JustCare

Tag: Preventive care

  • Watch your feet: Foot care is critical and pain is treatable

    Watch your feet: Foot care is critical and pain is treatable

    You’ve heard the expression, “watch your back.” When it comes to older adults, you might say “watch your feet.” Caring for an older adult means checking vision, gait, hearing and balance on a regular basis.  It also should mean checking feet.  Feet are a window into whether an older adult is able to care for himself or herself.

    When it comes to feet, older people have lots of issues. Your primary care doctor or geriatrician should be sure to check your feet regularly. Here are seven things to watch out for and talk to your doctor about:

    1. Foot pain: People are more likely to have foot pain in later life as the skin becomes thinner and less elastic. Painful feet can usually be treated.
    2. Fungal infections between the toes causing redness, blisters or itching: Use an over-the- counter fungal spray or cream. And, talk to your doctor. Make sure your feet, including the area between the toes, are dry to prevent infections.
    3. Corns and calluses: Make sure your shoes fit well, and your feet are not rubbing up against them. Use a pumice stone or foot file to remove hard or calloused skin. You also can rub the corns or calluses gently with a washcloth but do not shave them. Moisturize dry and rough skin on your feet to prevent cracks.
    4. Ingrown toenails: Cut toenails regularly to avoid ingrown toenails caused by the nail growing too long and cutting into the skin. Keep in mind that many older adults can’t bend down to cut their own toenails.
    5. Tissue build up in the ball of the foot or toes causing pain. This could make it harder to balance. Make sure your shoes are wide enough.
    6. Toes that are pulled back: This can affect balance. Make sure shoes have enough space in them.
    7. Swelling.  See a doctor if your feet are swollen.

    If you have diabetes, you may have poor blood flow in your feet. And, you are more prone to scrapes, bruises and infections. You should check your feet every day for red patches. If you have sores or blisters or cracks in your skin, see a foot doctor. You want to avoid getting infections.

    And, regardless of your health status, exercise your feet to increase blood flow and improve the health of your feet. You can also do foot exercises.  For more information, check out this pamphlet from the National Institute on Aging.

  • Pneumonia vaccine: Medicare covers it

    Pneumonia vaccine: Medicare covers it

    You should do what you can to avoid getting pneumonia, especially if you’re older. Pneumonia is a lung infection that can cause fever and chills;  it can make it hard to breathe, and it can be life-threatening. One way to avoid getting pneumonia is by getting a vaccine. Fortunately, Medicare covers the pneumonia vaccine without a deductible or coinsurance.

    • If you are enrolled in traditional Medicare, your costs are fully covered through Medicare Part B, so long as you use a doctor who takes assignment, accepts Medicare’s payment as payment in full.
    • If you are enrolled in a Medicare HMO, PPO or other Medicare Advantage plan, the plan should cover the full cost so long as you use an in-network doctor.

    Talk to your primary care doctor about getting the pneumonia vaccine. You should also discuss the flu shot, another important vaccine.  Medicare covers the flu shot, along with most of the preventive care you need. 

    Here are more ways to keep yourself and the people you love safe and healthy.

  • Eight things you should know about the Affordable Care Act

    Eight things you should know about the Affordable Care Act

    Thanks to the Affordable Care Act (“ACA”), 16.4 million more people in the United States have health insurance, though 13.2 percent of the population is still uninsured. Here’s eight other interesting facts about the ACA in 2015, post King v. Burwell.

    1. The ACA guarantees Americans and permanent legal residents the right to buy health insurance, regardless of whether they have a pre-existing condition; and it forbids insurers from cutting people’s coverage off if they get sick. Undocumented immigrants and legal immigrants in the US for 5 years or less are not eligible for coverage.
    2. The ACA requires insurers to offer “minimum essential health insurance coverage” to everyone who they insure, including mental health care, prescription drugs, having a baby, as well as a range of preventive services with no copay or deductible.
    3. The ACA requires insurers to charge everyone the same rate for the same policy based on their age, regardless of their health status. Also, your out-of-pocket costs must be capped. And, it limits the amount that insurers can profit off the premiums they charge.
    4. The ACA requires everyone eligible for coverage to have coverage, although people can go without coverage if they pay a penalty (2% of income or $325, whichever is higher, 2015).
    5. The ACA requires every state to have a health insurance exchange, a marketplace through which people without insurance from their jobs and small businesses can buy insurance. Either the state can establish the exchange itself or the federal government can establish the exchange for the state. The exchange, which can be accessed online, allows people to compare the costs and benefits of the health plans available to them.
    6. The ACA provides a subsidy—help paying for coverage through a state’s health insurance exchange—for anyone with income up to 400 percent of the federal poverty level, $47,080 for an individual. If you’d like to know whether you’re eligible for a subsidy and the amount, click here. In the 30 states (including Washington DC) that opted to expand Medicaid, people with incomes under 138 percent of the federal poverty level are eligible for it, $16,242 for an individual and $27,724 for a family of three. About 3.7 million nonelderly adults in states that opted not to expand Medicaid fall into a coverage gap.
    7. The ACA allows parents with health care coverage through their jobs to include coverage for their children until they turn 26.
    8. The ACA requires chain restaurants to list calories on their menus.

