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Tag: Hearing

  • Medicare Advantage dental, vision and hearing benefits offer little value

    Medicare Advantage dental, vision and hearing benefits offer little value

     

    Medicare Advantage plans advertise their “extra” benefits as a way to lure in new enrollees. But, new research published in JAMA Network finds that Medicare Advantage dental, vision and hearing benefits offer little value to enrollees. Enrollees have no better access to dental, vision and hearing benefits than people in traditional Medicare.

    The most recent MedPAC data show that the federal government is spending 22 percent more per Medicare Advantage enrollee than for enrollees in traditional Medicare. The data are increasingly also showing that, notwithstanding the estimated $83 billion more the insurers offering Medicare Advantage received from the federal government in 2024, Medicare Advantage enrollees get fewer benefits than people in traditional Medicare.

    For the most part, insurers offering Medicare Advantage only cover care for their enrollees from a restricted network of physicians and hospitals. In rural communities, people have to travel long distances to see a doctor or get treated at a hospital because their local providers are not in their Medicare Advantage plan network. And, the specialists qualified to treat certain conditions are also often not in-network.

    Moreover, Medicare Advantage insurers often inappropriately delay and deny care to their enrollees, particularly when they have complex and costly conditions. The insurers’ financial incentive is to withhold care because the government pays them upfront regardless of the amount of money they spend on care. The less care they cover the more money they get to keep.

    A team at Mass General Brigham looked at whether the “extra” benefits Medicare Advantage insurers offer add value. Insurers misleadingly claim that they give their enrollees more than traditional Medicare in the form of extra benefits. But, that is not true in fact.

    Insurers often deny Medicare Advantage enrollees coverage for treatments that traditional Medicare covers. And, while insurers technically offer enrollees additional benefits, too often, enrollees are not aware of these benefits or the out-of-pocket costs present a barrier to care. The researchers found that fewer than six in ten enrollees knew their Medicare Advantage plan covered these “extra” benefits.

    Between 2017 and 2021, people in traditional Medicare and Medicare Advantage spent about the same amount for dental, vision and hearing services, notwithstanding that Medicare Advantage plans claim to offer these benefits and traditional Medicare does not.  They also received about the same number of services. There is no reason to be paying Medicare Advantage insurers more per enrollee than the government spends in traditional Medicare.

    “Medicare Advantage plans receive more money per beneficiary than traditional Medicare plans, but our findings add to the evidence that this increased cost is not justified,” said first author Christopher L. Cai, MD. At best, people in Medicare Advantage are getting a discount of less than 10 percent on vision, hearing and dental treatment. Out-of-pocket costs are high, even with the benefits, and the panel of covered providers is narrow.

    “Supplemental benefits are a major draw to Medicare Advantage, but our findings show that people enrolled in Medicare Advantage have no better access to extra services than people in traditional Medicare, and that much of the cost comes out of their own pockets,” according to senior author Lisa Simon, MD, DMD, assistant professor in the Division of General and Internal Medicine at Brigham and Women’s Hospital. “Older adults and people with disabilities deserve better from Medicare.”

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  • Need a hearing aid? Look no further than your AirPods

    Need a hearing aid? Look no further than your AirPods

    If you’re not hearing quite as well as you used to and would like some help, you might not have to look any further than your iphone AirPods. Apple claims its new technology will improve hearing for millions of people. The AirPods Pro 2 is about to become a medical device, reports Ben Cohen for the Wall Street Journal.

    Some audiologists believe that the new AirPods Pro 2 technology will be a terrific way for Americans who do not wear hearing aids to improve their hearing at little cost. Some 30 million Americans could benefit.

    Apple’s technology is for people with mild to moderate hearing loss, not people with severe hearing loss. Most people with some hearing loss, who can still hear, tend not to do anything about it. But, wearing AirPods is so normal, that the new technology is likely the best option for people who are not looking for help with their hearing.

    Apple’s hearing aid technology is approved by the Food and Drug Administration. The FDA says it improves “the availability, accessibility and acceptability of hearing support.”  One hearing expert called the Apple technology a “game-changer,” because of its convenience and people’s trust in Apple.

    The Apple AirPods with hearing aids is a breakthrough product in large part because about 22.5 million Americans who would benefit from hearing aids are not using them. Why would they us them, given how expensive hearing aids are and the time it takes to get fitted for one. Apple’s hearing aid, the AirPods Pro 2 will cost $249, its current cost.

