the PPACA did include a severability clause which meant that for some reason, someone pulled it out when the final version was reported out of Congress – possible evidence that Congress did not mean for the PPACA to include severability. Additionally, the judge did more homework and then came across news clips of the President of the United States talking about the importance of the individual mandate and saying that without the mandate, everything else including the provisions that mandate carriers to provide guarantee issue coverage with no waiting period on preexisting conditions would collapse. We can’t force carriers to do this unless everyone is covered, he said. Congress pulled the severability clause from a prior draft of the law and the President was publicly quoted as saying that without the mandate, other aspects of the law won’t work. So the judge concluded that legislators felt that you couldn’t have one without the other. And that’s why the Florida judge cited in his reasoning that the ruling that the individual mandate is an overreach and, therefore, the whole thing must go down with it.

With the judge ruling against the feds and striking down PPACA, the feds appealed to the District Court of Appeals.

The District Court of Appeals Ruling

Three judges were involved in the ruling of the district court – two Democrats and one Republican. Basically, one of the Democrats and a Republican agreed with the Florida judge on the mandate. And they carried the argument one step further. If the PPACA’s individual mandate is left to stand, then where do the feds stop? If a person’s coverage status affects the financial health of the overall healthcare delivery system, then why not compel him to workout, eat better, etc, etc, etc? Not stopping the mandate opens the door for the federal government to impose all kinds of requirements on citizens that the government deems beneficial to overall society. Where does federal authority stop? Allowing the individual mandate to stand would be tantamount to opening a giant door for additional federal influence over states’ rights.

But the appeals court disagreed with the Florida judge over the severability clause. The court said that standard protocol within the House of Representatives assumes that most legislation is severable and that a specific clause isn’t always necessary. The court was sensitive to the impact on the insurance industry if carriers are required to take all applicants with no waiting periods on preexisting conditions with a mandate. But the judges didn’t think this was all that important given that most of the people the mandate would apply to already have coverage. Those who don’t have coverage now, they said, are those who would be eligible for Medicaid and individual subsidies. So if the bulk of the population the mandate would apply to is already insured, then the mandate is not really that important (they did not address the scenario where people may opt to drop their coverage if they know they can get it anytime when they really need it).

So now we have a bit of a disagreement between the Florida court and the appeals court – not to mention all the other PPACA-related lawsuits that are being litigated in other courts throughout the county. Conflicting views and directives from a law as expansive as PPACA is not conducive to harmonious execution of the provisions of that law. Given the two different rulings, what is a given state to do? Do you follow through on the mandate or not? Do you begin building the exchanges or not? You have one court that says no and another that says kind of. It is for these reasons and many others that people believe the next stop is the Supreme Court.

Why and When the Supreme Court Will Likely Take the Case

Before we get into how the Supreme Court is likely to reconcile these contradictions between the lower courts, let’s talk about the question of whether or not the court will even take the case on and the basis of their decision to do so. The fact is that the Supreme Court has to be asked to rule on a case first. And if they are, 4 out of the 9 justices have to agree to take it. When the court takes on a case, it’s usually because the justices believe that the case particulars can create the foundation of a ruling over an issue that the justices have viewed historically as being inconsistent with constitutional law or that is confusing and something that they believe they should address or clarify. So the justices pick and choose cases that they can best use to harvest rulings that help the country in this regard. Often, when they take on a case, it has little to do with the actual issue of the case. More, it has much to do with a bigger picture question or issue pertaining to constitutional law.

So what is the big, compelling question/issue that the Supreme Court might want to resolve using the PPACA as the vehicle? I think it’s the Commerce Clause. This clause has been around for almost a hundred years and it has slowly grown to cover a lot of commercial activity throughout the country. The line between the autonomy of the states and the role of the federal government that was so carefully engineered by our founding fathers seems to have become more blurred over the last century and especially during the last decade. Where do you draw the line? How far reaching should the Commerce Clause be?

To the extreme, if the Commerce Clause continues to grow in influence and affect more and more businesses and everyday life, then what’s the point in even having states? These are very compelling questions for the justices to address, in my opinion. And I can’t imagine a greater platform and vehicle for a grand discussion and directive on this than the PPACA. A prospective ruling on this could be the ruling of the decade – not because of the mandate but because of how it affects states and their relationships with the federal government. So that’s why I believe the Supreme Court will take it. But when will they get it? No one’s sure. The federal government will want to delay the time the case gets to the court as long as possible. The more it’s delayed, the more aspects of the PPACA are likely to be rolled out and become part of societal infrastructure – if a state has already received money and built an exchange with it, what do you do if the court throws out PPACA? My bet is the exchange (or pieces of it) stays in place. And this is why the states want to see the case go to the court right away. From what I’ve read, there’s a 50/50 chance that the court will issue a ruling before the next year’s election.

How Will the Supreme Court Rule On the PPACA?

I for one think there’s a 60/40 chance in favor of the court ruling against the mandate. I have no clue whether they will consider the mandate severable or not, but many observers think the possibility of the court overturning the entire PPACA is unlikely.

What If the Supreme Court Overturns Just the Mandate and Leaves the Rest of the PPACA Intact?

If they rule against the mandate leaving guarantee issue and the no-preexisting clauses intact, we’ll have an individual insurance market rife with adverse selection and severe price increases just like the health insurance environments we already have in New York and New Jersey. So what would lawmakers do with this kind of ruling and the prospects of the entire country turning into a New York-like market? There is no clear cut answer here. Democrats and many republicans consider medical underwriting an anathema. They don’t like it at all. So there would be a natural reluctance to repeal the guarantee issue portion of the law. The other thing is that many democrats believe that the mandate is not really necessary. Last year, I heard an advisor to the White House state that eliminating the mandate will make no difference at all and that people will continue to buy coverage because it “is the right thing to do”. So I really doubt that if the PPACA remains intact sans the mandate, that we will see congress abolish the guarantee issue portion of the law. However, I do believe that we will see regulations that will be geared towards protecting the integrity of the individual market such as special open enrollment periods.

Right now, as the law is written, anyone after January 1st, 2014 will be able to sign up for individual coverage, be covered for their pre-existing conditions and not be rated up according to their health history. There is a mandate to buy coverage but the penalty for failing to do so is very weak. This is a recipe for adverse selection and disaster. There might be a way to fix this, though, via regulations. A rule could be promulgated that states that all citizens have a one-time opportunity to sign up for individual coverage and it is during the month of January, 2014. Sign up then and you’ll get your coverage as envisioned by the PPACA. If you miss this date and change your mind later, then carriers would have the right to rate you up and impose a waiting period. I see the scenario of creating a rule like this more likely than Congress making a politically unpopular law that reinstates medical underwriting.

What If the Supreme Court Overturns the PPACA Entirely?

If the Supreme Court throws the whole thing out, then a lot of things will revert back to the days before PPACA was implemented but ghosts of it will remain.

The MLR requirement will go away – but some of the states will miss it and might pass legislation to reinstate it on their own with perhaps even tighter restrictions. Will commissions on individual climb back up to the levels they were before the PPACA was signed into law? Probably, but I wouldn’t be surprised to see carriers take a little while to increase them.
The federal funding and rules for exchanges go away – but states are already developing them. Do they stop midstream and throw out what has already been built? Or do they stay the course and continue building them (keep in mind that Utah and Massachusetts already have exchanges up and running). It’s hard for me to believe that exchange development for all states will be stopped wholesale if the PPACA goes away entirely. My bet is that some states will continue to build their exchanges albeit with an emphasis on the individual market and less on small group.
Will healthcare delivery costs go up or down if the PPACA goes away? Delivery costs are always trending up but if the law is overturned, the rate of increase is likely to slow due to providers not needing to cost shift as much as they are now due to higher populations of Medicaid patients and cuts to Medicare.
Agents and the industry can breathe a sigh of relief – maybe. For about a month or two. PPACA relieved a lot of pressure on the states to do something about escalating healthcare costs and the growing populations of uninsureds. If PPACA goes away, states will feel more compelled to act on their own. America’s healthcare system has been broken for sometime. That’s why Congress acted and created the PPACA. Unfortunately, the law is bending the healthcare cost curve up and is making things worse. But if PPACA goes away, we’re still left with a broken system that is rapidly becoming a black hole in our economy. Healthcare eats up 16% of our GDP. In 40 years, at the current rate of growth, it will account for 40% of our GDP. How are we going to pay for it? PPACA’s demise would lead to a short term sigh of relief for many but the problems that we’ve had before and after March, 2010 will continue to haunt lawmakers, business, agents and our industry until they are tackled in a meaningful way.
John Nelson

If you would like more information or have any questions, please call me at 949-248-3112 or visit www.capistranoinsurance.com and send me an email.

