Wednesday, June 29, 2016

Medicare Explained

By Beth Sullivan, CIC, CAC, SHIP Counselor


Does Medicare have you confused?  Do you want an explanation that you can understand? Let’s start at the very beginning. I hear it’s a fine place to start.


Medicare A

Medicare A is Hospital Insurance.  It is usually free if you or your spouse has worked enough quarters to earn 40 work credits. About 99% of Medicare beneficiaries do not pay a premium for part A.


Medicare A hospital coverage is measured by benefit periods, not the calendar year.  The benefit period starts the first day you receive Medicare covered inpatient services and lasts until you are out of the hospital or a skilled nursing facility for 60 consecutive days.  Then, the benefit period starts over again. The deductible in 2016 is $1,288 per benefit period.


Medicare B

Medicare B is Medical Insurance.  Medicare B covers 80% of your medical care.  Medicare B has a monthly premium that is usually deducted from your Social Security check.  In 2016, several changes were made to Part B.  The deductible is now $167 per year for all participants.  The premium varies, depending on your income. If your Medicare premium is being deducted from your social security check, it will stay the same at $104.90.  If you are enrolling in Medicare for the first time and your income is less than $85,000 per year, your premium will be $121.80, plus a $3.00 service fee for a total monthly premium of $124.80.

Medicare B covers most doctor visits, lab tests, x-rays, outpatient procedures and emergency room visits.  Part B covered services are generally covered at 80%, with the patient being responsible for the rest.  Be sure and check to see if your doctor provides services to Medicare patients, so you are aware of your costs before being seen. However, unlike private insurance companies, there is no out of pocket maximum for Medicare. 


Medicare C

Medicare C is also known as Advantage Plan.  These plans include Part A and Part B and, usually, Part D.  To find an Advantage plan, it is good to get your information from an unbiased source like the State Health Insurance Assistance Plan, also called SHIP.  In Indiana the number is 1-(800) 452-4800. 


Medicare D

Medicare D is Prescription Drug Plans. These plans are required by law and if you do not enroll when first eligible, you will be assessed a penalty for every month you do not have it.  A SHIP Counselor will be able to help you find coverage, or you can visit Medicare.gov.


The Medicare that does not have a letter


Medigap is also called Medicare Supplemental Insurance.  These policies help defray the cost of the patients 20% that Medicare B does not cover and can also help with deductibles.  There are many plans to choose from and a SHIP counselor is a good resource to help with this also.


Note: If you would like more information, please visit www.windrosehealth.net for our locations. You can schedule an appointment with one of our Eligibility Navigators and/or a SHIP Counselor. 

Thursday, June 23, 2016

Summer Safety Tips

By Staci Brandenburg, R.N. 

The kids are out of school and the weather is warm, which brings people outside! Before going out into the heat, there are some basic safety tips that every person should know.  Here are a list of a few I find important:

  • Drink 2 eight ounce glasses of water 2-3 hours before going outside.
  • Protect your skin! 
    • Use sunscreen with at least a 15 SPF that protects agains both UVA and AVB rays at least 20 minutes before going outside. Put it on again every 2 hours if you are staying outside. 
    • Wear tightly woven long sleeve shirts and long pants, a hat, and sunglasses when out in the sun. 
    • Keep drinking water when outside. Swallow ten big swallows, about 10 ounces of water, every 15-20 minutes when outside. 
  • Stay away from drinks like soda that have caffeine, sugar, and carbonation. 

Try to stay out of the heat during the day between 10:00 a.m. and 4:00 p.m. each day.  It's the hottest part of the day!

Have a fun and safe time outdoors!



Monday, June 20, 2016

What Is A Wind Rose?

By Scott Rollett, M.B.A., C.M.P.E


Before the advent of the compass rose, navigational maps included a “wind rose” to help orient the helmsmen on a sailing ship to the directions of the wind.  The wind rose’s 32 points came from the directions of the eight major winds, the eight half-winds and the sixteen quarter-winds. The term “rose” comes from the figure’s directional points which resembling the petals of the well-known flower.  

Keep in mind that the great sea voyages of Europe’s “Age of Discovery,” such as Christopher Columbus’ trip to the West Indies in 1492, would not have been possible if the compass, and its predecessor the “wind rose”, had not become common navigational devices.
     
The “wind rose”, itself, is a much older device than the compass, and its history is richly symbolic when it comes to the nature of human life - - and man’s relationship to the universe. Throughout mankind’s history, many civilizations have crafted stories relating human beings to the four cardinal winds: North, South, East and West.  The image of a circle that encloses a cross with equal length arms, (indicating the four cardinal directions of the winds), has been used by Western and Eastern cultures alike to mark the tombs, homes, tools, and clothing of people who were in charge of caring for bodies and souls of their countrymen - - such as priests and healers.
     
The above paragraphs offer an excellent background on the rationale for why we chose our organization’s name: “Windrose Health Network.”  Our organization began in 1996 simply as the “Trafalgar Family Health Center”.  In 2002, upon the addition of a second Health Center in Edinburgh, the name generically evolved to the “Edinburgh / Trafalgar Family Health Centers” and this name was used for seven more years - - even as we opened two new health centers.  In 2008, realizing the old name didn’t quite fit, we began the search for a name that better described not only the four health centers that we had at the time, but also our vision for expansion into the future.  With Franklin, Indiana, as our epicenter, we hoped to branch out to other towns and cities that reside in our Service Area - - Johnson, Morgan, Brown, Bartholomew, Shelby, and Southern Marion Counties.     

We also liked the idea of a “wind rose” pointing one towards the direction that they need to go.  As Primary Care Providers (PCP’s), we are sometimes called “gatekeepers”.  But in today’s world, PCP’s are expected to be more than just gatekeepers, we are expected to encourage patients to become active participants in their health care and to lead them down the care pathways that they need to go in order to live happy and healthy lives.   


Many modem day organizations use the wind rose or a compass rose in their logos because those symbols evoke concepts like “clear direction,” “ informed guidance,” and a “a holistic outlook.”  As Windrose Health Network continues to expand its scope in central Indiana, the “wind rose” is a highly appropriate symbol because it denotes our organization knows its true “course” as a business, as well as the direction of our mission - - to always lead our patients to better health by providing the highest quality healthcare.

Thursday, June 16, 2016

Welcome!

Windrose Health Network would like to welcome you to our new blog page! Our goal is to educate and inform you about topics related to the health and well-being of you and your family.  We will be sharing helpful information regarding physical, mental, and behavioral health topics, as well as alternatives to traditional medicine.  We also hope to provide general information about third party insurance coverage such as Medicare, Medicaid / HIP, and ACA Marketplace Exchange Plans.  Finally, we hope to share information that can help you better access WHN’s services, such as how to use WHN’s Patient Portal.  You will find information on a wide variety of topics throughout the months ahead.


We welcome any feedback from you, our community, to help us better provide information to you. Remember, as always, please talk with your Provider for all of your health care questions and concerns