    One drawback of Apple’s new hearing aid is that its battery life is shorter than the battery life of other hearing aids. One benefit is that Apple’s technology also can give users a short hearing test.

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  • US House passes Build Back Better Act

    US House passes Build Back Better Act

    Last week, the US House of Representatives passed the Build Back Better Act, legislation designed to improve the lives of tens of millions of Americans. The Senate still needs to pass the bill before President Biden can sign it into law. In all likelihood, the Senate will water it down some. But, as it stands, here’s what it will do to reduce the cost of health care for people with Medicare and all Americans:

    1. It strengthens Medicaid to cover more home and community-based services. Millions of people with Medicare who also have Medicaid can benefit from this provision. Medicare only covers home care in limited situations, for people who need skilled nursing or therapy services on an intermittent basis.
    2. It adds a hearing benefit to Medicare. If passed, Medicare would cover audiology services and hearing aids.
    3. It allows Medicare to negotiate the price of some popular high-cost prescription drugs that have been on the market for at least nine years. Over time, Medicare would negotiate the price of up to 60 prescription drugs.
    4. It caps out-of-pocket costs in Medicare Part D, outpatient prescription drug coverage, at $2,000 a year.
    5. It caps the coinsurance cost of insulin for people with Medicare and people with private insurance at $35 a month.
    6. It limits the amount pharmaceutical companies can raise prices on their drugs from one year to the next to no more than the rate of inflation.
    7. It helps low-income people in the 12 states that have not expanded Medicaid access health insurance coverage through their state health insurance exchanges at low or minimal cost.

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  • Caregiving: How to prepare for a visit to aging loved ones

    Caregiving: How to prepare for a visit to aging loved ones

    Now that the pandemic is somewhat behind us, we are reconnecting in person with older friends and family members. If you’d like to help them with the to-do list they were forced to put on hold for so many months, here are some suggestions from the New York Times and elsewhere.

    Start by asking them to put together a list of the things they would like help with when you see them. If possible, have them let you know what’s on the list before your visit. If you want to help with the list, here are the items you might want to cover.

    Before your visit:

    1. Doctors’ appointments: Most people skipped preventive care visits during the pandemic. Are there doctors’ appointments that are overdue? If so, schedule those.
    2. Home maintenance: Most likely some appliances are no longer working and need fixing. Other items around the house might also need attention. If so, arrange for service people to come to the house.
    3. Legal matters: Do the people you love have a healthy care proxy, someone they’ve named to speak for them if they can’t speak for themselves and that it is documented in an advance directive legal document? If so, you should find out who that person is and, if possible, get a copy of the document. Someone also should have durable power of attorney to take care of financial matters if they are unable to do so.

    During your visit:

      1. Time your activities around your loved ones’ schedules. Try to engage them when they are most alert, in the morning or after a nap. And, try to meet all the people in their circle, including caregivers, neighbors and others who they spend time with. Having contact information for those people could be invaluable over time.
      2. Assess how your loved ones faring mentally and physically. How independent are they? Are they able to cook for themselves? Are they taking their medicines? Check the dates on any prescription pill bottles to see whether their prescriptions are up to date. If not, ask whether they would like a pharmacy to deliver medications to them.
      3. Talk to them about their hearing. Can they hear the phone, the doorbell and the TV? Explore with them whether they would like a hearing aid.
      4. Discuss the location of various items in the house. How easy is it for them to access what they need? Find out whether they think it would be helpful to rearrange items for easier access. Offer up your muscle to move items inside or outside the house.
      5. There could be tripping hazards in the house. Steps, throw rugs, wires. Would they like some nightlights? Do they still want the throw rugs or are they more of a nuisance that could lead them to fall? Would it be good to have an electrician come in to put in electric outlets in more convenient places and to reduce the possibility of tripping over electric cords?
      6. Confirm that their balance is good. If not, discuss what you might do to help them from falling. Are guardrails needed in the bathroom? Talk to them about doing balance exercises and other exercise for mental and physical health.
      7. Draw up a plan for caregivers if there isn’t one. Talk with your loved ones about what their ideal weekly schedule looks like, in terms of outings, meals, exercise and social and cultural events. Include contact information for the most trusted people in their circle.
      8. Make sure there’s a file that contains all the basic information needed to care for them if needed.

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  • Will Biden expand Medicare benefits or strengthen the ACA?

    Will Biden expand Medicare benefits or strengthen the ACA?

