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Navigating the Medicare maze

Medicare is the federal health insurance program for people who are age 65 or older and those younger than 65 with a disability,
The definition of disabilities used to determine Medicare eligibility is the same as that used for Social Security benefits.

Medicare can be a maze all by itself. It has various components, designated by the letters A through D. Each one provides different benefits. In general, out-of-pocket costs are lower in Medicare than in commercial health plans. Here is a summary of what each part covers: 

Planning the rest of your life

Health care, living situations, end-of-life decisions. Address them now so you can focus on living your life.


 Image: © ChristianChan/Thinkstock

General Dwight Eisenhower once said that plans are nothing, but planning is everything. This sage advice from the man who orchestrated the largest military invasion in history can apply to your life too. His point was that life happens and things change, but you always need to work toward your goal.

For many older men, this means addressing some unpleasant realities like advancing age, financial challenges, and yes, even death.

Seeking a second opinion: When, why, and how?

In many cases, another physician's perspective about a proposed heart procedure can be helpful.

You've just found out that several of your heart's arteries are almost completely blocked. Your doctor believes bypass surgery is the best treatment option for you, but you wonder if a less invasive procedure might be possible. Or perhaps you have a heart valve that isn't working well — should you have it repaired, or fully replaced?

These scenarios are two heart-related examples that often prompt people to seek a second opinion. "But any time a physician suggests a surgery or procedure, consulting another doctor often makes sense, especially if you have questions that aren't being explained in a way that makes sense to you," says cardiologist Dr. Dale Adler, professor of medicine at Harvard Medical School.

Should I see a “resident” doctor?

Ask the doctor

Q. In the hospital recently, a "resident" cared for me. Should I ask for a more experienced doctor?

A. Residents are doctors in training. They have graduated from medical school, been awarded an M.D. degree, and now are training to be a particular type of doctor — such as a pediatrician or pediatric specialist, or a type of surgeon. In their first year of such training, residents are sometimes called interns. All residents are supervised by a legally responsible senior physician. For over 40 years, I have been such a supervising physician. The residents typically have more time to spend with a patient than the supervising physician does. At the major teaching hospitals, like those here at Harvard, the competition to be selected for a residency is fierce. Those chosen are extraordinarily intelligent and knowledgeable. I've seen many residents save many lives. In fact, a recent study found that the quality of care was better in teaching hospitals. In short, you generally are in very good hands with a resident. But if you are concerned about the way a resident is handling your care, you always have the right to speak to the supervising physician.

4 things you can do if the price of your medication skyrockets

Prescription prices can rise without warning, but there are things you can do to pay less for the drugs you need.


 Image: © Wavebreakmedia/Thinkstock

Recent news has brought reports of sudden jumps in medication prices. In August 2015, the price of pyrimethamine (Daraprim), a drug used to treat the parasitic infection toxoplasmosis, leaped from $13.50 to $750 per capsule. From May 2011 to May 2015, the price for a two-pack of EpiPens, the epinephrine autoinjectors that treat potentially fatal allergic reactions, rose from $160 to $608.

Even commonly used drugs that have been on the market for decades have been subject to unexpected price increases. In the past few years, the prices of generics — antibiotics like doxycycline and erythromycin and heart medications like captopril and digoxin — have shot up.

Medicare now covers exercise training for blocked leg arteries

Research we're watching

About 8.5 million Americans have peripheral artery disease, or PAD, in which fatty plaque clogs arteries outside of the heart, most commonly in the legs. The hallmark symptom is calf or thigh pain while walking that goes away when you rest.

The safest, most effective treatment for PAD is supervised exercise training, in which you're monitored while walking on a treadmill. Few people participate, however, partly because of the expense of the regimen. It involves up to 36 sessions of 30 to 60 minutes each over a period of three months.

What’s the best time of year for a flu shot?

On call


 Image: © Ildo Frazao/Thinkstock

Q. I always get an annual flu shot, but should I get it closer to the official beginning of flu season?

A. In simplest terms, the best time to get a flu shot is anytime you can. Waiting for the "perfect" time could cause you to procrastinate and miss the benefit of a yearly vaccination against the flu, which prevents 50% to 60% of the influenza infections in a typical season. But if you want to time it so it's closer to the typical flu season, October is ideal.

Tips to find a new doctor

Do your homework and ask questions to find a primary care physician who'll meet your needs.


 Image: © Thinkstock

Don't wait any longer if you've put off your search for a primary care physician (PCP). The United States is in the midst of a doctor shortage, and demand will continue to outpace supply, suggests the Association of American Medical Colleges. In March, the group projected a shortfall as high as 43,000 PCPs by 2030, fueled by an aging population.

The time to establish a relationship with a PCP is sooner and not later, but not just because you need to stake your claim on a doctor. "There are a lot of things that sneak up on you if you don't go for regular check-ups. For instance, you won't know if your blood pressure is creeping up, or you may not know if it's time to get important cancer screenings," says geriatrician Dr. Suzanne Salamon, an assistant professor at Harvard Medical School.

Easy ways to spot health scams

Marketing terms like "cure" and "miracle" can alert you to bogus treatments.


 Image: © MaryValery/Thinkstock

We all want a magic pill to make aches and pains go away. But that longing sometimes makes us vulnerable to health scams. These come in the form of untested remedies promising to treat or cure everything from arthritis to aging. "From my experience, some older adults fall for the scams that focus on issues where there really is no good medical treatment or cure, such as Alzheimer's disease, arthritis, or cancer. The vulnerability comes in because people are looking for hope," says Dr. Anthony Zizza, a geriatrician at Harvard-affiliated Beth Israel Deaconess Medical Center.

Warning signs

The first tip-off to a health scam is often the way a product is described. Be wary of words used in marketing claims, such as quick fix, miracle, secret, cure, and breakthrough—and anything that promises to relieve your medical problems. "You might see something that says 'Take this pill and you'll reverse memory loss,' but don't believe it," says Dr. Zizza. Other clues include the terms no-risk, money-back guarantee, free gift included, or limited supply.

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