JustCare

Category: Health conditions

  • When you need care quickly, should you use a health clinic?

    When you need care quickly, should you use a health clinic?

    Sometimes you may need health care quickly. And, the question becomes where to go for that care. If you can’t reach your doctor, should you get treatment at a health clinic or urgent care center rather than your hospital’s emergency room? In situations that are not life-threatening and when you are not in a crisis, to save time and money, you should consider seeking care at a health clinic or urgent care center.

    Is there an FQHC near you? If you do not believe you are in an emergency situation and your doctor is not available to see you, you should consider getting care at a federally qualified health center (FQHC) if there is one near you. These health clinics are administered by the federal government and provide free and low-cost health care. Today, there are nearly 1,400 health centers providing services at 11,000 service delivery sites throughout the US.

    Is there a free or charitable health clinic near you? There are more than 1,200 free or charitable health clinics across the US. You might check to see whether there is one near you.

    What about a commercial walk-in clinic or an urgent care facility? There are more than 7,500 urgent care centers (where you can usually see a doctor) in the US today. There are also more than 2,800 commercial walk-in health clinics (where you typically see a nurse) located at pharmacies and retail stores like Walmart and Walgreens.

    Why go to an urgent care facility or walk-in clinic instead of an emergency room? If you have a common problem, such as a fever, an infection, a stomachache or a deep cut, ask yourself these questions:

    • What does my doctor recommend? Call your primary care doctor to see if he or she is available to see you. It is always best to have your primary care doctor providing your care. If that’s not possible, find out where the doctor recommends you go for treatment.
    • Is there an urgent care center or walk-in clinic near me? If so, can it provide the care I need? And, will my Medicare plan cover my care?
    • What will I pay out of pocket? The cost of your care at a walk-in clinic or urgent care center is likely to be much lower than at the local hospital emergency room or ER. However, if you have traditional Medicare, and supplemental coverage, it should cover your ER care. If you are in a Medicare Advantage plan with a high deductible, your health plan may deny coverage if it decides it was not an emergency. And, even if it covers your care, you will likely save money by avoiding the ER.
    • How long am I willing to wait to get care? The wait for care may be much shorter at a health clinic or urgent care facility than at an ER.

    Keep in mind that quality of care you receive is likely to vary significantly depending upon the care you need and the skills of the health care provider delivering the care.

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  • Protect your eyesight: Free and low-cost vision care

    Protect your eyesight: Free and low-cost vision care

    Your ability to see well is precious. But, your vision is likely to deteriorate as you age. Some people develop eye diseases that have no early warning signs, including age-related macular degeneration, glaucoma, dry eye and diabetes eye disease. They require treatment to help preserve vision. In some cases, if you do not get treatment, you could lose your vision. So, you want to get your eyes checked regularly. While Medicare does not cover routine eye care or eyeglasses generally, here are some options for free or low-cost vision care.
    • Medicare pays for procedures to treat a chronic eye condition like a cataract, as well as glasses you need post cataract surgery.
    • Medicare pays for annual eye exams if you have diabetes or are at high risk for glaucoma.
    • Medicaid generally pays for eye care. For information about Medicaid coverage in your state visit the Kaiser Family Foundation.
    • PACE (Program of All-Inclusive Care for the Elderly). PACE programs generally provide vision care to program participants, along with an array of other important services. For more information, click here.
    • Federally Qualified Health Centers (FQHC). Across the country, thousands of FQHCs, sometimes called Community Health Centers or CHCs,  offer a wide range of free or low-cost health care services, including vision care. To find a health center near you, click here.
    • If you’re a Vet, the VA may cover your eye exam and glasses.
    • EyeCare America offers no-cost eye examinations through the Foundation of the American Academy of Ophthalmology,
    • Lions’ Club may assist older adults needing vision care. Contact your local Lions’ Club chapter through this online Lions’ Club Directory.
    • For information about free or low-cost eye care in your community, visit Eldercare.gov. Also, The National Federation of the Blind provides a range of online resources for older adults.
    Here are three ways you can protect your eyesight:
    1. Get an annual eye exam: According to the National Institute on Aging, if you’re over 65 you should have your eyes checked regularly.  Dilating your eyes allows the doctor to detect diseases, which need treating—such as cataracts, glaucoma, corneal diseases, retinal disorders and dry eye–but which may not show any symptoms. Early detection can help preserve your vision.
    2. See the eye doctor right away if you have vision problems such as swelling around your eyes, double vision, light flashes, eye pain or blurriness.
    3. Take care of your eyes: Wear sunglasses in bright light to protect against ultraviolet radiation, wear a broad-rimmed hat, eat healthy, and keep your weight in check.

