by Karen Helen Szatkowski

The community service division of SCAN Health Plan held a seminar on April 21st at the Ventura Townhouse  to provide the residents with skills to defeat the many fraud tactics that target the senior community.

Karen Markle, as Volunteer Coordinator for SCAN introduced the speakers: Rachel DeMaree with eighteen years’ experience in health care fraud investigations and Sandhi Ton with four years’ experience. These two are an integral part of the Special Investigations Unit for SCAN and pursue, on a daily basis, cases of fraud targeting seniors and fraud perpetrators.

This meeting was organized with the Townhouse and attended by many of its residents who came with questions and worries about their activities on the phone and the internet. This particular audience has a hefty security that prevents most door knocking scams but it is not unusual for a variety of perpetrators to pursue information by posing as health care providers, medical equipment providers, laboratories or insurance officials through the phone and internet.

The two presenters went over these tools to avoid health care fraud:
Never sign blank insurance claim forms;
Make sure to understand your medical benefits and call the insurer if needed;
Never provide your Medicare or insurance ID to anyone except those that actually provide care for you;
Do not do business with salespeople who promote free medical equipment and be sure to know exactly what your doctor has ordered for you;
Get an up-front quote of charges from medical providers including how much comes out of your pocket.

There should never be requests by anyone for a blanket authorization of health care services and it is always good to keep accurate records of your medical appointments should questions arise in the future.

These approaches will thwart most if not all of the attempts to steal your information and your resources as regards your health care, however there are other goons out there that want your money.

Using the Internal Revenue Service is a favorite channel with fraudsters using scary phone calls to demand payment of past due taxes and requiring use of a specific payment method, such as a credit or debit card. Some of these will threaten to have you arrested for non- payment. The IRS does not place unsolicited phone calls to anyone. So, again, please hang up.

Confronting worrisome doubt by wooing a techie family member or friend for help can boost your experience of the world and broaden your interests. Thanks to SCAN and Karen, Rachel and Sandhi for preparing and presenting the workshop and answering the many questions.

For more information on bringing a presentation like this to your facility or for volunteer opportunities serving seniors, call Karen at 660-1047 or email [email protected].

By Cate Kortzeborn

Have you recently enrolled in Medicare, or will you in the near future?

During the first 12 months that you have Medicare Part B, you can get a “Welcome to Medicare” preventive visit with your doctor. This visit includes a review of your medical and social history related to your health. Your doctor will also offer education and counseling about preventive-care services, including certain disease screenings, shots, and referrals for other care, if needed.

When you make your appointment, let your doctor’s office know that you’d like to schedule your “Welcome to Medicare” visit. You pay nothing for this if your doctor or other qualified health care provider accepts Medicare payment rates.

If your doctor or other health care provider performs additional tests or services during the visit that aren’t covered under this preventive benefit, you may have to pay coinsurance, and the Part B deductible may apply.

Your “Welcome to Medicare” visit will record and evaluate your medical and family history, current health conditions, and prescriptions.

Check your blood pressure, vision, weight, and height to get a baseline for your care.

Make sure you’re up-to-date with preventive services such as cancer screenings and shots.

Order further tests, depending on your general health and medical history.

Following the visit, your doctor will give you a plan or checklist with free screenings and preventive services that you need.

You should do a little preparation before you sit down with your doctor. Pull together your medical records, including immunization records. Even if your current physician does the visit, gather as much medical information as you can to make sure nothing is overlooked.

And bring a list of any prescription drugs, over-the-counter drugs, vitamins, and supplements that you currently take, how often you take them, and why.

If you’ve had Medicare Part B for longer than 12 months, you can get a yearly “Wellness” visit to develop or update a personalized plan to prevent disease or disability based on your current health and risk factors.

When you make your appointment, let your doctor’s office know that you’d like to schedule your yearly “Wellness” visit.

Your first “Wellness” visit can’t take place within 12 months of your enrollment in Part B or your “Welcome to Medicare” preventive visit. However, you don’t need to have had a “Welcome to Medicare” preventive visit to qualify for a “Wellness” visit.

As with the “Welcome” visit, you pay nothing for the yearly “Wellness” visit if your doctor or other qualified health care provider accepts Medicare payment rates.