    Jeff Stein reports for the Washington Post on health care reform proposals the Biden administration could include in the American Families Plan. House Speaker Nancy Pelosi is urging President Biden to invest in strengthening the Affordable Care Act. Senator Bernie Sanders wants him to add additional benefits to Medicare and make Medicare available to people 60 and older.

    Speaker Pelosi wants the next Congressional legislation to make greater subsidies to people under the Affordable Care Act permanent. In March, Congress expanded subsidies but they are  temporary. Her proposal would further entrench for-profit insurers in our health care system.

    Senator Sanders wants to shore up .the Medicare benefit package. He wants it to include dental, vision and hearing services. He also wants to lower the age of Medicare eligibility to 60 or 55. These benefits could bring down health care costs substantially for the 23 million people over 6o who are not eligible for Medicare today as well as for the 65 million people with Medicare.

    Biden, for his part, should recognize that pumping more money into our nation’s corporate health insurance system is going to drive up costs and keep us from having a sustainable universal health care system. Expanding public health insurance administered directly by the federal government is the only way to get a handle on health care costs and drive health care system improvements.

    The Biden administration is working on the American Families Plan. Right now, it appears it will cover child care, anti-poverty programs and health care. It could reduce prescription drug spending by $450 billion over ten years. Senator Sanders wants these savings, which are largely from Medicare, to benefit people with Medicare. Using the money on the ACA or any other health care initiative would take money out of Medicare.

    The savings on prescription drug costs should go to helping people with Medicare. The most up-to-date data show that older and disabled Americans suffer deeply as a result of not having comprehensive dental, vision and hearing benefits. Benefits available through Medicare Advantage plans appear to be theoretical and not meaningful. To the extent Medicare Advantage plans offer these benefits, they pay for only a fraction of the cost of treatment. Most people do not have the means to pay the substantial out-of-pocket costs.

    Consequently, nearly one in five people with Medicare over 70 have no teeth. An additional one in five of them suffer from tooth decay. Millions of people with Medicare also suffer from untreated severe or profound hearing loss. And millions suffer from lack of vision care. All of these services are prohibitively expensive. Lack of vision, dental and hearing care can lead to depression, increased risk of falls, social isolation, diabetes, cardiovascular disease and other co-morbidities.

    Whichever direction Biden goes, it will take enormous public pressure for Congress to pass the legislation. It will come after Congress passes an infrastructure package, which also will require a large public push.

    Here’s more from Just Care:

  • Medicare for all improves the lives of older adults

    Medicare for all improves the lives of older adults

    Letter to Chairman McGovern and members of the U.S. House of Representatives House Rules Committee in support of the Medicare for All Act of 2019, H.R. 1384, with a focus on its value for older adults:

    I want to share my thoughts on a very important and often overlooked aspect of the Medicare for All debate: How Medicare for All will greatly improve the lives of people with Medicare. Any discussion of this issue starts with the unacceptable state of the broader American health insurance system.

    Americans of all ages are increasingly being forced to make health care choices no one should have to make. Two in three[i] of us forego needed care in order to afford the rent, the heat, our dinner. In our commercial insurance marketplace, health care choice too often means gambling with our health. Not surprisingly, more than nine in ten Americans[ii] are asking Congress to address health care costs.

    Commercial health insurers charge Americans ever higher costs for their care. They have not succeeded at negotiating fair health care prices. Rather, prices are excessive and irrational. The same procedures[iii] cost tens of thousands of dollars more in one hospital than in another. On average, the US spends twice as much[iv] on health care as other wealthy countries; yet, the US ranks at or near bottom on most health outcomes, including infant mortality and life expectancy.

    Americans suffer or die needlessly for lack of health care. I recently spoke with one woman, Eve Meikle who was forced to “backburner” treatment for her ulcerative colitis in order to pay for diagnosis and treatment of her daughter’s gastritis. Eve and her family have insurance and an annual income just over $80,000. Still, it will take them years to free themselves of medical debt, and, left untreated, Eve’s condition may very well worsen and keep her from working.

    Medicare for All is the only policy proposal before you that controls costs and guarantees health care as a right[v] to everyone. Other proposals on the table– Medicare buy-ins, Medicaid expansion or state-based reforms–neither rein in costs nor make health care affordable for all Americans.

