Blue Shield CA Raises 'New To Medicare' Premium Discount

Blue Shield of California is now offering a Medicare Supplement Discount of $25 per month for the first 12 months for those new to Medicare (Part B).  

For California residents turning 65 and enrolling in Medicare, or those who are enrolling in Medicare Part B after 65 for the first time, this discount is available on Supplement Plans A, C, D & F (G will be coming out soon and will also offer this discount).  This discount is not available on High F nor Plan N.

An additional $3 per month discount is available if you choose to pay your premiums using their EZPay automatic deduction.  

Blue Shield currently offers year round birthday rule open enrollment for California residents.  

Call or e-mail for a quote and discounted premium rate on your Medicare Supplement plan.

Dave
www.davefluker.com

800-509-0659 Toll Free
dave@davefluker.com



No Vote For Graham Cassidy Healthcare Bill (Trumpcare Dead)

The US Senate will not vote on the ACA Repeal Bill (Graham Cassidy) this week.  

The budget reconciliation process ends on September 30th.  This is the time frame allowed to pass a bill with only 51 votes and not 60 votes.

Essentially, #Trumpcare is dead at this point.  

Read the full healthcaredive article here

Dave
www.davefluker.com






John McCain Torpedos Graham Cassidy Bill

Today Arizona Senator John MCCain announced that he would not be supporting the Graham Cassidy Healthcare Proposal.  

�I cannot in good conscience vote for the Graham-Cassidy proposal,� the Arizona Republican senator said in a statement, using the bill�s nickname.

The Senate has 52 Republicans.  With McCain's decision and Rand Paul already stating he would not support Graham Cassidy. the matter is in serious doubt.

The proposal needs 51 votes to pass the Senate.  VP Mike Pence could provide the 51st vote in the event that the proposal were to receive the necessary 50 votes for Pence to be the deciding vote.  

Problem is, the positions of Susan Collins (ME) and Llsa Murkowski (AK) are also in doubt. Collins stated today that she is leaning against the bill.

Read the article on Fox News


Dave
www.davefluker.com


Medi-Cal Implications of Graham Cassidy For Low-Income Californians

News sources are reporting that the last grasp Graham Cassidy bill will be voted on early next week.  Ahead of the September 30th deadline (the last day the bill could pass with less than 60 Senate votes).

Certain provisions within this legislation would have a direct  and potentially negative impact on Medi-Cal (California Medicaid).

Under the ACA (ObamaCare), California expanded Medi-Cal as allowed under the law.  This expansion is, in large part, funded by the federal government and not the state government. Adults with incomes below 138% Federal Poverty Level and children under 19 with family incomes below 266% are eligible to enroll in MAGI Medi-Cal.  The expansion did away with asset testing and eligibility is determined by income.  

Simply put, under the proposed Graham Cassidy bill, the expansion of Medicaid (Medi-Cal in California) would be reversed and future federal funds that might be used by states would be provided in block grants.  This reversal would essentially remove the income-based eligibility expansion in California.  This may also revert the system back to and income and asset based eligibility program.

For low-income families, this could be financially difficult.  As the Graham Cassidy bill also eliminates subsidies on exchanges (Covered CA in our state), families with incomes between 100-138% FPL might well find themselves priced out of healthcare coverage entirely.  

If the bill were to pass and be signed into law, California could certainly decide on how to allocate the block grant monies whether it be to continue Medi-Cal expansion, income-based subsidies, or Covered CA as a marketplace (exchanges would also be eliminated under the legislation).

Depending on the source, California has between 26-30% of its population covered by Medi-Cal, second only to employer group coverage.  

I will be paying close attention to this legislation and will be posting here, on Facebook and Twitter as things progress.