Thank you and God Bless America!

Darrell Fryer

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Healthy natural ways to decrease health risks

Posted on August 16, 2011 by Darrell Fryer
My family and myself were blessed to be invited on a beautiful Tahittian cruise in July. Everyone should go there if at all possible in their lifetime.  One of the many things I got out of the trip were all the natural foods and plants that can keep the body healthy.  They don’t have the doctors and healthcare like the U.S. does, but they have beautful healthy skin and do not have all the health issues we do in America.  They are not taking a drug everyday. In fact, over 50% of US adults take at least one drug a day and 7% take at least 5! 66% of the people who go to a doctor’s visit walk out with a prescription.  The Tahittian’s eat fish, chicken mainly and tons of fruits and vegetables.  They walk everywhere too.
A couple of things I was taught over there that you can buy here are- Noni (Costco) due your own research, but
  • Noni has a history of use as a topical preparation for joint pain and skin conditions.
  • Today, people drink noni fruit juice as a general health tonic, as well as for cancer and chronic conditions such as cardiovascular disease and diabetes.
Tamanu oil or creme- is a remarkable topical healing agent, with skin healing, antineuralgic, anti-inflammatory, antimicrobial, antibiotic and antioxidant properties.  It was their answer to skin protection from the hot sun, high humidity and ocean winds. Pacific islanders apply Tamanu oil to scrapes, cuts, burns, insect bites and stings, acne and acne scars, psoriasis, diabetic sores, anal fissures, sunburn, dry or scaly skin, blisters, eczema, diaper rash and herpes sores — and even to reduce foot and body odor!  It heals chapped skin, post-surgical wounds, skin allergies, cracked skin, bed sores, wounds, rashes, abrasions, athlete’s foot, boils, and infected nails.

Tamanu oil has even healed severe burns caused by boiling water, chemicals and X-rays.  Its anti-inflammatory properties reduce rashes, sores, swelling and abrasions. Tamanu  oil promotes new tissue formation, accelerating healing and healthy skin growth.

Tamanu oil reputedly relieves a sore throat when it is applied to the neck. It’s pain-relieving properties have also been used traditionally to relieve neuralgia, shingles and believe it or not, leprous neuritis! In the 1920s, Sister Marie-Suzanne, a nun stationed in Fiji, topically applied Tamanu oil to leprosy victims with positive results.  WOW!

Hibiscus Tea-Studies have shown that drinking hibiscus tea can effectively lower high blood pressure and reduce high cholesterol levels in many individuals! Besides lowering high blood pressure and high cholesterol, this healthful hibiscus beverage has several characteristics that make it much more valuable than conventional teas.

  • hibiscus and hibiscus mint tea are caffeine free
  • hibiscus tea is also rich in Vitamin C
  • hibiscus tea has a unique, delicious taste
  • hibiscus tea has a smooth, pleasant fragrance
  • hibiscus tea has a distinctive, vibrant, natural color
  • hibiscus tea is great served hot or cold
  • hibiscus tea has long been known to act as a natural body refrigerant in North Africa

Kava- an essential and integral part of life in the Pacific Islands often
thought of as one of the most precious gifts from the Earth.  Not only is it a
pleasant drink that can be a safe alternative to alcohol, but Kava Kava has been
prescribed as an effective folk remedy for anxiety, insomnia and back pain.  Go here for more information on Kava- http://www.kava.com.

There have been many times when I have been to the doctor and he wants to prescribe something and I will ask if there’s a natural or herbal supplement that treats the sympton and most of the time it’s YES.  I then go to my herbal natural store in laguna Niguel and this man knows everything about what you can take instead of a drug.  Dotors are paid the drug companies to write prescriptions.  I still am amazed they are allowed to do this by law.  In the isnurance business or real estate business, you can’t pay anyone who doesn’t have a license a referrla fee.  That seems very similar and a conflict of interest and should not be allowed.  If that was the case, I am sure we would not have so many people popping pills.

Thank you and God Bless America!

Darrell Fryer

 

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Healthy eating tips to feel great and shed fat 2

Posted on August 11, 2011 by Darrell Fryer

“What delicious food can I eat?”

All of the food I eat each day is incredibly delicious and healthy at the same time. I am able to achieve this because many of the foods people think are not healthy, really are. Examples of such foods are coconut oil, butter, bacon, and raw nuts. Yes many of those foods contain a high amount of fat but I am going to let you in on a very important fat loss secret right now:

Fat does NOT make you fat!

You actually need fat in order to shed your unwanted fat. The trick here is to make sure it is the right kind of fat.

Unfortunately, many people (this may include you) have been led to believe the opposite. People still think that butter and saturated fats are the reason heart disease is one of the top killers in this country (and now in many other countries as well). The truth is that it’s not the natural fats that are causing this epidemic, it’s the sugar, processed and packaged foods and overconsumption of refined oils that are causing so much disease (and you can add Diabetes, High Cholesterol and High Blood Pressure to this list as well).

1. Did you know that during the 60 year period from 1910-1970, the proportion of traditional animal fat in the American diet declined from 83% to 62%?

2. During this same time butter consumption plummeted from 18 pounds per person each year to 4 pounds per person each year.

3. During the past 80 years, the consumption of dietary cholesterol intake has increased only one percent.

So if our consumption of butter and cholesterol has actually decreased, where is the problem? Why all the heart disease?

1. During the same period, the average intake of dietary vegetable oils (margarine, shortening, and refined oils) increased by about 400%.

2. During the same period, the consumption of sugar and processed foods increased by about 60%

When people finally stop eating margarine, refined oils, “fake” butters, sugar and processed foods, their health sky rockets! (and by sky rockets, I mean: gets better, greatly improves, elevates to whole new levels). Not to mention all the body fat they lose off their body (isn’t that just an awful side effect?)

It’s important to mention that the butter you should use is organic and grass fed. The coconut oil, organic and unrefined and the bacon, is grass fed and nitrite/nitrate free. These are great foods to add into your meal plan. Not to mention the fact they will make any recipe absolutely delicious.

Remember , it is not the fat that’s keeping you fat. It is the refined oils, “fake” foods and sugar and artificial sweeteners that are the real culprits.

Now go on and enjoy some delicious food (while you shed off that unwanted fat at the same time!)

How are you doing on your “no white foods” plan? You should already be feeling the amazing, almost instant effects of giving your body a break from many of these foods. If you have not started yet, just begin today. If you are already 2 days in, good for you! Doesn’t it feel great?

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Healthy way to lose weight

Posted on August 11, 2011 by Darrell Fryer

3 super easy rules to follow. (These are magic bullets for getting your metabolism in fat burning mode.) You will lose a minimum of 10 lbs. in 14 days.

1. Don’t eat anything that is white. Think about most foods that are white and chances are you shouldn’t be eating it. Specifically, I’m talking about white bread, pasta, sugar, white rice, and most milk products. Healthy foods like cauliflower, chicken, turkey, fish are all exceptions to this rule.

2. Only drink water, NOTHING else! How about coffee? Just to keep any possible withdrawal headaches at bay, one small cup of organic black coffee is ok. Can you add half and half?…Well is it white?

3. Don’t eat anything with the word wheat in the ingredients list. What if it’s whole wheat? Look, if the word starts with W and ends in T and has the letters h-e-a in between, you can’t eat it.

I highly recommend you follow those same rules for the next 14 days (No, not for the rest of your life. Just for the next 14 days.) You will absolutely amaze yourself with your results. Remember, no white foods (except for the few I mentioned above), only water to drink and no wheat products.

I promise this is not how you have to eat for the long term in order to lose weight and keep it off but I do know that this is a great way to jumpstart your metabolism and see some initial weight come off a bit faster.

Get in some cardio too!

