CHA Blog

This time of year stress levels can rise as beneficiaries face increased Medicare and health plan costs for 2010, make choices on which health plan to switch to, enroll in, or disenroll from in Medicare’s annual election period, and prepare for the holidays. One easy way to reduce stress and strengthen health during this season that doesn’t involve health plans or doctor referrals is a “medicine” we all have. It’s also fun and free –it’s  laughter.

Research has shown that kids laugh about 400 times a day, and adults only about 15. Research also shows numerous benefits associated with laughter, including:

• Helping to reduce stress
• Enhancing the immune system
• Strengthening cardiovascular functions
• Oxygenating the body by boosting the respiratory system
• Improving circulation
• Toning muscles
• Helping with digestion and constipation

How does laughter help in these areas?

In terms of enhancing our immune system, just the act of laughing itself, and the muscular contractions we experience when laughing, moves our lymph fluid, therefore boosting the immune system’s function. Moving lymph helps clear out old, dead waste products from our cells, tissues and organs. As our lymph system doesn’t have a separate pump, our body needs to move around in order to circulate our lymph fluid so our immune system can function properly. Laughter is one good way to do so.

In addition, when we laugh, we oxygenate our body by taking in large amounts of oxygen at both the cellular and organ level. Being one of the primary catalysts for biological energy for the human body, oxygen is absolutely necessary for sustaining life. It also has the effect of destroying cancer cells in its presence. Many parasites and bacteria don’t survive well in oxygen’s presence as well. To the extent we can circulate extra oxygen throughout our body, we can help prevent, or in some cases treat, diseases.

Oxygenating our body also increases our circulation. And the physical act of laughing exercises our abdominal muscles, giving a good internal massage to all our digestive organs and supporting healthy digestion.

Laughing also has several healing biochemical effects on our body, emotions and general outlook on life. Below is an excerpt from Mike Adams, author of the Five Habits of Health Transformation.

When you laugh, you generate a wealth of healing biochemicals. I’ve often stated that for every minute of laughter, you produce somewhere around $10,000 worth of healthy body chemistry, and what I mean is that if you had to go out and actually purchase these refined chemical compounds from labs or pharmaceutical companies, you would have to pay at least $10,000 for the very same chemistry that your brain is producing free of charge when you engage in laughter.

Some of these are brain-altering chemicals such as serotonin; others are immune-boosting chemicals such as interleukins. If you were to make a long list of all the chemicals created by engaging in healthy laughter, you would have quite a list of healthy body chemicals that would carry a hefty price tag if you purchased them retail. And yet, once again, you can create these chemicals for yourself at no cost by simply engaging in laughter.

You will find that these chemicals have extraordinary positive healing effects on your body and mind. They will boost immune system function; they will improve your outlook on life; they will tend to diminish any symptoms of depression; and because they help reduce stress, they will also prevent all of the various diseases and disorders that are caused by chronic stress.

With all these benefits, how can one start laughing more? One way is to just laugh, be more silly, watch funny movies, get together with a friend and tell funny stories or make up goofy dances. When working with your beneficiary clients, see if you can get them and yourself laughing just for the fun of it!

Laughter yoga also offers an easy venue for laughing with large groups of people. Keep learning from children and grandchildren. With children laughing at an average of 400 times a day, adults have a lot more laughing catch up to do!

The California Department of Insurance (CDI) has put together a good list of reminders to help beneficiaries protect themselves against predatory insurance sales practices during the annual election period for Medicare Advantage plans and the Medicare Prescription Drug Program. Below is a list of tips edited from their advisory notice (PDF).

Make Sure They’re Licensed: Not all people marketing Medicare Advantage plans are insurance agents. If the person you are dealing with claims to be an insurance agent, contact the CDI at 1-800-927-HELP or select their Check License Status link to verify license status. Insurance agents are required to print their license number on all business cards, quotations, and advertisements. Also, verify that the insurance company is licensed to do business in California.

Cold Calls Prohibited: Federal regulations prohibit “cold calls” which may take the form of uninvited sales calls, door-to-door visits, unsolicited emails, telephone calls or any other type of sales contact without your express invitation.

Be Stingy with Personal Information: Never give out personal information such as your Social Security number, bank account numbers, or credit card information over the phone. Verify that the person you are dealing with has proper authority to act on behalf of the plan before you provide your Medicare number. This is a good time to seek assistance from a trusted relative, friend or advisor.

Medicare Has No Official Sales Reps: Be wary of any salesperson who says that he/she is a Medicare representative. Medicare does not send “representatives” to solicit your business.

No Marketing in Educational or Care Settings: Federal regulations prohibit the marketing of Medicare products in places where health care is delivered (such as a doctor’s office, clinic, or pharmacy counter) or at an educational event.