Dave
www.davefluker.com

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Diabetes & A 49 Blood Sugar That Sneaks Up Like A Bitch Ninja


It was a morning of trying to plow through, 
taking notes for an article I'm working on, two deadlines looming on the calendar, and doing my best to stop the Graham Cassidy insanity from happening. 
Focusing on getting shit accomplished. 
And out of nowhere, I suddenly felt shaky and tingly all rolled into one. 
I was sweaty and hungry and I didn't feel so steady on my feet. 
Diabetes had snuck up on me like a bitch Ninja and I was dropping fast. 
Status: Threat level Hot Mess, with a blood sugar of 49. 
I grabbed a juice-box, sucked it down, and immediately sucked down a second.
10 minutes went by and I ate 7 Swedish fish from the movie size box in my computer bag. 
The box of Swedish Fish I bought for 99 cents and on sale last week - and I don't even know why I'm mentioning that, but I am. 
Sidebar: Swedish Fish are now much smaller than they used to be. WEIRD. 
5 minutes earlier I was sitting at my computer and everything was fine.

Now? Not so much. 
I did my best not to overeat - easier said then done.
I watched the clock and tried my best to wait before treating again.   
20 minutes later my blood sugar was 95 and I let out a deep breath.
I fiddled with the InstaMessage App for a few, (see above pic,) and 15 minutes later I checked my blood sugar again. 
I was 142. 
A small correction bolus was given - what had gone dangerously low, was now on its way towards the cheap seats. 
Current Status: Blood sugar is172 with 1 unit of IOB. 
Pod PDM suggests I give myself a 0.30 correction. 
For now I'm holding off. 
Back to work - but a quick blog post because this is life with diabetes - and I continue to plow through. 


Our IT staff keeps us on track

Today is National  IT Professionals Day, and we want to take a moment to recognize the people here at the OIC who keep our systems running so we can accomplish our mission of protecting consumers and regulating insurers.
Some of the OIC's stellar IT staff 

Here are some the ways our IT staff help us protect consumers and regulate the insurance industry:

  • Consumers can file online complaints against insurance companies, agents and brokers, and get help from our consumer advocates. 
  • Insurance agents and brokers can apply for or renew their licenses online. 
  • Insurance companies can pay their premium taxes online, which goes to the state's general fund to pay for state government operations. 
  • Insurance companies file their rates electronically to use for review. 
  • And, of course, our IT folks keep our computers up and running so we can do our work every day. 
You can find all of those online services on our website, www.insurance.wa.gov




Graham Cassidy Healthcare Bill Last Effort Under Reconciliation

After several false starts on re-reforming healthcare (health insurance), the remaining bill (Graham Cassidy) has until the end of the month of September.


A ruling by the Senate parliamentarian earlier this month said Republicans can't continue after September 30th to use the process of reconciliation, which allows bills to be passed with a simple majority in the Senate if they decrease the deficit

The plan details include:


  • Shifting Medicaid Funding and Subsidies to State Block Grants
  • Eliminate the individual and employer mandates
  • State reinsurance funds to offset high claims
  • Adjustments/reductions to essential health benefits



Dave




New Medicare card design revealed today


Today, the Centers for Medicare & Medicaid Services (CMS) released a first look at the new Medicare card design. The new card contains a unique, randomly assigned number that replaces consumers' Social Security numbers. The purpose is to prevent fraud, combat identity theft and safeguard taxpayer dollars.

CMS will stagger the mailings of the new card to people with Medicare benefits, starting April 2018 through April 2019. 

In addition to today�s announcement, people with Medicare will also see the new design of the Medicare card in the 2018 Medicare & You Handbook, which will arrive throughout the month of September.  

Some property insurers are not selling policies in wildfire-affected areas

Some property insurers have temporarily stopped selling insurance in areas affected by the Eagle Creek, Norse Peak and Jolly Mountain fires in Washington state.
Photo courtesy Washington state
Department of Natural Resources 

What does that mean? 
If you are in the process of buying real estate or if your homeowner insurance policy is up for renewal, you may have a hard time finding a policy.

What should I do? 
Contact your agent or broker and ask what your options are. If you need a policy and don�t have one, shop around.

