Do you need to fear retirement?

Congress recently made significant changes to Medicare's Part D prescription drug benefit as part of the Inflation Reduction Act. While some changes aim to help seniors afford their medications, others may have unintended consequences.On the positive side, insulin costs are now capped at $35 per month for Medicare beneficiaries. This has already provided relief for many seniors with diabetes.Starting in 2025, out-of-pocket Part D drug costs will be capped at $2,000 annually. Seniors will also have the option to spread these costs throughout the year through the new Medicare Prescription Payment Plan. These changes can benefit seniors who rely on multiple brand-name medicines or have fixed incomes.However, awareness of the new payment plan is low. Medicare could do more to inform seniors about this option, which requires opting in. Seniors should consider contacting their Part D insurers during open enrollment if they would benefit from spreading out pharmacy costs.The law's drug price negotiation provision has led to some unintended effects on drug development. At least 36 research programs and 22 experimental drugs have been discontinued as a result.Part D premiums have also increased. This year, standalone Part D plans were set to cost 21% more on average compared to last year. Many seniors switched to lower-cost options as a result. The number of available plans has decreased by about 25% since 2020.Some insurers have moved certain medications to tiers requiring higher out-of-pocket costs, restricting access to previously covered drugs. New rules like step therapy requirements have also been implemented, potentially making it harder for patients to access drugs their doctors recommend.It's important for seniors to understand these changes and their potential impacts on drug access before Medicare's open enrollment period begins in October.  Contact Carleen Lachman, Independent Insurance Specialist at 724-571-4688 to learn more.  

Note: this is not medical advice and should not replace a discussion with your own treating physician. This document was created after compiling helpful over the counter and home remedies from patients and colleagues.Winter is a beautiful time of the year, but it also brings along various illnesses. With the constant change in temperature and dry air, it's easy to catch a cold or flu. However, being sick doesn't have to be miserable. Here are some tips to help you through your winter sickness.First off, make sure you are getting enough rest. Your body needs time to fight off the illness, so getting plenty of sleep is essential. Drinking lots of fluids is also crucial to staying hydrated. Warm liquids such as tea or soup can help soothe your throat and loosen congestion. Second, take over-the-counter medication to relieve your symptoms. Decongestants can help relieve nasal congestion, and pain relievers such as acetaminophen or ibuprofen can help reduce fever and body aches. However, be sure to read the instructions carefully and consult with a doctor if you have any doubts.Lastly, try to avoid spreading your illness to others. Cover your mouth and nose when you cough or sneeze, and wash your hands frequently with soap and water. Stay home if you're feeling unwell to prevent spreading the illness to others, and mask up if you need to leave the house. Reminder that we are fortunate enough to have vaccinations against flu, COVID and RSV which cause significant respiratory illness.In conclusion, being sick during the winter can be tough, but with plenty of rest, hydration, and medication, you can make it through. Ive gathered up some of the most common remedies used by myself, my patients, and my followers on social media and shared them below. Remember to take care of yourself and stay warm during the chilly winter weather.  Straight Off the ShelfNote: if you take other medications, its important to talk with your physician or pharmacist about how these over the counter meds may interact with your prescribed meds       Cough o   Vicks Vapo Rub on the chest and bottoms of feet o   Coricidin (good for those with cough and high blood pressure) o   Delsym Cough Medicine: dextromethorphan containing cough meds help with cough suppression, for dry coughs o   Mucinex: guaifenesin containing meds help to loosen up mucus in your though to help you cough it up, for wet coughs o   Sudafed: pseudoephedrine is a decongestant and can make you pretty wired/awake. caution if you have high blood pressure o   Dimetapp for kiddos 6 and older       Congestion/sore throat o   Afrin nasal spray: temporary congestion relief o   Flonase nasal spray: great for post nasal drip that causes sore throat o   Saline nasal rinses       General cold/flu symptoms o   Dayquil/Nyquil: remember, these contain acetaminophen aka Tylenol. so dont mix with additional tylenol unless instructed by your physician Know your meds! acetaminophen is also known as Tylenol; ibuprofen is also known as Motrin and is the same class of medications as naproxen aka Aleve  Home/Herbal RemediesNote: if you take other medications, its important to talk with your physician or pharmacist about how these remedies may interact with your prescribed meds      Nin Jiom Pei Pa Koa-Chinese herbal throat and cough syrup       Green tea       Ginger tea       Boom boom inhaler stick       Lemon, honey, and chamomile tea       Sleep      Epsom salts baths       Oscillococcinum       Black elderberry syrup       Raw garlic with honey       Mullein tincture       Electrolyte rich drinks like liquid IV, LMNT, pedialyte-- monitor sugar content       Fermented foods       Reishi       Ashwaghanda       Foods high in vitamin C (citrus!)  Soothing Tea RecipeIn a saucepan, bring the following to a boil, then remove from heat and enjoy: tips and enjoy:       8 oz water       1 tbsp apple cider vinegar      1 tbsp honey       1 cinnamon stick       1 clove of peeled and smashed garlic       small piece of peeled ginger             Tips & Tricks From a PCP:      after a viral infection, cough can last 4-6 weeks in some cases. if you have fever with the cough or its getting worse, talk with your doctor as it could indicate a bacterial infection       never underestimate the power of sleep and resting your body       a fever is technically a temperature over 100.4 degrees F       the symptoms of COVID, flu, and RSV overlap significantly. getting tested for these infections may be helpful in determining if you need further intervention       your gut health is key to your immune system. you may not be able to fully prevent getting sick, but a healthy mind and body will help you with resilience and recovery. focusing on fiber, mindfulness, sleep and regular exercise can help your gut stay strong!       most viral infections last about 5-7 days. but if you are experiencing shortness of breath, chest pain, high fevers, difficulty swallowing, dizziness, or wheezing, contact your physician immediately