    If you still have questions, you can call the government at 1-800-318-2596.

  • Do mammograms do more harm than good?

    Do mammograms do more harm than good?

    For sure, mammograms contribute to the income of radiologists and other professionals who provide medical services to screen for breast cancer as well as the medical device manufacturers.  And, the U.S. Preventive Services Task Force recommends a mammogram every other year for women between 50 and 74, suggesting that for this age group mammograms do more good than harm. But, the Task Force once again does not recommend mammograms for women under 50, concluding that, for younger women, mammograms do more harm than good.

    Since the U.S. Preventive Services Task Force last looked at the value of mammograms for women in 2009, according to Shannon Brownlee and Lisa Simpson, “the number of studies of mammography has grown, and if anything, the evidence is even stronger: we are consistently over-diagnosing and over-treating breast cancer — and younger women are paying the highest price.”  There’s a better than even chance that women under 50 who get mammograms for ten years will receive a false positive and need further unnecessary testing, increasing psychological stress and costs for them.

    There’s also mounting evidence that between one in three and one in five breast cancers that mammograms detect do not need to be treated or could be treated later in women’s lives.  For now though, doctors cannot know the difference between those cancers that need treatment and those that do not.

    The Cochrane Collaboration reviewed seven trials involving 600,000 women between the ages of 39 and 74, half of whom were randomly chosen for screening before a lump could be felt. They reported that the studies with the most reliable data showed that mammography screening did not reduce a woman’s chance of dying of breast cancer.

    At the end of the day, women should consult with their doctors about whether they need screening mammograms more frequently than the U.S. Preventive Services Task Force recommends.  They should understand the benefits and harms.  The Cochrane Collaboration has a good information sheet capturing the scientific evidence.

    The evidence on mammograms provides powerful reasons to heed the advice of the U.S. Preventive Services Task Force. Today, we collectively spend an estimated $4 billion a year on false positive mammograms and breast cancer overdiagnoses. Without compelling evidence of lives saved and little risk, it’s hard to see the benefits of more mammograms as worth their psychological and financial costs.

     

  • Health plans must cover preventive care services in full

    Health plans must cover preventive care services in full

    It’s always wise to question your health plan if it denies coverage for your care or covers less than you expected. Improper denials or inadequate coverage appear all too common. The latest evidence comes after a report by the National Woman’s Law Center finding that health plans had been refusing to cover all types of women’s contraceptives in full in violation of the Affordable Care Act. Last week, the Department of Health and Human Services made clear that health plans must cover preventive care services in full.

    Health plans cannot pick and choose among the preventive care contraceptive services they cover. They must cover the full range of FDA-approved contraceptive services. They must also cover well-woman visits at no charge to the patient.

    The National Woman’s Law Center surveyed 100 insurance companies in seven states and found that 15 health plans failed to cover all forms of FDA-approved birth control, including Cigna, Aetna and Anthem Blue Cross Blue Shield. The Kaiser Family Foundation conducted a similar study of 20 insurers in five states and found, among other things, that some insurers do not cover birth control patches, four insurers did not cover the contraceptive implant Implanon, and one insurer did not cover the NuvaRing.

    The Department of Health and Human Services clarified that the health plans must offer for free at least one of the 18 contraceptive drugs available, but they can cover the generic drug in full and charge a copay for the brand name drug. The ruling will take effect in January 2016.

    For answers to a range of questions on the Affordable Care Act, visit the Center for Consumer Information and Insurance Oversight. And, remember, if your health plan denies coverage, fight back.  Here’s how.