Consumers also have access to the property insurer of last resort in our state, called the Washington Fair Plan. The plan offers basic property insurance to consumer who are unable to obtain insurance in the standard insurance market. Consumers have to obtain coverage through a licensed insurance agent or broker, and you can work with whomever you choose. If your company won�t offer you coverage, your agent can help you get coverage through the Fair Plan.


Other considerations about wildfires
Even if you maintain insurance coverage on your home, you should learn about ways to decrease your risk of losing your home to fire. Here are some resources in Washington state.

10 Celebrities Who Worked In The Insurance Business Before Making It Big

Tip of the hat to colleague Aaron Kassover at Agent Methods for this interesting bit of insurance trivia. Some of these folks may surprise you.  No spoilers, you have to read the list.  Enjoy!

10 Celebrities Who Worked In The Insurance Industry Before Making It Big

As a Bills fan, honorable mention to kicker Scott Norwood of "wide right" Superbowl fame. Before going into real estate, Scott worked as an agent for NY Life in Virginia.  

Dave
www.davefluker.com

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Medicare fraud costs taxpayers $60 billion each year

Today, is National Report Medicare Fraud Day. We all pay the price for Medicare fraud, abuse and waste, which contributes significantly to rising health care costs. In fact, Medicare fraud costs taxpayers $60 billion every year.

What you can do to help stop Medicare fraud
  • Protect your Medicare number, located on your Medicare card. Treat it like a credit card and don�t carry it with you unless you need to use it.
  • Don�t give out your Medicare, Social Security or bank account numbers over the phone or in person, unless you made contact � and you trust the person.
  • Remember, nothing is ever free. Don�t accept offers of money or gifts for "free" medical care.
  • Ask questions. You have a right to know everything about your medical care, including the costs billed to Medicare.
  • Check your Medicare statements to make sure they are accurate and match the services you actually received.
  • Be wary of medical providers who tell you the item or service isn�t usually covered, but they �know how to bill Medicare� so Medicare will pay.
  • Be cautious if a company requests you pay for premiums in cash, pay a year�s premium in advance, or pressures you to buy right away because it�s your �last chance.�
  • Check with the insurance commissioner to make sure an insurance company or agent is allowed to do business in Washington state.
How you can report Medicare fraud

If you suspect fraud or have questions about fraud, call our Insurance Consumer Hotline at 1-800-562-6900 and ask to speak with our Statewide Health Insurance Benefits Advisors (SHIBA) program. SHIBA is Washington state�s Senior Medicare Patrol, a federally funded grant through the U.S. Dept. of Health and Human Services that works to reduce Medicare fraud.

If fraud or abuse is suspected, we will work with you and the appropriate state and federal agencies to investigate.



Single-Payer Isn�t The Only Progressive Option On Health Care (Vox)

Intriguing article from Ron Pollack on Vox.com.  Alternatives to single-payer solution.  

As we have seen, the single-payer model is very expensive and likely untenable with the attached price tag.  

This article, from a progressive standpoint, provides some interesting and thoughtful public/private alternatives with a more friendly price tag.

Read it here

Dave
www.davefluker.com

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California 2018 ACA Open Enrollment Period Extended

Covered California has announced that the 2018 California ObamaCare Open Enrollment Period will run from November 1st, 2017 until January 31st, 2018.

This is particularly important given the exit of Anthem Blue Cross from 16 rating areas.  As many as 300,000 Californians currently on Anthem plans will need to secure new health coverage for 2018.

Other states which have extended their open enrollment periods include:

Connecticut 11/1-1/12
DC 11/1-1/31
Minnesota 11/1-1/14
Rhode Island 11/1-12/31
Washington 11/1-1/15

States operating the federal marketplace (FFM) will only have 45 days (11/1-12/15) unless the federal exchange makes a change.  

Dave

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ObamaCare Making Middle Class New Uninsured (NY Post)

A recent article in the New York Post by Betsy McCaughey really makes a salient point.

The ACA favors those with incomes between 0-266% of the federal poverty level.  In those cases, combinations of Medicaid, enhanced silver cost share reductions and tax credit subsidies reduce the impact of healthcare and premium costs.