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  • Free and low-cost ways to address hearing loss

    Free and low-cost ways to address hearing loss

    While our hearing is likely to weaken with age, there are things we can do to address hearing loss.  Hearing aids can be very expensive—as much as $3500 for a single hearing aid and most people need one for each ear.  Batteries are also expensive—as much as $150.  So, you want to be sure you really need them.  If you do, here are ways to keep your costs down.

    If you think you need hearing aids, these resources may help keep your costs down.

    • Get a free annual wellness exam with Medicare.  Medicare covers an annual wellness exam in full so there’s every reason to make an appointment. During your visit, make sure that the doctor checks you for hearing impairments as well as your likelihood of falling.  While Medicare will not pay for a hearing aid, the doctor can tell you whether you really need one.
    • If you qualify for Medicaid, check the Kaiser Family Foundation web site to see whether Medicaid covers hearing aids in your state.  If you’re a Vet, the VA may cover your hearing aids depending upon the degree of your hearing loss or the cause of your hearing loss.
    • Help America Hear provides hearing aids to people with limited financial resources.
    • Starkey Hearing Foundation may help pay for hearing aids. Contact Starkey’s Hear Now program at 800-328-8602. Through the Starkey Hearing Foundation, Hear Now might be able to provide you with good hearing aids at low cost.
    • The Lions Club’s Affordable Hearing Aids project also might be able to help you get low-cost hearing aids. Contact the Lions Club to see if the Lions Club has a project in your state.
    • Sertoma, a civic, service organization, whose mission is hearing health, offers a list of organizations that help people who need hearing aids.
    • The Better Hearing Institute offers a free Guide to Financial Assistance for Hearing Aids, providing 47 different resources for securing help.
    • State assistive technology programs may loan you equipment, loan you money to buy equipment, or offer information and referral services. To learn about your state’s programs, contact the Center for Assistive Technology Act Data Assistance.

    Note: The price of hearing aids should be coming down. The FDA recently has approved the sale of hearing aids over the counter, without a prescription. Experts believe that once you can get hearing aids without a prescription, costs should come down significantly.

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  • How to get free or low-cost dental care

    How to get free or low-cost dental care

    Because dental care can be so expensive and most insurance—including Medicare—does not cover it, it is the number one health care service people skimp on. As a result, people put themselves at serious risk of gum disease, infections, dental pain and tooth loss. Dentists can remove plaque that builds up to reduce your likelihood of cavities and gum decay. Here are a few ways you may be able to get free or low-cost dental care.

    • In some states, Medicaid covers some dental care. And, even if you are not enrolled in Medicaid, you may be eligible, depending upon your income, health care expenses and where you live. The Kaiser Family Foundation web site lists dental services Medicaid covers in each state.
    • PACE (Program of All-Inclusive Care for the Elderly). PACE programs generally provides dental care to program participants, along with an array of other important services. For more information, click here.
    • Federally Qualified Health Centers (FQHC). Across the country, thousands of FQHCs, sometimes called Community Health Centers or CHCs,  offer a wide range of free or low-cost health care services, including dental care. To find a health center near you, click here.
    • Dental schools.  Dental schools often offer free or low-cost dental care in their clinics. Find out whether there is a dental school in your community.
    • Dental Lifeline Network offers comprehensive dental services for older adults in need. Its program, Donated Dental Services or DDS, has a nationwide network of 17,000 volunteer dentists and 3,700 dental laboratories, which provide dental treatments free of charge. To find out the number of the Dental Life coordinator in your state, visit Dental Lifeline.
    • Dentistry from the Heart is a worldwide nonprofit organization dedicated to providing free dental care to those in need. The organization sponsors events in different parts of the country at which people can receive free dental services. For more information, visit the Dentistry from the Heart .
    • NeedyMeds.org has a database of free, low-cost and sliding scale dental clinics throughout the country. You can enter your zip code to find the clinics nearest you.

    Your local Area Agency on Aging (AAA) may be able to point you to free or low-cost dental care in your community. To find your local AAA, call the Eldercare Locator at 1-800-677-1116.

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  • Congress must protect our community health centers

    Congress must protect our community health centers

    Every Thursday morning, I wake up excited for the 14-hour day I’m about to begin. My Thursdays are so long because that’s the day I work a second evening job at a Federally Qualified Health Center (FQHC) that serves New York City’s lesbian, gay, bisexual, transgender, and queer (LGBT+) population. Why am I so happy to work a longer day? Not because I am a glutton for punishment, but because the work is truly satisfying in the way that only feeling completely confident in the care I’m providing can make me feel.

    The FQHC I work at provides essential medical and mental health care to an often-vulnerable population. Beyond the stress of being LGBTQ+ in our society, the patients I see are mostly uninsured or on Medicaid. Many have HIV/AIDS, substance use problems, and/or significant mental illness. I see individuals from diverse backgrounds and all age groups, from trans youth struggling with histories of abuse or homelessness, to older gay men who survived the AIDS crisis and lost many loved ones. Each person comes with a painful yet inspiring story, filled with strength, resilience, and love.