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The Top 5 Killers of Men

Posted on June 26, 2011 by Darrell Fryer

It was a sunny September day in the Pacific Northwest, and Jeff Hale had just closed a $1.5 million deal. To celebrate, he was taking the afternoon off, relaxing on his patio lounge, and playing ball with his dog. That’s when he began feeling compression high in his chest, some pain in his left shoulder, and an unsettling sense of dread. At 44, he was in relatively good shape, although 15 pounds overweight and under a lot of stress from work. At first, he thought it was an asthma attack and took a hit off his inhaler. But when that didn’t help, he remembered an article he’d read in Men’s Health.

“There were two things from that article I recalled,” he recounted to our reporter a few years ago. “One was that every heart attack is unique. My symptoms will be different from your symptoms. The other was, if you suspect you’re having a heart attack, take an aspirin.” Hale took two and drove himself to the hospital. He almost didn’t make it. Doctors found blockages in three arteries and performed a triple bypass the next day. “They told me I’d saved my life,” says Hale. “The aspirin thinned my blood, and the inhaler dilated my arteries.”

Heart disease is the number one killer of men, claiming the lives of nearly 400,000 fathers, friends, brothers, and sons every year. Often, the difference between life and death is razor thin—remembering to pop an aspirin, not delaying your trip to the E.R.

Here is a list of the most popular ways to die as a man in America. Collectively, these diseases kill nearly one million of us annually. And, chances are, your lifestyle or genetic profile puts you at risk for at least one of them.

But, as Jeff Hale learned, our fates are not sealed. If you understand your risks, and learn how to negate them, you can outrun the reaper. Here’s how:

#5- STROKE
Why you’re at risk: Each year, nearly 50,000 American men die of a stroke, according to the American Heart Association. I know what you’re thinking: But those are really old men. But you’re wrong. In fact, 1 in 14 stroke victims is younger than 45. As a neurologist I interviewed a few years ago told me: “If you did MRI scans on a hundred 40-year-olds, you’d see that a large number have already had a silent stroke.” And that’s scary because small, silent strokes often precede large, debilitating strokes.

What you can do about it: Keep your blood pressure at 120/80 or lower. Every 20-point increase in systolic BP (the top number) or every 10-point rise in diastolic BP doubles your risk of dying of a stroke, says Walter Kernan, M.D., an associate professor of medicine at Yale University. The good news: Simple lifestyle changes can dramatically reduce your risk. Assess your stroke risk right here, and learn how to turn the odds in your favor.

#4- CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Why you’re at risk: Nearly 60,000 men died from COPD—which includes chronic bronchitis and emphysema—in 2006, according to the CDC. The chief cause: the Marlboro Man. In fact, smoking causes 80 percent of COPD deaths. Considering that tobacco use has also been directly linked to the other man killers on our Top 5 list—notably, heart disease (#1) and cancer (#2)—you have to ask: Why are people still smoking?

What you can do about it: It’s pretty simple, really. You need to figure out how to kick butts for good. Improve your odds by joining a gym—smokers who are trying to quit often fall off the wagon during stressful moments. Regular exercise lowers levels of cortisol, the stress hormone, in the brain. Warning: Going cold turkey is one of the least successful ways of quitting. Find out how to tilt the odds of success in your favor by checking out Will You Be Able to Quit Smoking?

#3- ACCIDENTS
Why you’re at risk: According to the CDC, 80,000 men die each year in unexpected tragedies, from sports injuries to fires to falls. But the most preventable accidental deaths are the 30,000 that occur on America’s roads every year.

What’s that? You’re a great driver? Not surprising that you think so. According to a study by the Insurance Institute for Highway Safety, 72 percent of drivers regard themselves as more skilled than everyone else. Researchers trace the bias to a fundamental information imbalance, namely that the poorest performers are also the least able to recognize skill (or lack of skill) in themselves or others.

But fine, let’s say it’s true. Then consider the guys you’re sharing the road with: Surveys indicate there’s a nearly 80 percent chance they speed regularly, and a 53 percent likelihood they talk on the phone while driving. There’s a 4 percent chance they run red lights—on purpose—and a 2 percent chance they have driven after drinking too much. These guys make Evel Knievel look like a defensive driver.

What you can do about it: If you do one thing today, make it this: Stop texting while driving. You’ve probably heard that texting behind the wheel is just as dangerous as drinking and driving. Not true. Texting is way more dangerous. In fact, texting increases your risk of a crash by 23 times (versus 11 times for driving under the influence), according to a Virginia Tech study. Step into the MH Driving Simulator and test how well you multitask behind the wheel.

#2- CANCER
Why you’re at risk: The Big C killed nearly 300,000 men in 2010, according to the American Cancer Society. Lung cancer tops the list, accounting for 29 percent of all cancer deaths, followed by prostate cancer (11 percent) and colon/rectum cancer (9 percent). We all know that smoking causes lung cancer, but the risk factors for prostate cancer are less well known. Yet, it’s one of the most common—1 in 6 men will get prostate cancer in their lifetimes—and least understood killers of men.

What you can do about it: Take our quiz to determine your risk. If you’re at high risk, put certain staples of the Mediterranean diet on your plate. A study published in the Journal of the National Cancer Institute shows that men who eat more than 10 grams of garlic or scallions (about three cloves of garlic or 2 tablespoons of scallions) daily have a 50 percent lower risk of prostate cancer than those who eat less than 2 grams. Sound like too much of a good thing? Other studies have linked the lycopene in cooked tomato products to lower prostate cancer risk; aim for at least two servings a week. And if you really like coffee . . . Harvard researchers found that drinking 6 cups a day reduces your risk of developing advanced prostate cancer by 59 percent.

#1- HEART DISEASE
Why you’re at risk: This is the deadliest disease known to man. More than 1 in 3 adult men have some sort of heart disease and more than 390,000 men died of the killer in 2007, according to the American Heart Association.

But you’re a fit, healthy guy, right? Why would you die of heart disease? Believe it or not, not every victim of the disease is overweight or inactive. Men’s Health Editor Peter Moore discovered this eight years ago. He was doing everything right: He was thin, exercised regularly, and ate a healthy diet. But none of that prevented one of the arteries in his heart from becoming 99 percent blocked. Still think you’re risk-free? You can find out your heart disease risk by clicking right here.

What you can do about it: Small lifestyle changes can yield big results when it comes to improving heart health. Here are four simple changes you can make today:

• Exercise for 30 minutes. Middle-aged men who exercise vigorously for two hours a week (aim for 30 minutes, four times a week) have a 60 percent lower risk of a heart attack than inactive men.

• Lose the spare tire. If you’re overweight, dropping 10 to 20 pounds lowers your risk of dying from a heart attack. In fact, a 10-year study found that overweight people had heart attacks 8.2 years earlier than normal-weight victims.

• Drink five glasses of water a day. Men who drink that many 8-ounce glasses are 54 percent less likely to have a fatal heart attack than those who drink two glasses or fewer. Researchers say the water dilutes the blood, making it less likely to clot.

• Count to 10. Keeping your cool under stress may keep you alive. Men who respond with anger are three times more likely to have heart disease and five times more likely to have a heart attack before turning 55.

By Bill Phillips and Editors of Men’s Health

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Long-Term Care comes Of Age

Posted on May 17, 2011 by Darrell Fryer

 May 2011

By: Constance Gustke,
Special to CNBC.com

Putting off planning for long-term care? Think again. These days, your assets can be quickly drained — especially with skyrocketing costs and strained Medicare and Medicaid programs..

Costs for nursing homes and assisted living are rising twice as fast as inflation.

The national average for a private room in a nursing home cost $83,585 a year, according to a 2010 MetLife survey. Less costly assisted living was $32,930, but had even heftier price hikes.

“People are burning through their money,” says Matthew Tuttle, CEO of Tuttle Wealth Management in Stamford, Connecticut. “They didn’t plan ahead.”

Nevertheless, about two-thirds of those 65 years or older will use — or need — some form of long-term care.

The challenge — as we live longer — is how to pay for it.

Most experts favor insurance. A new hybrid life insurance or annuity policy can be used to cover long-term care costs. Or you can use traditional long-term care insurance. The latter is especially cost effective — about $3,000 to $5,000 a year, a fraction of the cost of a nursing home. And the policies are wide-ranging, covering home care, assisted living or nursing homes.

After seeing their parents deplete their life savings, more baby boomer are signing up for this insurance, says Diana Scheel, a financial advisor at Sapient Financial in San Antonio, Texas. She expects the trend to accelerate as long-term care costs rise.

Despite rising demand, though, some companies have left the space and others are raising premiums because they underpriced policies—complicating the process.