Those on the high end income spectrum, while paying high premiums, can often easily afford a Bronze HDHP (HSA compatible) for themselves and their families.

Caught in the middle are those whose incomes exceed the cost sharing or tax credit subsidy levels.  With premiums going up by double digits and less choice of carriers in the marketplace, the middle and upper middle class really feel the squeeze.  

"But the law is driving premiums so high that middle-class people can no longer afford insurance.  Several million are expected to drop coverage in 2018."

Your family health insurance plan premium should not be more than your monthly mortgage or rent payment.  Especially in California.

Click here to read the full article

Dave
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My Omnipod Experience - Part 2

Yesterday I wrote about part 1 of switching things up and starting the Omnipod. 
Today I share part two of my experience, where I discuss the stuff I love about podding - and the stuff that takes some getting used to. 
#########
The Stuff I Love
Swimming in the ocean with my Pod - I LOVE IT.
Not having to disconnect, and more importantly - not worrying about the contortion issues re: access to my pump site to reconnect after swimming - which for some reason, was always trickier for me, is freeing in all dimensions. 

The same goes for showering without disconnecting and sleeping naked if I so choose. 
Also: YAY!!

Wearing dresses and not having to wear bikes shorts or pump garters - makes things so much easier. 
I still have to deal with Spanx on occasion, but at least I don't have to worry about dealing with infusion site issues!

Access/Utilizing Arm/Leg Sites Is A Game Changer 
I could never navigate arm sites with my tubed pump and the thought of getting tangled in tubing freaked me out.
Every time I tried a thigh site with my previous pump, they had a limited shelf life and normally only worked for 24 to 40 hours before crapping out. 
Thighs = high access area and the tubing was continually being pulled, yanked, etc. 

With Omnipod, I�m able to wear arm and thigh sites for three days and that makes my life with diabetes easier. 

Scar tissue was a huge issue with me on my previous pump and is the primary reason I chose the Omnipod. I was changing out my site every 30 hours - that�s no longer the case and I�m thrilled. 

Good To The Last Drop
Most of the time I�ve been able to use all the insulin in my pod - that wasn�t always the case with my old pump reservoirs - which normally would be less efficient when the reservoir went below 30 units.

Cool Techno:
When you activate your new pod on your person, the PDM tells you the exact date and time it�s supposed to expire, based on your personal pump settings and insulin amount.
My pods run low on insulin between 3 and 4 hours earlier. 
That�s not on Omnipod issue, that�s a Kelly issue - yours truly needs to do some MAJOR basal rate testing, which I  didn�t want to consider let alone  attempt until I was wearing new diabetes tech. 
Basal Testing is now on the horizon. 

Loud Alarms
 The first time my 15 unit Low Reservoir went off, my PDM was in another room and I thought it was my smoke detector.

The PDM & Pod do their priming dance BEFORE you put it on your body.

Cool Software 
I can download the Omnipod PDM to Glooko, making it easy for my CDE to access all my PDM info: Carbs; blood sugars, basals, carb ratios, etc. 
This should allow for easier tweaks and I'm looking forward to giving it a try.

Blood Sugars
4 out of the first 8 days, my daily 24 hour insulin intake was 10 to 12 units lower than my old �low side� of normal. 
That still seams to be the case 36 days in - sans elevated bg's due to a couple "dead sites," and the summer cold that's been the bain of my existence for the past week.

Facing Fears 
I have officially conquered arm, thigh, calf and love handle infusion sites. 
day 18 (and for the first time, ever,) I attempted a back /love handle site, it required some major twisting on my end, but mission accomplished!
BONUS: Great numbers with that never before used real estate space.
I tried an inner side calf site - it was easy but I had absorbtion issues. 
I�m going to try the back of calf to see if works better. 
Still have not tried back or front belly sites. 

I�ve decided that before I give my abdomen areas a complete break, I want to see how that area works with the omnipod verses my old pump - I haven�t done it yet - but I will. 