Cate Kortzeborn is Medicare’s acting regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

By Phil Chandler, Owner of Right at Home of Ventura County, Home Care Agency

Many individuals with serious chronic illnesses find that meeting and discussing their illness at support groups provides comfort and tips in dealing with the disease. The Breeze will be highlighting local support groups for several different conditions in future issues.

Dementia isn’t a specific disease. Instead, dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with daily functioning. Though dementia generally involves memory loss, memory loss has different causes. So memory loss alone doesn’t mean you have dementia. Alzheimer’s disease is the most common cause of a progressive dementia in older adults, but there are a number of causes of dementia. Depending on the cause, some dementia symptoms can be reversed.

Alzheimer’s disease is by far the most well-known and common type of dementia. Common symptoms include memory loss, confusion, difficulty communicating, anxiousness and paranoia. Alzheimer’s disease is caused by the buildup of abnormal proteins called amyloid plaques and tau tangles in the brain.

Vascular dementia is the second most common cause of dementia. The main symptoms include memory loss, impaired judgment, decreased ability to plan, and loss of motivation. It is caused by bleeding within the brain from a stroke that causes cause brain damage.

Lewy body dementia is the third most common cause of dementia. Main symptoms include sleep problems, memory loss, hallucinations, and frequent swings in alertness. It is caused by abnormal proteins, called Lewy bodies, that appear in nerve cells and impair functioning.

None of these major types of dementia can be cured or reversed, but doctors will use a wide array of therapies and treatments to improve the patient’s quality of live and alleviate symptoms.

There are about one hundred other types of dementia, and they differ by the area of the brain that is impacted and the mechanism of nerve cell damage. Most dementias lead to (currently) irreversible cognitive impairment.

Family members of those affected by dementia have a great support group that is facilitated by the Coast Caregiver Resource Center and co-sponsored by the Cottage Hospital of Santa Barbara, Community Memorial Hospital, and Alzheimer’s Association of the Central Coast. They meet at Community Memorial Hospital on the second Friday of each month from 3:00 PM to 4:30 PM in the Nichols Auditorium on the 8th floor. Community Memorial Hospital is located at 147 North Brent Street, Ventura.

The group is led by Carolyn Kopp, Family Consultant for the Coast Caregiver Resource Center, and typically has between 15 to 20 attendees. Attendance is limited to family caregivers and other family members.

Barbara Hess is a long time participant in the group. She joined after her husband, Jerry, was diagnosed with Alzheimer ’s disease. They have been married 63 years. Barbara said, “Jerry has always been active, and was working well into his 70’s. As his memory problems became more severe, I joined this group. I have developed many friendships and learned from the variety of experiences that have been shared.”

The next meeting will be held on May 13 from 3:00 PM to 4:30 PM at Community Memorial Hospital.

For more information, call Carolyn Kopp, Family Consultant for the Coast Caregiver Resource Center at 492-0601 or go to http://www.cottagehealth.org/ .

What are the potential benefits of taking part in a clinical trial?

There are so many benefits to taking part in a clinical trial. Your participation may help others get a better treatment for their disease in the future and allow researchers to learn more about how diseases can be prevented, identified, or managed. If you’ve always wanted to Contribute to Health Research, now is the perfect time to do so!

If the treatment being studied is more effective than the standard treatment, you may be among the first to benefit. Researchers, doctors, and other health care professionals may check your physical condition frequently, giving you regular, careful medical attention, because they need data to make comparisons in a trial. This means that if they do find anything wrong with you, they’ll be able to treat you quickly and efficiently.

It may be a way to get an experimental treatment for a life threatening illness that is not available to people outside of a clinical trial. This is a huge advantage of taking part in a clinical trial, particularly if you are of ill health. For example, if you suffer from cancer, you may be given a drug that can help with the symptoms during your clinical trial.

These are some possible risks of taking part in a clinical trial:
You may experience serious, unpleasant, or even life-threatening side effects.
You may get the standard treatment or placebo instead of the experimental product.
The experimental product may not be better or even as good as the standard treatment for your condition.
You may need extra tests. Some of the tests could be uncomfortable or time consuming.