And other social safety net alternatives like Medicare and Medicaid are under the gun. Medicare is due to run dry as soon as 2017, says Larry Van Horn, professor of health care economics at Vanderbilt University. And it’s highly limited, usually only covering 20 percent of long-term care costs.

Meanwhile, state-run Medicaid keeps tightening its rules. Experts see it as the payer of last resort, and soon some things won’t be covered.

“Medicaid will get worse,” says Van Horn, as states struggle to pay for it.

The answer, then, is doing aggressive financial planning, say experts; for starters, make sure you have three to four sources of income to fund long-term care.

Fortunately, most people prefer home care, which is cheaper than the institutional kind. Costs have barely risen for the past ten years. Nationally, the average hourly rate for a licensed home health aide was $21 last year, according to MetLife.

“People can arrange their affairs so they can stay at home,” says Tuttle. “Nursing homes are expensive and depressing.”

And long-term care policies can help shoulder the costs. But you must use the policy or lose the money you contributed—much like health insurance. And policies can be complex because they’re customized. You decide when they start, how you’ll pay and how long the waiting periods are. Also, costs are rising quickly.

The sweet spot for buying insurance is when you’re in your 50s, says Scheel. After that, long-term insurance is more expensive and poor health can disqualify you. She suggests adding inflation benefits to your policy to cover rapidly rising rates. Also, choose a plan that covers your full stay at a nursing home — usually three years.

To guard against being caught short, over-fund the policy, suggests Louis Berlin, president of Insurance for Enhanced Living in Miami, whose mother was bankrupted after spending 27 years in a nursing home.

Lately, some experts are recommending hybrid policies, which combine death benefits and long-term care insurance. They come in two versions: a deferred fixed annuity or life insurance policies; both leave money to heirs. The death benefit is simply reduced if you use it to pay for your care.

But there are drawbacks—they’re highly complex and carry higher premiums than regular long-term policies. Tuttle calls them a “marketing gimmick,” preferring long-term care insurance.

“Long-term care is a colossal train wreck,” says Van Horn, adding that costs will very likely keep rising. “We’ve shifted home care from kids to public vehicles. We can’t afford that anymore.”

Hope this makes you think of getting a LTC policy.

Call me or send me an email, and I will send you some figures on how inexpensive it is and the most likely to be used insurance you will buy.

Darrell Fryer
949-248-3112
www.capistranoinsurance.com

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Imagining a Better Healthcare System

Posted on May 3, 2011 by Darrell Fryer

I believe it is very important that people fully understand the mechanics of America’s healthcare delivery system, why it is broken and what it might look like if it’s successfully overhauled.

The fundamental problem with the American healthcare system is that we hardly spend any money on basic, general care which causes us to spend a whole bunch of money on specialty care. The fact is that five chronic diseases account for 70% of our country’s $2.6 trillion in annual healthcare expenditures. Those diseases are coronary artery disease, congestive heart failure, diabetes, depression and asthma. The status quo of the way we deliver healthcare is conducive to inadequate management of chronic illness. There’s not a lot of money in educating a family on what brings on an asthmatic attack and what to do in case a child suffers from one. But there’s a whole lot of money spent when an asthmatic is admitted to the hospital. The lack of proper care and management of diabetes can lead to very expensive care including amputations, dialysis at $10,000 a day and maybe even a new kidney at $250k. Outreach programs to help diabetics methodically check their blood chemistry, see their doctors regularly and gain access to nutritionists are generally poorly funded, if they exist at all. So it’s no wonder that diabetes alone accounts for 35% of Medicare expenditures. Shortages in access to primary care due to lack of financial incentives (why be a general practitioner when you can make three times the money being a specialist???) cost our system hundreds of billions of dollars a year. Unless our country does more to encourage chronic disease management, the healthcare cost curve will continue upward and ultimately drive our country off the edge of an economic cliff.

Having said this, our system appears to be in the early stages of changing for the better. For example, Congress included within the Patient Protection and Affordability Care Act (PPACA) language to encourage development of Accountable Care Organizations (ACOs) to help save Medicare money. According to Wikipedia, many healthcare leaders define the three core principles for ACOs as follows: 1) Provider-led organizations with a strong base of primary care that are collectively accountable for quality and total per capita costs across the full continuum of care for a population of patients; 2) Payments linked to quality improvements that also reduce overall costs; and, 3) Reliable and progressively more sophisticated performance measurement, to support improvement and provide confidence that savings are achieved through improvements in care. Living examples kind of look like Integrated Delivery Systems such as Kaiser and HealthCare Partners Medical Group. In other words, in this model, hospitals and specialists within an ACO would be rewarded for positive health outcomes even if they never see the patient.

While Congress had making Medicare more effective and efficient in mind when they incorporated ACOs into PPACA, my bet is that large employers will be watching the development of this model with a great deal of interest. One of the advantages that large groups have over small groups is the fact that they can realize a return on investment (in the form of lower premiums and higher employee productivity) by incorporating chronic disease management and wellness programs into their employee management regimen. And that’s a good step towards lowering the cost of healthcare in our country.

But what about small employers??? Small employers don’t have the advantage that large employers have because of how small group rates are pooled in our markets. An employer with 10 employees who tries to help his employees live healthier lives will not realize a meaningful decrease in his health insurance premiums for his efforts because his company’s rates are pooled with thousands of others. But carriers being sensitive to the escalating cost of the delivery system and the threat this poses to the industry via reduced commercial enrollment are likely to take steps to modify their networks to look more like integrated delivery systems, ACO’s and, yes, even fully capitated HMO’s (remember those?). Furthermore, since the PPACA and its related changes to Medicare and Medicaid became the law of the land, the nature of conversations between providers and insurers appears to have changed for the better. So there is likely to be more productive innovation when it comes to developing future, new healthcare delivery models. Everyone realizes that unsustainable increases in cost are simply that; unsustainable.

Will these initiatives work? I think they will. All of this equates to more optimism that the healthcare delivery system has the potential to change and that the cost curve can begin to change course and begin to trend downward.  The public needs to understand what we talked about above. The more the public know about how the healthcare delivery system works, the more they will embrace and expect positive changes to it. If you would like real case examples of the benefits of managing chronic diseases, let me know and I’ll forward you the article. I promise you that it will find it eye-opening and inspirational.

This document is not intended to be authoritative, and its accuracy is not guaranteed. It is believed to be correct at the time of its printing.

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Wake up America and do something

Posted on April 20, 2011 by Darrell Fryer

This article appeared in The Wall Street Journal.
Obama in 2012, No Matter What
By Dr. Walter Williams
Williams is a black conservative professor at George Mason University.

Can President Obama be defeated in 2012? No. He can’t. I am going on record as saying that President Barak Obama will win a second term. The media won’t tell you this because a good election campaign means hundreds of millions (or in Obama’s case billions) of dollars to them in advertising. But the truth is, there simply are no conditions under which Barak Obama can be defeated in 2012.

The quality of the Republican candidate doesn’t matter. Obama gets reelected. Nine percent unemployment? No problem. Obama will win. Gas prices moving toward five dollars a gallon? He still wins. The economy soars or goes into the gutter. Obama wins. War in the Middle East? He wins a second term. America’s role as the leading Superpower disappears? Hurrah for Barak Obama! The U.S. government rushes toward bankruptcy, the dollar continues to sink on world markets and the price of daily goods and services soars due to inflation fueled by Obama’s extraordinary deficit spending? Obama wins handily.

You are crazy Williams. Don’t you understand how volatile politics can be when overall economic, government, and world conditions are declining? Sure I do. And that’s why I know Obama will win. The American people are notoriously ignorant of economics. And economics is the key to why Obama should be defeated. Even when Obama’s policies lead the nation to final ruin, the majority of the American people are going to believe the bait-and-switch tactics Obama and his supporters in the media will use to explain why it isn’t his fault. After all, things were much worse than understood when he took office .