    And the care provided at this clinic, like most FQHCs – also referred to as Community Health Centers (CHCs) – is not just “good for the safety net.” It is the highest quality; often better than many private practice settings on multiple quality measures. Why is this?

    First, the care is truly integrated. I share a single medical record and can easily communicate with my patients’ medical providers. This reduces the chances of errors and conflicting treatments, such as drug-drug interactions. Quality improvement initiatives from the medical clinic apply to the mental health clinic and vice versa.

    Second, as federally funded clinics that participate vigorously in the Medicaid program, CHCs are often the first to know about and participate in health systems improvements and innovations. Despite what some private providers might tell you, government does a lot more than add bureaucratic hurdles; it attempts to ensure that health care is delivered in a safe and equitable way, is informed by evidence and guidelines rather than idiosyncratic clinician ideas and habits, and is responsive to public health needs. For instance, CHCs were on the frontline during the AIDS crisis, and are now playing a similar role in responding to the opioid epidemic.

    Third, CHCs are often full of passionate, mission-driven clinicians who deeply believe in what they are doing and care about the populations they serve. At the CHC where I work, clinicians are constantly sharing recent evidence, clinical advice, and local resources relevant to the LGBTQ+ population. Wouldn’t you want to be cared for by a group of individuals who are passionate about serving you and continuously communicating about better ways to do so?

    Finally, CHCs specialize in providing high quality primary care, which has been shown to produce the best outcomes. They are beacons of well-coordinated, efficient medical care in our specialist-driven and siloed health care system. This translates to better care at a lower cost!

    There are more than 10,000 CHCs in the United States, providing care for about one in thirteen Americans (and an even higher proportion in some states). In addition to primary care and behavioral health (i.e., mental health and substance use) services, like those provided where I work, many CHCs also provide dental and vision care. For the reasons above, 86 percent of primary care providers at CHCs are satisfied with their work, and 73 percent of patients who use CHCs as their primary source of medical care feel that it is high quality.

    It is therefore not surprising that CHCs have long enjoyed strong bipartisan support. Regardless of your political leanings, CHCs are clearly a rare example of a great deal in American healthcare. However, during recent fights over funding the federal government that resulted in two brief shutdowns, the Community Health Center Fund expired on September 30, 2017, and was not reauthorized until February 9, 2018. The Continuing Resolution that reopened the government in January included funding for the Child Health Insurance Program (CHIP) but not CHCs.

    If Congress had not restored funding in the nick of time, the Department of Health and Human Services estimated that about a quarter of CHCs would have had to close, resulting in nine million people losing access to healthcare and 51,000 job losses. Many CHCs had already begun deferring important investments and delaying staff hiring.

    This barely averted tragedy has received far too little attention. Let’s not take our CHCs for granted ever again; let’s avoid this kind of near miss in the future.

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  • Benefits and risks of telemedicine

    Benefits and risks of telemedicine

    Telemedicine allows doctors to remotely assess the conditions of patients via telephone or video. Medicare covers some telemedicine services, both real-time audio and video, for some conditions in certain situations. If you don’t have Medicare, check with your commercial insurer about the coverage available through your plan.

    What are the benefits of telemedicine? There’s no denying that telemedicine is convenient, saves time and generally saves money. Through telemedicine, you can see a doctor and get a prescription with ease, even if you live in a rural community or a community with few doctors. Moreover, you don’t generally have to wait for an appointment. You also don’t have to leave your home or leave work to get a diagnosis.

    Does telemedicine improve health outcomes? According to Cochrane, based on the research to date, the jury’s still out on the benefits and risks of telemedicine. A series of studies show overall patient satisfaction. But, the evidence is still scant on the clinical benefits of telemedicine or the effects of telemedicine on health outcomes.

    One analysis of 80 reviews of telemedicine revealed that 21 reviews found telemedicine effective, 18 reviews found telemedicine “promising but incomplete,” and others still found that the evidence was still limited and not consistent.

    What are the risks of telemedicine? It can be difficult for doctors to evaluate patients remotely. Doctors get a better sense of patients’ conditions in person, through a physical evaluation. So, there is a real likelihood of misdiagnosis with telemedicine.

    While Medicare only covers limited home care services, it is now in the midst of a demonstration project that pays for doctors and nurse practitioners to make house calls. That could be a better option than telemedicine.