Health insurance jargon can be the hardest to understand for consumers. Thats why you have a broker who goes to work for you and explains your policy options with clarity. However, not all brokers work ethically. You may not have an insurance broker who values you and may not elaborate on your policy limitations. The omission of these limits is illegal and should result in the termination of that broker. In contrast, the insured typically doesnt take legal action, and the broker makes his or her desired commission.This is not to say that all health insurance brokers operate in this zone of immorality. Just as with any profession, there are good and rotten eggs. Your moral compass and ability to judge a persons intention is a significant factor people can typically smell a sleazy salesperson. Below, are the most common limitations obscurely mentioned in health insurance policies. This information should adequately equip you for when you are asking questions of your broker.Heres a screenshot from the summary of the benefits of an insurance carriers product:*Note these limitations do not exist in all policies. Ask your broker.The list of benefits above is towards the end of the policy summary. Most people are interested in seven factors when it comes to their health insurance:Deductible/coinsurance/max out of pocket, doctor visits/specialists/urgent care, the network, prescription coverage, preventative/wellness coverage, emergency room fees, and ambulatory services. If your insurance broker goes over those seven things, this is how the policy would look and sound:Choice of $500-$10,000 deductible/max out of pocket (1 million in coverage)Choice of 70/30, 80/20, or 100/0 coinsuranceUnlimited $25 copay to doctor, specialist, and urgent carePHCS Network (PPO)$50 copay for annual wellness/preventative checkupER subject to deductible and coinsuranceAmbulatory services (above) $500 per transportMost people would agree that those seven things sound fantastic for health coverage. You have all your daily doctor needs taken care of and one million dollars in coverage, right? Wrong, let me show you a scary breakdown if you had an appendectomy while being covered by this policy.On average, the Fair Price for an Appendectomy lies somewhere between $7,000 and $25,000 (may vary due to zip code). If there are complications, it could be upwards of $35,000 or more. Heres a breakdown of the services and their estimated costs. You can always check on any surgery, and its price by visiting Healthcare Bluebook.Hospital Services for a 2-day admission, itll cost roughly $9,700.Physician Services the fee for procedure and routine postoperative care costs around $1,400.Anesthesia the price for an average surgery time of 1 hour and 15 minutes costs about $750.This cost adds up to the lower end of about $11,000 for an appendectomy. If you look above at the example policy, youll see that for the entire coverage term an appendectomy will be given a $2,500 coverage benefit. Even though your plan has a deductible, coinsurance, and max out of pocket; theres a specific limitation for appendicitis. With this knowledge, the insured will be left an $8,500 bill as an out of pocket expense! Keep in mind; these numbers are on the low end with no complications.Of course, its always better to have health insurance instead of going uninsured. With insurance, that remaining $8,500 for the appendectomy may negotiate to a lower bill. Policygenius.com does a great job explaining the functionality of network negotiated rates. Without insurance, you would be paying the almost full retail price for your medical surgery, which is a terrifying thought!