Obama’s re-election is really a very, very simple math problem. Consider the following:
1) Blacks will vote for Obama blindly. Period. Doesn’t matter what he does. It’s a race thing. He’s one of us,

2) College educated women will vote for Obama. Though they will be offended by this, they swoon at his oratory. It’s really not more complex than that,

3) Liberals will vote for Obama. He is their great hope,

4) Democrats will vote for Obama. He is the leader of their party and his coattails will carry them to victory nationwide,

5) Hispanics will vote for Obama. He is the path to citizenship for those who are illegal and Hispanic leaders recognize the political clout they carry in the Democratic Party,

6) Union members will vote overwhelmingly for Obama. He is their key to money and power in business, state, and local politics,

7) Big Business will support Obama. It already has. He has almost $1 Billion dollars in his re-election purse gained largely from his connections with Big Business and is gaining more everyday. Big Business loves Obama because he gives them access to taxpayer money so long as they support his social and political agenda,
8) The media love him. They may attack the people who work for him, but they love him. After all, to not love him would be racist,

9) Most other minorities and special interest groups will vote for him. Oddly, the overwhelming majority of Jews and Muslims will support him because they won’t vote Republican. American Indians will support him. Obviously homosexuals tend to vote Democratic. And lastly,

10) Approximately half of independents will vote for Obama. And he doesn’t need anywhere near that number because he has all of the groups previously mentioned. The President will win an overwhelming victory in 2012.

A lot of Americans say we’re reaching a tipping point between freedom and tyranny.

Or have we past it?

Spread the word, we are not that stupid to sit back and allow this to happen are we?!

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1099 Repeal Bill Passes Senate

Posted on April 18, 2011 by Darrell Fryer

Following months of procedural and political back and forth, stand-alone legislation that would repeal the 1099 tax reporting requirement for businesses included in the Affordable Care Act (or the health care reform law) was signed by President Barack Obama on April 15. This reporting requirement would have required businesses to file a 1099 form with the Internal Revenue Service every time they spent more than $600 a year with another business – greatly increasing the burden on businesses.

To offset the revenue losses by the repeal of this provision, the repeal legislation requires eligible individuals to repay the subsidies they are eligible for under the health care reform law if their income rises above 400% of the federal poverty level.

Passage of the 1099 repeal legislation is considered a victory for business groups that have expressed opposition to the provision since the health care reform law’s passage last year, but this also represents the first time the health care reform law has been successfully changed.

Yahoo!

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Factors that affect your auto rates

Posted on February 21, 2011 by Darrell Fryer

You and your neighbor could own identical cars yet pay a vastly different sum for insurance. That’s because you each may have a different set of circumstances that affect the level of risk you represent to an insurance company. Your premium, which is the amount that you pay for the policy, will be determined based on several factors.

A few of these factors you cannot control, such as your age and health. But most are under your control, such as your driving record, claims history, other cars you own, other drivers on your policy, the amount of your deductible, the policy limits, the age and type of vehicle you drive, even your credit rating. By maintaining a favorable status in as many of these areas as possible, you can whittle down the size of your premium.

Your Car and How You Drive it
It’s no secret that a good driving record is critical to your ability to obtain, afford, and retain auto insurance. If your past is free of tickets, accidents, and drunk driving arrests, chances are excellent that you will pay much less than the person who has a history of these infractions.

Fortunately, your driving record only goes back so far. Driving offenses typically disappear from your record after three or more years, depending on the seriousness of the offense.

The type of vehicle also figures prominently. Sports cars, for example, can cost significantly more to insure because they may be a favorite among thieves, because statistically people tend to drive them faster, and because they may have a higher replacement cost than something like a sedan or a van.

You can lower your premium by buying less expensive cars and maintaining a clean driving record. Your insurer may offer discounts if your car has added safety measures such as anti-lock brakes and air bags, and anti-theft devices such as an alarm or a tracking device. If you drive an older car, you may want to consider carrying only liability coverage if the cost of collision and comprehensive coverage outweighs the potential benefits.

Your Address and Your Family
Where you live also enters into the premium equation. You’ll pay more for living in an urban area where your car stands a greater chance of vandalism, theft, or accident. Drivers who live in rural areas may pay lower rates because they are less at risk for these types of misfortune. Some companies will discount your premium if you keep your vehicle in a garage.

You may qualify for a discount if you have multiple drivers or vehicles on the same policy, or for carrying your other policies, such as homeowners or life insurance, with the same company.

If your teenage driver earns good grades in school, you may get a discount. But in some cases, adding teenagers to your policy might cause your rates to go through the roof, because teens are among the riskiest drivers on the road. Take time to compare the cost of including a teen on your policy versus buying him or her a separate policy.

Look for premiums to fluctuate with your age as well. Just as a teenager will have to pay more for being young and inexperienced, drivers can expect to pay less as they reach the age range where they are statistically the safest on the road, roughly from ages 40 to 55. In some cases, rates may go up as a driver becomes elderly.

Policy Limits, Deductibles and Extended Coverages
Most states require drivers to provide proof of financial responsibility or carry a minimum amount of liability coverage. You can elect to purchase liability coverage beyond the level required by the laws of your state, but your premium will go up as a result. Why would you want to buy more insurance than is required? If you are found to be liable for an amount greater than the coverage limits of your policy, you must pay the difference. If you don’t have enough cash, the injured party can go after your assets and future earnings. It’s wise to consider increasing your liability limits when you own a house or other valuable assets.

Deductibles for auto insurance operate the same way as in other kinds of policies. For certain losses, usually a collision that was your fault, or damage from some external force such as a fallen tree or a vandal, you will be required to assume typically the first $250, $500, or $1,000 of the loss, depending on which deductible you chose when you bought the policy.

Except in rare instances, you get to choose the amount of your deductible. Generally, the higher the deductible, the lower your premium will be. That’s because the more risk you assume, the less risk you assign to the insurance company, which charges according to how much risk it is insuring against.

But the amount of your premium may be only one factor in your deductible decision. If you carry a $1,000 deductible, you may want to consider whether it’s likely you would have that much cash at the ready if you suffered a loss. You may also want to consider whether you are prone to accidents, whether your car is exotic and would cost more to repair, and whether you would be more likely to live with minor damage than paying to fix it.

Some companies will sell you additional coverage for towing and replacement transportation while your car is being repaired. Your circumstances will dictate whether the additional coverage is warranted. If you live alone and your life would grind to a halt without a car, you may elect these upgrades. Conversely, you may decide to forego these coverages if you have a second car to drive in emergencies, or if you already pay for a separate towing policy.

No Two Carriers Alike
Finally, your premium will vary with the insurance company you choose. Here are some examples.

•Some companies are structured to best serve safe drivers, and may be too expensive for risky drivers. On the other hand, some carriers are structured to serve risky drivers, which may prevent them from offering competitive rates to good drivers.

•Some companies may consider your credit rating at the time you purchase the policy. If you have had enough recent credit activity to raise your score, you could pay more, even if you are a good driver or have good credit. Of course, a change in your credit won’t affect your premium after the policy is in force. When you are shopping for a policy, it would be wise to inquire about the role of your credit rating in your premium.
•Some companies will raise the premium after your first accident, but others may forgive the first claim with no increase. Some increase rates after a claim only if the settlement exceeds a stated maximum.
•Some companies will know right away if you are cited for moving violations, and raise your rates as a result. Others may not update that kind of information for months or years, and some may not penalize you even when they do find out.
•Some carriers may give a discount for paying the premium in a lump sum. Others may add a fee if you make monthly payments.
When you are shopping for a policy, it’s important to know the cost to you can vary greatly depending on the your lifestyle and the policy options you choose. Be certain to know and understand the limits and provisions of a policy before you buy it.

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What to Say during your next doctor’s visit

Posted on January 12, 2011 by Darrell Fryer

Have you ever walked out of the doctor’s office realizing you don’t remember what was discussed and what your supposed to do?
Most of us don’t have a problem talking to our friends, sharing a problem with a family member, questioning a sales clerk, or listening to our boss. However, most people have a hard time talking to your own doctor or nurse.

Paula Alinskas, R.N. of 27 years, offers ways to get the most of your visits.