    Medicare for All guarantees health care for all. It promotes the public good. It provides greater security to older adults by filling Medicare coverage gaps, eliminating premiums, deductibles and coinsurance, and adding vision, hearing, dental and long-term services and support benefits. And, it does so while reducing national health care spending. It uses the leverage of all Americans to rationalize health care prices and eliminate administrative waste. Even by conservative estimates, it saves $2 trillion[vi] over 10 years. And, if we paid what other countries paid for their drugs, as President Trump and Senator Sanders have both proposed, it would save still more.

    Medicare for All builds on Medicare, which has a 50-year track record of providing health and financial security to older and disabled Americans. Medicare has helped significantly to reduce the poverty rate among older adults, which has fallen from 29 percent in 1965 to nine percent in 2016.[vii]

    Medicare works. I know firsthand. I am the founder and past president of the Medicare Rights Center, a national not-for-profit consumer service organization.

    Medicare works because it is designed to meet the needs of everyone, including people in poor health with costly conditions. It works because it gives people the freedom to travel or move in with an out-of-area family caregiver and see the doctors they want to see, wherever in the US they happen to be. Medicare works because it allows its enrollees, their children and grandchildren, to sleep at night knowing they can and will get the care they need. Still, three in four older adults say the government is not doing enough to address health care costs.[viii]

    Medicare for All would significantly improve the health and financial security of older Americans. Older adults are counting on you[ix] to expand Medicare benefits. Older adults, much like their kids, increasingly struggle to pay for health care that Medicare does not cover. One in four of them have less than $15,000 in savings.[x] Half live on annual incomes under $26,200.[xi] Social Security benefits are critical, but inadequate, to cover many basic needs. Private sector retiree benefits have eroded.

    Even with Medicare, Americans have thousands of dollars in out-of-pocket health care costs for hearing, dental, vision and long-term services and supports. They also need supplemental coverage to fill Medicare coverage gaps and protect themselves financially, which can be extremely costly. A Gallup poll[xii] released last week reveals that one in seven older adults, 7.5 million people, are unable to pay for the medicines their doctors prescribe. And, of those, eight in ten say that these medicines are for a somewhat or very serious condition.

    Traditional Medicare, without supplemental coverage, has high out-of-pocket costs and no catastrophic cap. For this reason, many older Americans have no choice but to sign up for commercial Medicare plans, known as Medicare Advantage plans, which have a catastrophic cap. The commercial Medicare Advantage system is a looming tragedy for older Americans that can only be addressed through Medicare for All.

    Commercial Medicare plans offer lower upfront costs than people with government-administered Medicare. Older and disabled Americans enroll in Medicare Advantage plans hoping to save money. But, there is compelling reason for serious concern that Medicare Advantage plans are keeping enrollees from getting needed care, jeopardizing their health, and overcharging the government and taxpayers. I want to highlight these three big issues.

    Wrongful Delays and Denials of Care

    Medicare Advantage plans routinely and improperly delay or deny coverage for needed care. The Office of the Inspector General[xiii] reports that audits by the Centers for Medicare and Medicaid Services (CMS) reveal “widespread and persistent [Medicare Advantage] performance problems related to denials of care and payment.” This should come as no surprise. The less care they deliver, the more Medicare Advantage plans profit.

    CMS has sanctioned dozens of commercial Medicare plans[xiv] for, among other things, “threatening the health and safety” of their members and “charging incorrect copayments to enrollees for medical services.”

    Poor Quality Care

    In addition, Medicare Advantage plans may prevent their enrollees from receiving good quality care. A recent study published in Health Affairs[xv] shows that Medicare Advantage plans send enrollees to lower quality nursing facilities than traditional Medicare. Research soon to be published shows that Medicare Advantage enrollees generally have less access to top hospitals than people in traditional Medicare. They also lack access to higher quality home care.

    A recent study in JAMA Internal Medicine[xvi] shows that people with significant health care needs are disenrolling from Medicare Advantage plans to traditional Medicare at far higher rates than people without significant health needs.

    In addition, Medicare Advantage enrollees cannot rely on continuity of care from their doctors. Kaiser Health News[xvii] reported earlier this month on a cancer patient in a Medicare Advantage plan who is losing the in-network doctors who have kept her alive over the last several years but are no longer in-network. She cannot afford to pay out-of-pocket for her doctors’ out-of-network services.

    No trustworthy public data is available as to which, if any, Medicare Advantage plans promote access to quality providers and good care. The current five-star rating system for Medicare Advantage plans is regarded as a farce. CMS policy[xviii] permits a Medicare Advantage plan to get a five-star rating even though CMS has sanctioned[xix] it for threatening the health and safety of its members and has “a longstanding history of noncompliance with CMS requirements.”

