Thursday, August 28, 2008
Options for medicare explained and compared

By Dr. Anthony Policastro As our country ages, more and more individuals are reaching Medicare age. The multiple Medicare programs can be somewhat confusing. However, there are two main programs to be aware of. One of them is Medicare Part A and the other is Medicare Part B. You can sign up only for Part A or you can sign up for Part A and Part B. Medicare Part A is the inpatient insurance program. If you have worked for enough years (10 years) and paid Medicare taxes over that time, you do not usually have a premium. Fewer years means premiums at higher rates based upon the number of years worked. The deductible if you are hospitalized is $1024 per hospital stay. Therefore, if you remain healthy and are not hospitalized, Part A is a good deal. If you have more than one hospitalization, you can run up the bill very quickly. For example, if you are diagnosed with cancer and require frequent hospitalizations for chemotherapy or treatment, you can quickly run the bill into the tens of thousands of dollars. Another part of the issue is prolonged hospitalization. Most hospital stays are now very short. However, if you have a major illness or accident, it can very easily result in a prolonged stay. The $1024 deductible is only good for the first 60 days of hospitalization. After that the deductible is $256 per day for days 61 - 90 and $512 per day after day 90. Part A does not cover outpatient services. Many people forget that same day surgeries in an ambulatory surgery center are outpatient services. So are overnight hospitalizations. Therefore, one short outpatient stay like this could run the bill into the thousands of dollars out of pocket. This is probably the most important point in this article. Short stays are now the rule rather than the exception. The bottom line is that Part A is a very good deal financially if you have no outpatient surgery, if you are not hospitalized frequently and if you do not have a prolonged hospital stay. As long as you can guarantee those things for as long as you have Part A, it is a very good deal. Medicare Part B is the outpatient portion of things. It comes with an up front premium. The premium is related to how much the individual makes. For those people who make less than $82,000 per year, the premium will be $96.40 per month. The premiums can run as high as $238.40 per month for someone who makes more than $410,000 per year. The Part B deductible is $135 per year. You then pay 20% of additional expenses. Therefore, even when you use it, it can become expensive due to the deductible. While most Part B costs are related to physician's office visits, there are many other things that can run your bill into the thousands of dollars. For example, one outpatient surgical procedure could do that. One 23-hour or less observation period in the hospital can do this. 23-hour stays are very common. As I indicated above, this is very important to remember. Physical therapy is covered by Part B and not Part A. Outpatient X-rays like CT scans and MRI's can become expensive very quickly. They can easily cost over $2500 apiece. If you decide to start with Part A and later switch to Part B if your health worsens, there is a penalty. The Part B premium goes up 10% for each year that you were in Part A. Under current rates that is a little less than $10 per month per year. Another thing to remember is that you need to apply for Medicare before you hit 65. There is about a three month period to enroll and they will not cover expenses that occur during that three month period. The bottom line is that these are like any insurance situations. If you never need to use them, they only cost you a premium. However, if you do need to use them, they can be expensive very quickly. Many people will carry supplemental private insurance to cover the things that neither Part A nor Part B will cover. Depending on your health, this could be a very good deal. I suspect that I did not make things less confusing. However, the goal is to have each individual do their homework very carefully before making a decision that could bankrupt them if they gamble by taking lesser insurance and then are not as healthy as they expect to be.

Nanticoke plans golf tournament The 22nd annual Nanticoke Health Services Golf Tournament is Friday, Sept. 5 at the Seaford Golf and Country Club. The day will consist of practice, lunch, 18-holes of golf, dinner and door prizes. A full field of participants is expected with a noon shotgun start and scramble format. The tournament's goal is to raise over $35,000 for Nanticoke Memorial Hospital. All participants will have the opportunity to putt through a three-step qualifying round. Following dinner, three people will putt for $2,500 each. Entry fees are $150 per player and $600 for a foursome. Sponsorships packages are available. Anyone interested in individual reservations or sponsorship opportunities should contact the Nanticoke Health Services Development office at 302-629-6611, extension 2404 or email

Low-cost mammograms Bayhealth Medical Center offers low-cost mammograms every month. The low-cost mammograms are offered on the third Wednesday from 1 to 3 p.m. Local screenings are held at Bayhealth Women's Center at Milford Memorial, 200 Kings Hwy., Suite 3, Milford. Pre-registration is required. For appointments and more information, contact Breast Care Coordinator Trisha Bentley at 302-744-6773.

Osteoporosis screenings offered Bayhealth Medical Center offers free osteoporosis screenings. Osteoporosis is a disease causing bones to become fragile and more likely to break. Patients place their heel in a bone density scanner that checks the bone for early stages of osteoporosis. Screenings are offered from 9 to 11 a.m. on the third Wednesday of January, May and September at Milford Memorial Hospital Women's Wellness Center. Pre-registration is required. To register, call Bayhealth's Education Department at 302-744-7135 or toll-free at 1-877-453-7101.

Caregiver support group Join our monthly support group at the Cheer Community Center, the second Monday of each month at 11 a.m., 854-9500. This support group is for you, whether you are a new caregiver or have been taking care of a loved one for years. We are turning the "Fearless caregiver" book into a guide for our support group. Each month a chapter will be discussed, concerns shared and support given.

Beebe offers diabetic foot screening Beebe Medical Center's Wound Care Services/Diabetes Management Department, located on Long Neck Road in Millsboro, will offer a free diabetic foot examination from 12:30 p.m. to 4:30 p.m., Wednesday, September 3. The free examination is one in a series to take place on selected Wednesdays. It is designed for people with diabetes who do not have podiatry care. Participants will receive a foot screening, as well as education on daily foot care, proper footwear and the problems that require treatment. People with diabetes are at risk for developing serious complications when they suffer injuries to their feet. If circulation is impaired by diabetes, the tissue in the foot is less able to fight infection. If nerve sensation is impaired, an injury can go unnoticed unless the feet are regularly examined. To register for the foot examination, or for more information on diabetes education, call the department at 302 947-2500.