1. Take notes. Bring a notebook that you can bring over and over to keep track of your health issues. Take notes and write the date and reason you were there. Most importantly is to write the answers to your questions.
2. Be ready to fully explain your symptoms, even if they are embarrassing.
3. Have questions ready before your appointments. When you are there for a checkup and may not have questions, questions might revolve around recommendations for screening tests.
4. Take all your medications, or at least write them down and bring them with you. All medications even if over the counter, vitamins, home remedies, herbs. Also the dosage and how often.
5. If your doctor prescribes a new medication, find out why. What side effects and does it need to be taken with food? How long must you stay on it? I am not a fan of prescriptions and the least you can take, the better. There are natural herbs you can do that will do the trick for a lot of issues. I don’t like how the doctor likes to throw pills for treatment which can lead to knew problems and then you need a pill for that. And so the spiral goes on…
6. If the doctor is ordering a test, ask why. Will the results change the course of treatment? Are there any special instructions before or after the test? Can you get a copy of the test? If so, save it in your binder.
7. If you have a know diagnosis for which you are seeing your physician, try to find as much information as you can about it and the usual treatment plans. Formulate questions before you go in about the treatment plans. If you are unsure about a treatment or test that is being prescribed, ask what would happen if you did not follow the recommendation. If you are planning to ignore a recommendation, explain why. If you want a second opinion, say so.
8. You may be nervous and not hear everything accuarately. If you feel it would be beneficial, bring a close friend or family member to join you at your visit to help take notes and provide a second set of ears.
9. If you have difficulty reading, tell your doctor. Don’t be embarrassed. If you don’t understand something the doctor said, ask for clarification. You need to understand what is happening to you, to your body.
10. If additional questions come to mind after you’ve left the office, call back and leave a message with someone who can rely your questions to your doctor.

In addition to this, your health insurance provider might have an online 24 hour question to the nurse either through email or live chat.  You type the question, and someone will reply back. 
Just remember your doctor has seen it all and heard it all. Don’t leave anything out. They are there to help you.

If you have any questions, drop me a line or give me a call.

God Bless America,

Darrell Fryer, Certified Health Insurance Professional
www.capistranohealthlife.com

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What Does Medicare Cover?

Posted on December 31, 2010 by Darrell Fryer

What Is Medicare?
Medicare is the federal health insurance program for elderly persons and certain disabled individuals. In 1965, Medicare was enacted to provide a “safety net” of health-care coverage for qualifying individuals.

Medicare is packaged in two major parts. Part A is hospital insurance protection. It covers hospitalization, some hospice care, and a limited amount of post-hospital skilled nursing and home health care. Part B, which is medical insurance, covers physicians’ services, outpatient hospital care, physical therapy, diagnostic tests, and a variety of other services. More recently, Medicare added Part D, prescription drug coverage.

At first glance, it appears that Uncle Sam has everything covered. But unfortunately, there are many limitations.

Medicare Costs
Every time you go to the hospital, you have to pay a certain amount of your hospitalization costs, unless your visits are separated by fewer than 60 days. If that’s the case, you pay the deductible only the first time.

If you stay in the hospital longer than 60 days, you will be required to pay a copayment every day for days 61 through 90.

You also have a lifetime reserve of 60 days that can be used in conjunction with more than one extended stay. These days also have an associated copayment. Medicare won’t cover any stays longer than 90 days once you have depleted your 60-day reserve.

Will Medicare Pay for Skilled Nursing Care?
Medicare will pay for the first 20 days of skilled nursing care, but only after you’ve been in the hospital for three days. This means you’ll have paid at least the deductible for that three-day stay. From the 21st day through the 100th day, Medicare will cover some of the costs of skilled nursing care, but you still have a copayment. After 100 days, Medicare will not pay for skilled nursing care, and you must bear the full cost. The 100 days are per benefit period.

What About Medigap?
Medicare supplemental insurance, or “Medigap,” is designed to pick up where Medicare stops. As such, it usually pays the deductibles and copayments required by Medicare. Coverage will vary according to the benefits outlined in each specific policy.

Medigap insurance may not pay for any additional procedures that aren’t specifically addressed by Medicare. Most policies will only help to cover the deductibles and copayments imposed by Medicare.

What About Long-Term Care?
Medicare provides only limited coverage for skilled nursing care and pays for only up to 100 days of care following a three-day hospital stay. Medigap doesn’t fill the gaps in this coverage.

If you are concerned about meeting your potential long-term-care needs, you should look into additional insurance to help fill in the gaps. In many cases, it may be best to consider purchasing a private long-term-care insurance policy to help protect against these potentially devastating costs.

To find out more information, please call 949-248-3112 or visit www.capistranofinancial.com

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Long Term Care as an option

Posted on December 14, 2010 by Darrell Fryer

In general, Americans are not sufficiently prepared to pay for long-term care. Many of them go through their lives simply hoping that they won’t ever need it. Unfortunately, in the event that you or a loved one does need long-term care, hope won’t be enough to protect you from potential financial ruin.   Also, the odds that you will need some kind of long-term care increase as you get older.

Self-Insurance as an Option
To self-insure — that is, to cover the cost yourself — you must have sufficient income to pay the rising costs of long-term care. Keep in mind that even if you have sufficient resources to afford long-term care now, you may not be able to handle rising future costs without drastically altering your lifestyle.

The Medicaid Option
Medicaid is a joint federal and state program that covers medical bills for the needy. If you qualify, it may help pay for your long-term-care costs. Unfortunately, Medicaid is basically welfare. In order to qualify, you generally have to have few assets or will need to spend down your assets.

 State law determines the allowable income and resource limits. If you have even one dollar of income or assets in excess of these limits, you may not be eligible for Medicaid.  To receive Medicaid assistance, you may have to transfer your assets to meet those limits. This can be tricky, however, because there are tough laws designed to discourage asset transfers for the purpose of qualifying for Medicaid. If you have engaged in any “Medicaid planning,” consult an advisor to discuss any new Medicaid rules.

Long-Term-Care Insurance
A long-term-care insurance policy may enable you to transfer a portion of the economic liability of long-term care to an insurance company in exchange for the regular premiums.

Long-term-care insurance may be used to help pay for skilled care, intermediate care, and custodial care. Most policies pay for nursing-home care, and comprehensive policies may also cover home care services and assisted living. Insurance can help protect your family financially from the potentially devastating cost of a long-term disabling medical condition, chronic illness, or cognitive impairment.

 A complete statement of coverage, including exclusions, exceptions, and limitations is found only in the policy.

 Long-Term-Care Riders on Life Insurance
A number of insurance companies have added long-term-care riders to their life insurance contracts. For an additional fee, these riders will provide a benefit — usually a percentage of the face value — to help cover the cost of long-term care. This may be an option for you. 

For more information, please visit www.capistranofinancial.com

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What types of health coverage is available

Posted on November 17, 2010 by Darrell Fryer

Rising health-care costs have driven the demand for, and the price of, medical insurance sky-high. The availability of group coverage through employment has helped many Americans face such costs. However, people who are not currently covered by their employers have few affordable sources for group coverage. If you are not covered at work, inquire about coverage through your religious affiliation, professional organizations, or alumni association.

Individuals seeking medical coverage on their own can explore purchasing an individual health insurance policy. And those aged 65 and older may qualify for Medicare coverage.

There are three general classifications of medical insurance plans: fee-for-service (indemnity), managed care (e.g., HMOs and PPOs), and high-deductible health plan (HDHP). Older persons may be eligible for Medicare coverage.

Fee for Service

With a basic fee-for-service (indemnity) insurance plan, doctors and hospitals are paid a fee for each service provided to insured patients.

Indemnity plans normally cover hospitalization, outpatient care, and physician services in or out of the hospital. You select the service provider (physician) for consultation or treatment. You are then billed for the service and reimbursed by the insurance company, or you can “assign” direct payment to the provider from the insurance company. Indemnity plans typically require the payment of premiums, deductibles, and coinsurance. Limits on certain coverage or exclusions may apply. Because many policies have lifetime limits on benefits that the insurance company will pay, you should look for a policy with a lifetime limit of at least $1 million.

Managed Care

Managed-care plans became popular in the 1990s as a way to help rein in rising medical costs. In managed-care plans, insurance companies contract with a network of doctors and hospitals to provide cost-effective health care. Managed-care plans include health maintenance organizations (HMOs), preferred provider organizations (PPOs), and point-of-service (POS) plans.

Health maintenance organization. An HMO operates as a prepaid health-care plan. You normally pay a monthly premium in addition to a small copayment for a visit to a physician, who may be on staff or contracted by the HMO. Copayments for visits to specialists may be higher. The insurance company typically covers the amount over the patient copayment amount.

Each covered member chooses or is assigned a primary-care physician from doctors in the plan. This person acts as a gatekeeper for his or her patients and, if deemed necessary, can refer patients to specialists who are on the HMO’s list of providers. Because HMOs contract with doctors and physicians, costs are typically lower than in indemnity plans.