  • ER visits for dental care on the rise, but some states are finding ways to address the problem

    ER visits for dental care on the rise, but some states are finding ways to address the problem

    Data from the American Dental Association reveals that emergency room visits for dental care more than doubled in the 12 years between 2000 and 2012, according to USA Today. Largely because neither Medicare nor standard private health insurance covers dental care, some 2.2 million people ended up in the emergency room because of tooth pain in 2012. But, some states have developed innovative solutions to reduce emergency room visits for dental care.

    A report by the American Dental Association shows that in the majority of cases that people visit the emergency room for dental care, they should be visiting the dentist instead. Nearly 24 percent of emergency room visits for dental care are non-urgent and another 54.8 percent are semi-urgent.

    People often avoid going to the dentist because they lack insurance coverage and don’t want to pay out of pocket for dental care, which can be very expensive. Most insurance does not cover dental care. Medicare never covers dental care. And the Affordable Care Act only covers dental care for children, not for adults. Medicaid pays for some dental services, but what Medicaid covers depends on what state you live in.

    And, most states do not allow dental therapists to provide dental care, even though the data suggests that they can provide several services safely and well and at lower costs. The American Dental Association has blocked dental therapists from providing dental services in all states but Alaska.

    Maine, Michigan and Virginia have developed innovative solutions to reduce the number of emergency room visits for dental care by as much as 72 percent. One Michigan county created a volunteer dental force for patients with low incomes. In Maine, several hospitals are piloting a program that gives patients a painkiller when they present at the emergency room and then refers them to a clinic for treatment. A Virginia pilot program developed an in-hospital urgent dental care clinic to treat patients and reduce costs.

    Emergency rooms must treat anyone who visits, regardless of whether they have insurance or are able to pay for their care. But, they generally only treat the dental pain and do not deliver dental services. As a result, they often end up having repeat visits from people with dental pain. And, by some estimates, the cost for emergency room services is three times more than the cost of a dental visit. For sure, it’s important to choose your emergency room carefully ahead of time, if you have a choice of them, so you get the best care and keep your costs down.

    Here are some ways to get free and low-cost dental care.  Or, contact your local area agency on aging to find out about resources in your community.

  • Making medical decisions for someone you love: Your rights

    Making medical decisions for someone you love: Your rights

    You shouldn’t have to pull strings to be able to make medical decisions on behalf of the people you love if they are unable to make them for themselves. And, it should be easy if you’ve been named their health care proxy. But, without a written health care proxy, it could be hard to make medical decisions for the people you love or even to speak with their doctors about their medical conditions.

    If there’s no legal document naming you as the health care proxy, sometimes called an “advance directive,” whether you have the right to act on behalf of someone you love depends on state law, even if you’re the caregiver. Some states allow next of kin to act on behalf of a patient who is unable to make medical decisions. However, if the next of kin disagree on the treatment, you might have to go to court to settle the matter.

    If there is no health care proxy, in many cases the doctor and hospital staff end up responsible for making medical decisions. Click here to learn about advance care planning and how to get a free health care proxy document for you and the people you love. For sure, advance care planning is important for end-of-life care.

    And, if you’d like to learn more about why you should have an advance directive, click here.

     

  • Health caring for mom: Three ways to let your mom know you love her on Mother’s Day

    Health caring for mom: Three ways to let your mom know you love her on Mother’s Day

    Mother’s Day is the time to show your mom some serious love. But how? Most of us love flowers and chocolate. So, consider getting mom a little of both. What we really treasure, though, is the priceless gift of time together and conversation. And there are few things more important to talk about than your mom’s health.  So here are a few priceless gifts for mom on her special day:

    1. Make sure your mom is safe and healthy.  Talk to her about all of the drugs she’s taking, both over the counter drugs and painkiller prescriptions. If your mom has a chronic condition like asthma or diabetes, find out whether her primary care doctor is doing a good job of coordinating her care. Click here to learn how your mom’s primary care doctor can help her. And, if your mom wants to stop smoking, lose weight or change another unhealthy behavior, here are some tips for motivating her to do so.
    2. Talk to your mom about planning for her future health care needs. Who would she want to take care of her when she cannot take care of herself?  Would she like to remain at home as long as possible? What are the tradeoffs she would like to make? And, make sure your mother has a reliable health care proxy and a living will. (You should have those too!)  Click here for free help with these advance directives.
    3. Double check that your mom is getting the preventive care services she needs.  She should get regular pap tests, pelvic exams and breast exams. If she’s over 60, she should get a shingles vaccine.  Medicare and most insurance cover all these tests in full. Next time she’s headed to the doctor, consider tagging along. Mom, like all of us, could use a health care buddy to ask the questions she might not ask.

    These are important conversations. Most of us know we should talk to our mothers about their health, but we never quite get around to having the actual conversation. Why not use Mother’s Day as a reason to get serious about your mom’s health? Just talking to your mom about these issues can be healthy for her.