Issues /Learning Curves
The only insulin pump delivery system that�s 100% perfect is a fully functioning pancreas. 
I don�t have that - same goes for many reading this post. 
Andit makes sense that changing pumps = dealing with some issues and learning curves 
as I learn to navigate wearing/using the Omnipod insulin delivery system.

Bad Pod/Bad Pod sites 
Dealing with Pod failures and insulin reimbursement issues. 

Unexpected Pod Change Out On Day 2 of Wearing My First Pod  
I wasn�t thrilled, but shit happens - how many times did I rip my old pump's tubing out by walking by a door knob or getting caught on my car's emergency break? .
Answer: ALOT.  
Anyway, everything was working great with my first official pod (left arm,) the first 27 hours. 
Then I started noticing blood sugar spikes that wouldn�t come down, no matter how much I corrected. Something was up and the top of my pod looked uneven. 

I called Insulet's Customer Service and the Rep and I spent almost an hour on the phone. 
I told him my issue, answered a series of questions, emailed the Rep pics of the pod on my arm so Insulet could study the issue and send out a replacement pod.  
The Rep also talked me through my Pod change - it was only my second time and I was a little nervous - but it was easy and he was patient. 
CS Rep and I discussed the insulin reimbursement program - 7 cents per unit (OK, it�s something,) with an insulin receipt and 5 cents per unit without.
I emailed a photo of my insulin receipt from my pharmacy and via my phone to Receipts@insulet.com
Insulin Reimbursement takes up to 6 weeks to be approved and payment received. 
  
There�s two different procedures - one for dealing with a bad pod and or bad pod site, another dealing with insulin reimbursement issues - that can get confusing if you're new to  podding
I�ve learned to take notes and jot down the the case numbers for both, along with the date and the name of the CS I spoke with. 

Follow up
I�d like the follow up fort the insulin reimbursement (it takes 6 weeks,) to be better. 
I�d like an email to be sent saying they received my email and receipt photo and are working on my case.
Sidebar: My second pod (on my right arm,) stayed put for 3 days through daily showers and body surfing in the Atlantic, no problem.

ALWAYS follow up
7 days post my first pod site failure, I called Customer Service to check on the status of my insulin reimbursement and found out the wrong report had been filed.
The new CSR rectified the situation, immediately - and yes, I followed up to make sure.

Day 24 - Pod Failure Alarm
PDM called a Pod Failure while said pod was in Prime Mode and not yet attached to my bod. 
FTR, I liked and very much appreciate that the PDM recognized an issue with the Pod BEFORE it was officially up and running on my person. 
I called CS, they asked me some questions and then told me they�d FedEx me a new Pod. Filed both a failed pod report and insulin reimbursement report. 
This time, the phone call took less than 10 minutes and I received my replacement pod 
3 days later. I returned the failed pod to them in the package and shipping label Omnipod included with my replacement pod. 

All in all, I'm learning and going with the curve~
#######

Embracing Something Different 
Change is difficult - even when it's good. 
Diabetes or not, we get used to doing things a certain way and I love that going with the Omnipod is helping me knock down my walls when it comes to embracing change in life... and life with diabetes.
 I wore a different brand's insulin pump for 15 years, I knew the idiosycricies of that pump brand like the back of my hand - I was losing real estate because of scar tissue and I needed to switch things up - so I did. 


So far, I�m glad that I made the change - and I 'll keep sharing my podding experiences with you guys - The good, the bad, and the diabetesalicious of it all. 

And if you have any questions - ASK! 