Preferred provider organization. A PPO is a managed-care organization of physicians, hospitals, clinics, and other health-care providers who contract with an insurance company to provide health care at reduced rates to individuals insured in the plan. The insurance company uses actuarial tables to determine “reasonable and customary” fees for each type of service, and health-care providers accept the PPO’s fee schedule and guidelines.

The insured can see any doctor or hospital within a preferred network of providers and pays a copayment for each visit. Insured individuals have to meet an annual deductible before the insurance company will start covering health-care services. Typically, the insurance company will pay a high percentage (often 80%) of the costs to the plan’s health-care providers after the deductible has been met, and patients pay the balance.

Although insured individuals can choose physicians or providers outside the plan without permission, patient out-of-pocket costs will be higher; for example, the initial deductible for each visit is higher and the percentage of covered costs by the insurance company will be lower. Because PPOs provide more patient flexibility than HMOs, they may cost a little more.

Point-of-service plan. A POS health-care plan mixes aspects of an HMO and a PPO to allow greater patient autonomy. POS plans also use a network of preferred providers whom patients must turn to first and from whom patients receive referrals to other providers if deemed necessary. POS plans recommend that patients choose a personal physician from inside the network. The personal physician can refer patients to other physicians and specialists who are inside or outside the network. Insurance companies have a national network of approved providers, so insured individuals can receive services throughout the United States. Copays tend to be lower for a POS plan than for a PPO plan.

High-Deductible Health Plan

An HDHP provides comprehensive coverage for high-cost medical bills and is usually combined with a health-reimbursement arrangement that enables participants to build savings to pay for future medical expenses. HDHP plans generally cover preventive care in full with a small (or no) deductible or copayment. However, these plans have higher annual deductibles and out-of-pocket limits than other insurance plans.

Participants enrolled in an HDHP can open a health savings account (HSA) to save money that can be used for current and future medical expenses. There are annual limits on how much can be invested in an HSA. The funds can be invested as you choose, and any interest and earnings accumulate tax deferred. HSA funds can be withdrawn free of income tax and penalties provided the money is spent on qualified health-care expenses for the participant and his or her spouse and dependent children.

Remember that the cost and availability of an individual health insurance policy can depend on factors such as age, health (pre-existing conditions), and the type of insurance purchased. In addition, a physical examination may be required.

Medicare

Medicare is the U.S. government’s health-care insurance program for the elderly. It is available to eligible people aged 65 and older as well as certain disabled persons. Part A provides basic coverage for hospital care as well as limited skilled nursing care, home health care, and hospice care. Part B covers physicians’ services, inpatient and outpatient medical services, and diagnostic tests. Part D prescription drug coverage is also available.

Medicare Advantage is a type of privately run insurance plan that includes Medicare-approved HMOs, PPOs, fee-for-service plans, and special needs plans. Some plans offer prescription drug coverage. To join a Medicare Advantage plan, you must have Medicare Part A and Part B and you have to pay the monthly Medicare Part B premium to Medicare, as well as the Medicare Advantage premium.

Medicare Supplement Insurance, or Medigap, is sold by private insurance companies and is designed to cover the deductibles and copayments that Medicare doesn’t cover. At one point, there were more than 200 different policies available. Then the National Association of Insurance Commissioners stepped in and created 10 standard packages of coverage, designated by the letters A through J. Starting in June 2010, plans E, H, I, and J will no longer be sold, although you can keep your plan if you already had one of these plans before June 2010. There are also two new policies (plans M and N) that offer different benefits and premiums. Plans D and G bought on or after June 1, 2010, have different benefits than D and G plans bought before June 1, 2010 (although the benefits won’t change for those who participated in these plans prior to June 1). Only Medigap insurers are able to offer these plans. Although each standardized plan is identical from insurer to insurer, prices may differ and all these plans may not be available in every state.

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Repeal Obamacare

Posted on November 16, 2010 by Darrell Fryer

No matter how much the new Congress does to encourage private sector growth, ObamaCare will become a severe drag on the economy and lead to lower quality care. Many businesses facing unknown tax hikes and enormous regulations from this law will not hire additional full time workers.

The Obama-Pelosi-Reid team also ignores the fact that major companies like McDonald’s, 3M, and Boeing have said the new taxes and mandates will force them to drop coverage or lay off workers. Instead of listening to them, the Obama administration has threatened those who dare to blame higher taxes and more regulation for an inability to grow their businesses.

Here are some facts you need to know about ObamaCare:

Costs taxpayers a staggering $1 trillion over the next decade.
Increases health care spending by more than $200 billion.
Raises drug prices and the cost of premiums.
Raises taxes on small businesses.
Burdens state governments with costs nearing $10 billion between 2014 and 2019.
Forces companies to drop employer-provided health coverage for workers.
Incentivizes individuals to drop their own coverage, pay a penalty, and only get health insurance when they get sick.

Despite all these problems, President Obama and his liberal allies still defend the law as good for American business. But this should not be surprising; they still defend the $787 billion stimulus legislation as good for job creation. Put simply, as long as ObamaCare is the law of the land, America will not be providing an environment that allows businesses to grow, which means accepting stagnant growth and high unemployment as the new normal.

We shouldn’t have to accept that. For that reason, we must begin the process of repealing this destructive law and replacing it with common sense health reforms.

Repeal and replace will not happen overnight and it will not happen after a week’s worth of debate in Congress. Repeal will require a grassroots movement that puts strong and sustained pressure on Washington.

The time to start that movement is today.

Over the next few weeks we will be very active in starting the movement to repeal and replace ObamaCare.

We intend for this advocacy effort to be our biggest to date.

Thanks for everything you did to elect job creators last week, and thank you for all that you will do to keep the pressure on the new representatives in Congress to do the right thing.

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Posted on August 4, 2010 by Darrell Fryer

What about a high deductible health plan??
A higher deductible is an option for someone who needs to lower their health premiums.  If you have a high deductible now, you are probably feeling vulnerable if something happens.  Also, I know you are saying that you are paying all this money for health insurance and have to pay a huge up-front chunk before you see any benefit.  An option for you to consider is Accident coverage.  This is very popular for parents who have kids in sports or active in various sports.  For example, if you have a $5,000 deductible, then get an $5,000 accident plan for $44.95 per month that will cover your deductible in an accident.  I wish I had it when my daughter was playing club & high school soccer.  Cost of going to ER and having an MRI is EXPENSIVE. This is very inexpensive coverage to fill the gap.  The odds of you going to the hospital on an injury are much greater than on an illness. Go to www.getaccidentcoverage.com for complete details and to apply online. 

Free Life Insurance $100,000

If you could buy life insurance for free you would wouldn’t you?  Well you can with a return of premium rider.  All premiums returned in 20 years if you have not passed away.  Incredible.  Life insurance is so inexpensive now, add this low cost rider and it makes it a no brainer.  Parents are doing this on their kids at just a few dollars a month.
Call or email for more information or a quote.

What if you became disabled?

Is State Disability or Worker’s Comp going to pay the bills? Not in Orange County. What would you do if you or your spouse couldn’t work and receive your salary? Disability coverage is the one insurance plan you are most likely to use, along with Long Term Care, than any other insurance plan you are paying for.  For very little per month, you can get coverage to help cover the bills if you become disabled.  It happens…everyday!  Call or email me for a brochure and a quote.

Husbands seldom believe in Life Insurance, But widows always do.

We Even have Life Insurance for Diabetics, or other major illnesses.  Did you know just burial costs can be $15,000+.

 43% of all people age 40 will have a long-term disability event prior to age 65.
- JHA Disability Fact Book, 2008

There is a death caused by a motor vehicle crash every 12 minutes; there is a disabling injury every 13 seconds.
- National Safety Council®, Injury Facts® 2008 Ed.

Follow me on Twitter at www.twitter.com/darrellfryer

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WellPoint Responds to Inaccuracies in President Obama’s Weekly Radio Address

Posted on May 11, 2010 by Darrell Fryer

In his weekly radio address, President Obama discussed the early implementation of some health reform benefits for young adults, retirees, and families. We were disappointed that President Obama chose to reference the highly inaccurate and misleading Reuters’ story regarding WellPoint’s coverage of breast cancer as part of his address.