    Government Overcharges

    Of concern as well, government overpayments to Medicare Advantage plans appear significant. Congress entrusts commercial Medicare Advantage plans with covering the healthcare of our most vulnerable citizens at significant taxpayer expense. Yet we know from government audits that the Medicare Advantage plans bill taxpayers for tens of billions of dollars[xx] they are not due. They “upcode,” services, improperly claiming the health status of their enrollees is worse than it is in order to generate higher payments.

    The GAO[xxi] reports that the Centers for Medicare and Medicaid Services identified $14.1 billion in overpayments to Medicare Advantage plans in 2014 alone but that CMS is not recovering nearly as much in improper payments as it could with better oversight.

    A more recent study published in Health Services Research[xxii] estimates that “upcoding” by Medicare Advantage plans could account for as much as 13 percent of payments[xxiii] to Medicare Advantage plans and increase Medicare spending over ten years by $200 billion. And, it is not clear whether CMS can recoup this money.[xxiv]

    The litany of wrongful and harmful behaviors by Medicare Advantage plans is likely greater than we know. Critical Medicare Advantage data is unavailable for analysis. We know more about how restaurants, automobiles and televisions perform and rank against one another than we do about Medicare Advantage plans. Yet, the government paid them $210 billion in 2017[xxv] alone.

    With or without the data, we know that commercial health insurers are hard-pressed to meet the needs of people with Medicare or anyone else who develops a complex and costly condition. Imagine the best commercial health insurance company in the US. Let’s promise that it will always provide high value care for people with stroke, cancer and heart disease. This best health insurance company would be out of business before it opened its doors. Everyone in poor health would join, driving premiums up so high that no one could afford them. To make a profit, commercial health plans must compete to avoid high-cost enrollees.[xxvi]

    Instead of meeting our needs, commercial health insurers offer little health or financial security. They can and do change their network providers all the time, keep doctors from providing the care their patients need, shift costs onto their members who most need care and pull out of markets. They do whatever they need to do to promote their business interests.

    Medicare for All—an improved and expanded Medicare system—can do what commercial health insurance can never do: Protect Americans from the high cost of health care, while ensuring access to good quality care.

    To some, Medicare for All may seem too big a change too quickly. For Americans, the change could not come quickly enough.

    Thank you for your consideration.

    [i] Becker’s Hospital Review: https://www.beckershospitalreview.com/finance/64-of-americans-avoid-treatment-due-to-cost-of-medical-care-5-survey-insights.html

    [ii] Politico.com: https://www.politico.com/story/2019/01/07/politico-harvard-poll-medicare-for-all-1061791

    [iii] Modern Healthcare: https://www.modernhealthcare.com/article/20160427/NEWS/160429918/the-striking-variation-of-commercial-healthcare-prices

    [iv] Peterson Kaiser Health System Tracker: https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/

    [v] Political Economy Research Institute: https://www.peri.umass.edu/publication/item/1127-economic-analysis-of-medicare-for-all

    [vi] Blahous, Charles, The Costs of a National Single-Payer Health Care System: https://www.mercatus.org/system/files/blahous-costs-medicare-mercatus-working-paper-v1_1.pdf

    [vii] Joint Economic Committee, Democrats, Medicare: Protecting Seniors and Families: https://www.jec.senate.gov/public/_cache/files/5f4be5d9-b297-467a-948a-e7525d04f924/medicare-final.pdf

    [viii] Gallup: https://news.gallup.com/opinion/gallup/248741/seniors-pay-billions-yet-cannot-afford-healthcare.aspx

    [ix] Gallup: https://news.gallup.com/opinion/gallup/248741/seniors-pay-billions-yet-cannot-afford-healthcare.aspx

    [x] Kaiser Family Foundation: http://files.kff.org/attachment/Issue-Brief-Income-and-Assets-of-Medicare-Beneficiaries-2016-2035

    [xi] Kaiser Family Foundation: https://www.kff.org/medicare/issue-brief/how-many-seniors-live-in-poverty/

    [xii] Gallup: https://news.gallup.com/opinion/gallup/248741/seniors-pay-billions-yet-cannot-afford-healthcare.aspx

    [xiii] Office of the Inspector General: https://www.oig.hhs.gov/oei/reports/oei-09-16-00410.pdf