No Such Thing as a Free Lunch: Federal regulations prohibit offers of free meals for listening to a sales presentation or for signing up in a particular plan. Do not fall victim to buying additional insurance products during any sales or marketing presentation for a Medicare Advantage or prescription drug plan. Federal regulations prohibit this type of “cross-selling.”

Don’t Let Them Oversell You: Federal regulations prohibit selling additional insurance products during any sales or marketing presentation for a Medicare Advantage or prescription drug plan. Know that you have rights! Contact the CDI if you have any questions about an insurance offer, scheme or agent. You can also contact your Senior Medicare Patrol (SMP) project through your local Health Insurance Counseling and Advocacy Program (HICAP).

Read and Understand the Plan: Be sure that the plan that you choose matches your needs and that you can continue to see your current health care providers if you wish. It may be very difficult or even impossible to “undo” your selection later.

You have rights! Contact the SMP project through your HICAP office at 1-800-434-0222 if you have any questions about an insurance offer, scheme or agent. You can also visit our website and/or contact CDI at 1-800-927-HELP (4357).

To educate others on these tips, you can use our updated 14-slide powerpoint presentation on Medicare marketing regulations.

CMS announced a new system to help beneficiaries who receive the Part D low-income subsidy (LIS) have better access to their prescription drugs when they’re not enrolled in a Part D plan. As of January 1, 2010, this system will replace the current Point of Sale (POS) system operated by WellPoint. The new system is called Limited Income Newly Eligible Transition (LI NET) program, and Humana has been awarded the CMS contract to operate it.

The POS system is designed to provide temporary prescription drug coverage when someone who is enrolled in the LIS is not enrolled in a Part D plan. This can happen for a variety of reasons, including if there’s a glitch in the system and people who are supposed to be auto-enrolled in a Part D plan aren’t, or if a beneficiary experiences a time gap from when they are found LIS eligible and when their Part D plan enrollment becomes effective.  The POS system gives people coverage and therefore access to their prescription drugs AND at the same time randomly enrolls the people using the POS system into a Part D benchmark prescription drug plan.

Starting in 2010, the new system, LI NET, in addition to offering temporary drug coverage and prospective random enrollment into a Part D plan for uncovered LIS-eligible beneficiaries, it will also offer some retroactive coverage to uncovered LIS eligible beneficiaries and full-benefit dual eligible and SSI-only beneficiaries.  Uncovered full-benefit dual-eligible and SSI-only beneficiaries will have retroactive coverage up to at least 36 months, while all other beneficiaries with LIS will have retroactive coverage for 30 days.

For more information, see CMS’ webpage. It contains a helpful fact sheet (PDF) and ppt presentation on the new LI NET program.

On a call regarding health care reform and Medicare beneficiaries today, Health and Human Services Secretary Kathlene Sebelius and staff from both the White House Office of Health Reform and White House Office of Public Engagement specifically asked all beneficiaries and Medicare advocates to help end the myths that health reform hurts Medicare.  In fact, health reform strengthens Medicare in several key ways.  For instance, several Medicare provisions in the newly introduced House bill, Affordable Health Care for America Act (H.R. 3962) are that it:

1. Immediately begins reducing out-of-pocket costs in the Part D coverage gap, or donut hole by $500 in 2010 and eliminates the gap altogether by 2019 (versus 2024 in the earlier version of the House bill).
2. Allows the government and Part D plans to negotiate lower drug prices for Medicare beneficiaries.
3. Improves quality of care and, through a number of payment method changes, reduces unnecessary hospital admissions and re-admissions.
4. Emphasizes prevention and wellness by eliminating any deductible or copayment amounts for Medicare-covered preventive services.
5. Increases coordination of care for beneficiaries with chronic conditions by changing how Medicare reimburses for certain services.
6. Provides affordable insurance coverage options for people 55-64. Many people without good coverage during this time period may postpone getting needed treatment until they have Medicare at age 65. This results in 1) them having poorer health and more serious health conditions and 2) Medicare having higher expenditures. Making sure this pre-Medicare population has health coverage will actually help lower Medicare costs.
7. Extends Medicare’s long-term solvency by at least 5 years.

Secretary Sebelius and staff reiterated President Obama’s promise that Medicare is a sacred trust and they fully intend to keep and strengthen that trust. In an effort to support this promise, they asked assistance in ending the myth that health reform is bad for Medicare.  One challenge continues to be that several Medicare Advantage plans are sending out misleading information to plan enrollees that health reform will cut benefits. They don’t explain that health reform will cut the overpayment of subsidies to MA plan sponsors, NOT Medicare benefits themselves.  As a result if this misleading information, many beneficiaries erroneously believe health reform will hurt their Medicare and have opposed reform legislation.

One easy resource White House staff suggest to share with people who have been misinformed is Obama’s 4-minute video on health reform. The video is at WhiteHouse.gov.

I’ll also be posting a newsletter article next week with many more resources and good articles to share with people on health reform facts and how it affects Medicare beneficiaries and strengthens the Medicare program.