My Omnipod Experience - Part One

Learning and discovering new things every damn day and glad that Insulet gives us 45 days to figure it out. 
There�s a learning curve when it comes to wearing the Omnipod, but so far it's been good - except for a few hiccups along the way.
I�ve taken copious amounts of notes - so many notes that I had to divide them up into two posts!
Part one is below and I hope you enjoy!
######
So this happened!
Day 1: Omnipod training with my CDE went well and I'm officially untethered!
Wearing pod on my right arm. It's weird not being tethered to my electronic pancreas ,but in a really great way!
Also, discovered that I walk freakishly close to the edge of door frames.
Seriously, why have I not realized this about myself before?  
Another also, since noticing this Kellyism, I have become better at not slamming into door frames.  
Day Day 2: Experienced absorption issues 27 hours into wearing with perfect numbers up until then. I was the wearing the pod on my arm - the one I kept banging into door frames. 
Called CS and replaced pod. More on that in part 2.
Day 5: I swam in the Atlantic ocean with my pod for the very first time - it was fantastic!
Also, it stayed securely on my person - muddy legs and all. 
Also: AWESOME. 
Actual aerial footage of my and my pod about to
go in for a dip in the Atlantic~
Day 8: I left my PDM/case on the table in a restaurant that I had just exited. 
I immediately noticed after checking my hand bag (to make sure I had my PDM,) and ran back in to retrieve it - and all the while silently praying to the Diabetes Gods that it was still there. It was and I was grateful - it has not happened since. 
Day 9: Wearing the pod on my left arm - it's working well, but I'm aware of my pump whenever I twist to exit my vehicle. 
Day 17: Getting the hang of podding and no longer waking up and reaching to check if my pump is attached to the waistband of my Pajamas. 
Same goes for reaching to disconnect every time I walk towards the bathroom to shower.
Day 35: OK, every once in a while I Still grab my waist band to disconnect before taking a shower - old habits die hard.

Maybe it�s just me
For the first few days, I kept confusing my PDM with my iPhone and whenever I was trying to take a picture of my PDM screen. 
I�d stare at the screen for a few seconds, all confused as to why I couldn�t take a screen shot. 
Unlike an iPhone you can�t take a picture of the PDM screen with said PDM and no matter how hard you try and attempt to press Home button and the nonexistent Silent switch


No matter how hard one tries, you cannot take a
screenshot with your PDM.
But you can customize your PDM~
Day 33 and since I'm being balls out honest, sometimes I still grab my iPhone when I mean to grab my PDM and then wonder "why" and out loud when I press the "Home" button and start to bitch out load because I can�t scroll down.
Then I realize why and I feel like an idiot. 

Spacial Issues
I still have them, but instead of doorknobs and edges issue with pump tubing, arm pods and door frames have become my new jam - literally.  
like I mentioned earlier in the post, for the first few days of podding, I banged my pod arm into my kitchen and bedroom door frames more often than I�d like to admit. 
Now, I'm specially more aware of my surroundings - at least when I'm wearing the pod on my arm. 

Black on Black pump skin 
PDM came with a black Skin. Black PDM + Black Case/ Black Skin means the potential for misplacing is an issue because diabetes or not, I am extremely nearsighted - there's a reason I avoid handbags with black lining and my wallet is not black for a reason - I can't freaking find anything in a blackened handbag - especially a black wallet.
Also, I've put aqua blue K-tape on my black remote control for the same reasons.
My Fix
I have a collection of several brightly colored and insulated, 3 and 3/4 inch X 7 inch, makeup bags. I use one of these bags daily and rotate whenever the mood strikes. 
Currently the one I'm using has owls all over it  - and people stop me every damn day because it's so cute.
 I always put the PDM (and my canister of teststrips/lancets because the PDM also acts as a meter,) back in whatever bag I�m using, ASAP and without fail.
It's now become a full fledged habit - and it didn't take 30 days!

When I go out, I put the PDM, spare pod, test strips,and insulin in said makeup bag, and place in my handbag/work bag. 

Sidebar: Lipstick, eye-drops, my driver�s license and a credit card also fit in the bag along with all of the above mentioned - VERY IMPORTANT.
Also, recently started using bright green skin for the PDM because it brings out my eyes  - but I still bag it~
Owl bag because functional and very cute!
Tune in tomorrow for Part 2, where I break down and get to the nitty gritty re: what I love about podding, as well as the learning curve when it comes to being a Podder~ 

New Medicare cards are coming starting in April

The Centers for Medicare & Medicaid Services (CMS) will start mailing redesigned Medicare cards to beneficiaries in Washington state aft...