    [xiv] CMS Compliance and Audits: https://www.cms.gov/Medicare/Compliance-and-Audits/Part-C-and-Part-D-Compliance-and-Audits/PartCandPartDEnforcementActions-.html

    [xv] Meyers, David J. et al., Health Affairs: https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0714

    [xvi] JAMA Internal Medicine: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2725083

    [xvii] Kaiser Health News: https://khn.org/news/patients-caught-in-middle-of-fight-between-health-care-behemoths/

    [xviii] CMS policy memo: https://s3.amazonaws.com/assets.fiercemarkets.net/public/004-Healthcare/external/star_ratings_memo.pdf

    [xix] CMS policy memo: https://www.cms.gov/Medicare/Compliance-and-Audits/Part-C-and-Part-D-Compliance-and-Audits/Downloads/Cigna_Sanction_01_21_16.pdf

    [xx] GAO: https://www.gao.gov/products/GAO-16-76

    [xxi] Ibid.

    [xxii] Health Services Research: https://onlinelibrary.wiley.com/doi/full/10.1111/1475-6773.12977

    [xxiii] Van de Water, Paul, Center on Budget and Policy Priorities: https://www.cbpp.org/blog/medicare-advantage-upcoding-overpayments-require-attention

    [xxiv] UnitedHealthcare Insurance Company, et al. v. Alex M. Azar II, et al., Secretary of the Department of Health and Human Services: https://s3.amazonaws.com/assets.fiercemarkets.net/public/004-Healthcare/external_Q32018/UHvBurwell_overpayments.pdf

    [xxv] Cubanski, Juliette and Neuman, Tricia, Kaiser Family Foundation: https://www.kff.org/medicare/issue-brief/the-facts-on-medicare-spending-and-financing/

    [xxvi] Archer, Diane and Marmor, Theodore, Health Affairs, Medicare and Commercial Health Insurance: The Fundamental Difference: https://www.healthaffairs.org/do/10.1377/hblog20120215.016980/full/

     

  • Will over-the-counter hearing aids help people with Medicare?

    Will over-the-counter hearing aids help people with Medicare?

    Medicare does not cover hearing aids. But, more than 20 million people with Medicare suffer from hearing loss. Most of them cannot afford to go to the audiologist and buy hearing aids out of pocket. Will over-the-counter hearing aids help people with Medicare?

    Janice Neumann reports for the Washington Post that, today, only about one in four people with Medicare who need hearing aids use them. Hearing aids tend to be super expensive–typically between $1,500 and $7,000. So, low-cost hearing aids that do not require a prescription, much like low-cost reading glasses, should allow millions of older people to hear better.

    The good news: Congress passed a law in 2017, the Over-the-Counter Hearing Aid Act, that will regulate personal sound amplification products (PSAPs) and allow them to be sold over the counter, without a prescription from an audiologist. They are designed for people with mild to moderate hearing loss, not people with severe hearing loss.

    The bad news: If people do not get their hearing aids fitted, they are less likely to hear well with them. But, Medicare will not pay for a hearing test from the audiologist or for the audiologist to fit the PSAP. The cost of the test and fitting could be several hundred dollars, more than what many people are able to spend.

    Under the new law, the PSAPs must be programmable. But, it is unclear what that means or whether that applies simply to volume. Time will tell how well the PSAPs will work for people.

    Medicare should cover the full range of hearing aids people need, along with the testing and fitting. Without hearing aids, people who struggle to hear are at greater risk of cognitive decline, depression and dementia. They also are at greater risk of falls.

    For now, take advantage of Medicare’s annual wellness benefit to have your hearing checked. At the very least, your doctor can let you know whether you would benefit from a hearing aid. And, if you also have Medicaid, see whether Medicaid covers hearing aids in your state. It sometimes does.

    Here’s more from Just Care:

  • Can eating more mushrooms prevent cognitive decline?

    Can eating more mushrooms prevent cognitive decline?

    There are hundreds of studies on the benefits of different foods and vitamins for your heart, your brain, your muscles and more. More often than not, these studies recommend eating more green leafy vegetables and nuts. The latest study, out of the National University of Singapore (NUS), finds that eating more mushrooms may prevent cognitive decline in older adults.