  • 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.

  • Three preventive care exams that every woman should get

    Three preventive care exams that every woman should get

    Cancer rates are falling and fewer people are dying of cancer. To help detect cancer early, it’s important for women to get three cancer screenings regularly. And, because older adults are more likely to get cancer than younger adults, older women should continue getting screenings throughout their lives. Medicare and health insurers cover three preventive care exams that every woman should get: Pap smears, pelvic exams and physical breast exams.

    Each of these exams can detect different types of cancer. Early diagnosis is important because it increases the chance that treatments will work. Medicare covers the full cost of these tests performed together every two years for women at low risk for vaginal or cervical cancer. Health insurers also cover these tests in full.  The Affordable Care Act requires insurers to cover an annual well-woman preventive care visit and any additional needed visits in order for adult women to obtain recommended preventive services. 

    • Pap smears are important for detecting cervical and vaginal cancer in their early stages. Pap smears can also reveal other genital problems, fibroids and sexually transmitted diseases. For this test, the medical professional scrapes cells from the cervix and vagina.
    • Pelvic exams help detect fibroids and ovarian cancer. The doctor checks the uterus, ovaries, vagina and rectum for changes in shape or size.
    • Clinical breast exams detect the possibility of breast cancer. For this procedure, the medical professional checks the breasts and underarms for lumps which can be a sign of breast cancer.

    For more information, visit Medicare Interactive.

  • Link found between having a purpose in life and better health

    Link found between having a purpose in life and better health

    A new study conducted by Eric Kim reveals a link between having a purpose in life and better health.  People with a purpose in life are more likely to take charge of their health by getting important preventive care services.  Fewer than half of people over 65 get the preventive services they need.

    Kim and his colleagues studied more than 7,000 people over 50 for six years.  Those with a purpose got more preventive services than those without one. These people also spent 17 percent fewer nights in the hospital. What’s most exciting is that studies show that people can increase their sense of purpose and, in the process, take better charge of their health!

    If you like this post, you might also like these:
    Having a purpose in life can be as simple as setting goals for yourself and plans for achieving them
    Mindful meditation: A way to prolong your life without exercise
  • Colonoscopy: Do you need one?

    Colonoscopy: Do you need one?

    If you take charge of your health, you can help prevent colon cancer.  Colon cancer is the third most common type of cancer in both men women.  And, 50,000 people die of colon cancer every year. The overwhelming majority of people with colon cancer are over 50.What can you do to minimize the risk of colon cancer significantly? Get a colonoscopy, which is a colon cancer screening that will identify cancer or precancerous polyps that need removing or monitoring.

    When should you get your first screening and how frequently should you get one?  It depends on your family history. Generally, without a family history, you should get your first colonoscopy at 50. After that, colon cancer screening frequency varies quite a bit from individual to individual and depends heavily on both the results of your screening and your medical and family history. Talk with your doctor about what is best for you.If your results are normal, with no evidence of growths and you don’t have a family history of colon cancer, you can wait ten years before getting another colonoscopy.  That’s because the data show that precancerous polyps take more than ten years to grow into a cancerous form.  If the test shows you have polyps (or growths) on your colon, the doctor will generally remove them.  When you have to be screened again will depend on the size and type of growth.

    The test itself is safe and is generally painless. However, it takes time and can be an inconvenience.  For example, you usually have to drink an enormous amount of liquid the night before the test in order to clean out your system. You are also limited in what you can eat and drink the day before and day of the test. And you might need someone to drive you to and from the appointment.

    Very rarely, a colonoscopy can cause infections, heavy bleeding or tears in your colon, so it is not completely risk free. However, as always you should weigh your history and risk with your doctor.

  • Do I need a primary care doctor?

    Do I need a primary care doctor?

    You should not underestimate the value of a good primary care doctor. According to the American College of Physicians, having a primary care doctor means better health outcomes at lower cost. Better outcomes mean fewer hospitalizations as well as better management of chronic disease. An emphasis on primary care increases the overall health of patients and leads to lower healthcare costs.
    The American College of Physicians report compiled more than 100 studies to show evidence of the benefit of primary care in the healthcare system. According to the report, to improve patient outcomes and decrease overall costs, primary care needs to be supported: there needs to be incentives for physicians to become general practitioners as well as a restructuring of the payment system and a physician-guided model of care.