Integrity and meeting the needs of each customer are at the heart of what we do, and we are pleased that more than 34 million members continue to trust Anthem for their health benefits. Our priority remains meeting the health care needs of our members and ensuring they have access to affordable, high-quality care. We have already begun to adopt certain health care reforms earlier than required by law, and we will continue to work with our nation’s leaders to make health care more affordable for all.

We value your relationship with us and appreciate all you do for our customers. As part of our continued commitment to keep you informed, we are sharing our response to his radio address below. Over the weekend, President and CEO Angela Braly reminded the President, “To be absolutely clear, despite your claims, WellPoint does not single out women with breast cancer for rescission. Period.” Read the entire letter to the President below:

Dear Mr. President:

I was disappointed to hear you repeat false information regarding WellPoint’s coverage of breast cancer in your weekly Presidential radio address as a demonstration of your Administration’s commitment to strong patient protection. Mr. President, I will tell you the same thing I told HHS Secretary Sebelius in a recent letter, your statement grossly misrepresents WellPoint’s efforts to help prevent, detect and treat breast cancer among our 34 million members.

To be absolutely clear: despite your claims, WellPoint does not single out women with breast cancer for rescission. Period.

The actual facts could not be clearer. In 2009, WellPoint covered the treatment of approximately 200,000 women with breast cancer at a cost of nearly $2 billion. During that same period, there were four cases nationwide where the issue of breast cancer or the possibility of breast cancer was identified in a rescission, but they were not singled out because of their breast cancer. Clearly, covering the treatment of close to 200,000 while rescinding four policies should make our intent in this regard quite clear. Our policy on rescissions has always been that it is based on fraud or misrepresentation – a policy consistent with that contained in the new legislation. In fact, we adopted the precise policy of the new legislation before any other insurer.

We should also note that we cover screening for women 40 and older, 10 years earlier than the guidelines published by your own US Preventive Services Task Force. We made this decision because we know that early detection is the key to survival, with a 5 year survival rate of nearly 100% when diagnosed at stages 0-1. This also reduces costs for the entire system by avoiding the nearly ten-fold increase in costs associated with treatment beginning after stage 3.

Mr. President, this country has a long history of coming together after tough debates. The implementation of the new health care reform law should be no different. If we are going to make this law work on behalf of all Americans the attacks on the health insurance industry — an industry that provides valued coverage for more than 200 million Americans — must end. We believe that our recent action to adopt many of the insurance reforms earlier than required by law is an indication of our willingness to work with your Administration to achieve this objective.

We agree that healthcare costs are rising at an unsustainable rate. While we continue to strive to make healthcare coverage more affordable for our members, we know that there are many causes for rising costs. Some of the most concerning cost drivers include inflation in the cost for medical services provided, increases in utilization, or the frequency with which these services are provided, and the increased cost borne by the insured population when healthy individuals choose not to carry health care coverage. These issues are of critical importance to all Americans and will require solutions that include all stakeholders in healthcare, business and government. In fact, we have repeatedly asked to meet with Secretary Sebelius, but have not yet received a response. This is simply not productive and not in the best interests of Americans.

We share your vision for a better America and look forward to working with you and your Administration.

Sincerely,

Angela F. Braly

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Healthcare changes and what that means to you

Posted on April 6, 2010 by Darrell Fryer

As of April 6, 2010, Anthem Blue Cross California posted the following information on their website and what this means to you.  I am sure the answers are the same for all the carriers in California. 

From Anthem:  The new health care law signed by President Barack Obama in late March represents more than 2,000 pages of new federal law that will touch virtually every facet of the health care industry, including a variety of near-term and longer-term changes to the health insurance marketplace that will impact all Americans.
Because of the size and scope of the legislation, and the fact that the law requires federal departments to issue more detailed regulations for implementation, it will take time to fully analyze and digest the changes. As we learn more and prepare for the post-reform environment, we will update these Frequently Asked Questions, so check back often for new information.

Frequently Asked Questions:

Q: What does this mean for Anthem Blue Cross?
Our priority remains meeting the health care benefit needs of our members and ensuring they have access to affordable, high-quality care. As such, we will continue to put our members and customers first.
At same time, affordability is more important than ever before, and we remain concerned the bill signed into law by the president does not address long-term cost containment measures that will make the system sustainable.
We have teams of individuals reviewing and analyzing the impact of the legislation and any near-term requirements to ensure we are prepared to implement all required changes in accordance with the law.

Q: Will there be changes to my benefits or my network?
Based on the current law, we do not anticipate members will see immediate changes to their benefits. The requirements in this legislation will be phased in beginning later this year and continuing over the next several years.
This legislation does not impact our current physician or hospital networks. However, we do believe members may see an impact to their benefits and their premiums as the legislation is implemented.

Q: How will be premiums be affected?
At this point we do not know what the impact will be on our members’ premiums as we will receive additional guidance from the Department of Health and Human Services, but we anticipate the impact will vary depending on the type of product you have.

Q: Do I need to do anything?
At this time there is not anything for you as a member/customer/employer to do.

Q: What changes will take effect immediately?
Several near-term requirements will impact all contracts for new sales and renewals beginning in approximately six months. While there is a provision that “grandfathers” existing plans and allows members in these plans to keep their products, the new law requires us to add several new elements to all contracts, regardless of whether the plan is “grandfathered.” These include elements like:
-Allowing members to add dependents up to age 26 regardless of student status
-Eliminating lifetime limits on policies

It is important to note that our preliminary analysis of the “grandfathering” provision indicates that if a subscriber changes products after March 23, 2010, he or she will likely be subject to additional product requirements that are effective in the future.

For new sales and subscribers who change policies after approximately six months, we will be required to make additional changes, such as:
Removing any member cost sharing for “preventive” benefits, as defined by the legislation.

Other, more comprehensive insurance reforms will begin in 2014. Many of the more significant changes to the insurance marketplace — such as rating reforms, the individual and employer mandates, Medicaid expansions, the insurance exchanges and the insurance subsidies — are set to be effective on January 1, 2014.

Many of the new laws require federal agencies to issue more detailed regulations that will guide implementation, and we will share more information when it is available.

Q: I have a child under the age of 26. When can I add him or her to my policy according to the new legislation?
Effective six months from the effective day (when the president signed the bill into law), any new policy or any renewal on an existing policy will have the extended age benefit. This should take effect in late September or early October.

Click on the “RSS Feed” to receive automatic updates on the healthcare reform bill.  For all your healthcare and insurance needs, please visit www.capistranohealthlife.com

God Bless America,

Darrell Fryer

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Latest healthcare reform news and what it means to you

Posted on April 2, 2010 by Darrell Fryer

What Does This Health Care Reform Legislation Mean: The biggest changes to the nation’s health care system will not take effect until 2014. Some of the changes include: the creation of insurance marketplaces called “exchanges” where people can shop for insurance; rules requiring insurers to accept all applicants, including those with pre-existing conditions; and an expansion of state Medicaid programs. Some additional provisions will become effective immediately while others will kick in later this year.

These are some of the features of the new health care overhaul bill passed through the reconciliation process and slated to begin to take effect in 2010:

For new sales and subscribers who change policies after March 23, 2010, insurance companies will be required to make additional changes beginning in approximately 6 months, such as removing any member cost sharing for “preventive” benefits (as defined by the legislation). The renewal product requirements beginning for plan years 6 months after enactment include:
Coverage for dependents up to age 26;
Removal of limits on lifetime maximum benefits;
Temporary federal high-risk pools; and
Tax credits for small group employers.

Health Care Reform Impacts on Premiums: There are concerns that the new taxes on health coverage will likely increase premiums. Members of the news media report that under the health care overhaul , young adults who buy their own individual insurance will carry a heavier burden of the medical costs of older Americans. This is expected to raise insurance premiums for young people when the plan takes full effect in 2014.  Health companies that I have talked to all mention that premiums will be going up for everyone at some point and that there is no way they can stay in business and insure everyone and keep premiums and benefits the same.

In a nutshell, it’s way to early to know what’s going to happen.  Don’t stop making your payments thinking you can get it when you need it.  Lets hope the idiots who passed this bill will be voted out in November and then see what happens.  Reform is needed as we all agree, but not this reform.  It’s against our Constitution and a Socialistic agenda! I think it’s time to impeach Obama.

For all your financial needs, go to www.capistranofinancial.com.

Follow me on Twitter at www.twitter.com/darrellfryer

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