    Did you even know that mushrooms could have special health benefits? According to this new study, older adults who eat a half plate (300g) of mushrooms each week could reduce their risk of mild cognitive impairment–memory loss or forgetfulness or attention deficits–by half. The senior research fellow on the NUS study suggests this benefit may stem from the compound ergothioneine (ET), which is found in most mushrooms.

    ET (ergothioneine) is an antioxidant and anti-inflammatory. People cannot synthesize ET on their own. But, you can find ET in a variety of mushrooms, including golden, oyster, shiitake, white button mushrooms, dried and canned mushrooms. Keep in mind that there is no evidence that taking supplements containing ergothioneine is beneficial; it is not the same as eating mushrooms, and supplements have risks.

    Moreover, there is not enough evidence to say definitively that eating mushrooms forestalls cognitive decline. Still, there’s no harm in eating more mushrooms. If you don’t like mushrooms, there are other evidence-based ways to forestall cognitive decline.

    Keeping mentally and physically healthy may prevent cognitive decline and dementia, according to other research. Managing high blood pressure, having a social network , exercising, keeping a healthy weight, managing hearing loss, not smoking and drinking only small amounts of alcohol all may help.

    The NUS study was conducted between 2011 to 2017.

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  • Keeping mentally and physically healthy and engaged may prevent dementia

    Keeping mentally and physically healthy and engaged may prevent dementia

    A 2017 study by a worldwide team of dementia experts, published in Lancet, lays out the latest research findings on dementia, and the news is better than you might expect. There are a range of proven ways, particularly through mental and physical stimulation, to prevent or delay dementia.

    Dementia literally translates from the Latin to mean “out of mind.” It is a brain disorder that affects memory and the ability of people to process information. In 2015, 47 million people around the world, mostly people over 65, were living with dementia at a cost of $818 billion. By 2050, there are expected to be almost 150 million people living with dementia. Today, one in three older people die with dementia.

    Though there is no cure for dementia, people’s daily activities may delay or prevent its onset. And, for people diagnosed with dementia, there are ways to slow down the course of the disease and improve quality of life. The data suggest that people who are better educated, as well as more mentally and physically active and socially engaged, are less likely to be diagnosed with dementia.

    Not surprisingly, social isolation, not having friends or family to talk to and spend time with, and poor education, increases the risk of dementia. In addition, people with hearing loss who are not managing that condition are prone to getting dementia.

    Here are a few ways that have been found to delay or prevent dementia:

    • Treatment for hypertension or high blood pressure is important since high blood pressure has been found to cause dementia.
    • It is possible that more than one in three cases of dementia can be delayed or prevented through exercise, having a social network, and engaging your mind.
    • Smoking less.
    • Managing hearing loss,
    • Keeping your blood sugar level under control if you have diabetes.
    • Maintaining a healthy weight; and,
    • Treating depression.

    Getting a diagnosis of dementia in its early stages can allow for treatment interventions that maximize memory and cognition, and reduce stress and depression. There are many people living with dementia who are able to drive and function independently. You can learn more about the living with dementia movement, here.

    Here are ways to help people living with dementia remain independent. And, here are best practices for communicating with a person with dementia.

    Here’s more from Just Care:

  • Need a crown or dental implant? Consider a trip to Mexico

    Need a crown or dental implant? Consider a trip to Mexico

    Because Medicare does not cover some basic health care needs, Just Care offers advice on a number of ways to get free or low cost dental, vision and hearing care in the US.  Nation of Change reports that millions of Americans cross our southern border to Mexico for a crown, a dental implant and other affordable health care.

    About 25 percent of Americans or 74 million people lack dental coverage.  And virtually no Americans have coverage for crowns, root canals and implants. These common procedures can cost several thousand dollars in the US.

    At one crossing point alone in Arizona, 6,000 Americans travel to Los Algodones primarily for low-cost dental care, vision care and prescription drugs. In Mexico, people typically can get a crown for less than $700 and sometimes as little as $400. Implants are commonly under $1,700 as compared to $5,000 in the US.

    These procedures cost so much less in Mexico because the cost of living is so much less there and dentists earn less money than they do in the US. They also pay less for dental school.

    Americans can spend little time as well as far less money than they would in the US for their dental care in Mexico. Los Algodones has many dental labs. So, you can have a crown, bridge or dentures made in a couple of days.

    One of the goals of Medicare for All is to fill the gaps in health insurance coverage, including providing coverage for vision, dental and hearing care. Medicare for All legislation in the Senate and the House would cover these services.

    For other free and low-cost resources, visit Just Care’s Get Help page.

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