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Starting a session clicking the Description with more info enter without providing any password by adding you forgot to make it work. In order to make the interface and you'll see solely between you Personal password for. Creating roles can paper The right devices by a combination authenticating and.

Caruso, M. If it is determined that you owe a late enrollment penalty, you will still have to continue to pay this amount. Limitations, copayments and restrictions may apply.

The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Florida Blue is a Medicare Advantage organization with a Medicare contract. A Medicare-approved Part D sponsor. Take Class Online! But mostly, the Bill and Mr. Potato Head. Much to my pleasure, the kids were Grams was so many years ago. And bridging the years and bringing the you have and are 55their years of age or older, you are WIRE resurgence of the once ubiquitous sock they were License delighted at receiving generations together.

These charming little creatures own pairs of sock monkey foot wear. Donna produced the sock monkey kits women started fashioning Rockford and we spent much of the morning I saw that this was a gift my grandRed Heel work socks into monkey making personable little dolls— children would appreciate as well.

Floridabegan Department Highwaysignificance Safety the country toting theirofown with the children. Calculate your benefits at allkidsgifts. Annuity your benefits fixed income for life.

MakeMake a gift aand receive guaranteed, fixed income for life. Calculate benefits at allkidsgifts. CFRE 5. Bailey, CFRE 75 5. Lydia 75 80 5. Bailey allkids. Foundation annuities are not Foundation gift annuities notgift before entering into aare gift annuity available in all states. A Florida Prepaid College Plan or Florida Plan are tax-exempt plans and offer a variety of savings options to suit any budget.

And it solves the mystery of where the socks go in the washing machine. For The Foodie How about a gift box of 6 handmade 2 oz. The pens are ergonomically designed to reduce stress on the hand for a comfortable, effortless writing experience. Being a tech-obsessed geek has never been more fashionable and col lines form for the latest candy- colcomput ored phones, cameras and computers.

Young and old alike have an eye for style and an affinity for gadgets. Here are some tips: When choosing a recliner, consider the size, shape and fit of the chair. Here are five tips from Ekornes, makers of the Stressless recliner, to help you easily choose a recliner that fits your physical and aesthetic needs:. Choose a size. Keep in mind not only how much physical space you have for a new recliner but also the size of recliner that will fit your shape as well.

Consider longevity. Consider the quality of fabrics, leathers, woods and metals and remember that while quality recliners cost more up front, the right recliner will provide years of comfort and support. Stressless recliners are built to last between 20 and 25 years. Narrow down your style preferences. No longer bulky pieces, new designs and materials offer a variety of modern and sleek chairs or love seats. List your must-have features. Recliners now also offer a variety of features, including lumbar support and articulating headrests to cradle the head and neck in the reclining position.

Still stumped? To learn more about the variety of recliners available, and to find a store near you, visit ekornes. Family Features. Haute and Healthy For the fitness friends among us, get the Fitbit Ultra Wellness Monitor to measure steps, distance and calories and then upload wirelessly to a website for graphs and charts of steps, active steps, distance and sleep quality.

It helps track diet, heart rate, blood pressure, glucose and works with both PC and Mac — no additional subscription fee to track activity online. It has an iPhone app and an Android app and integrates with an increasing number of other apps and fitness tracking sites.

High-Tech Watch Many different types of high-tech watches from GPS watches to health watches that monitor heart are available.

Join the Fun! Call , go to www. Most have pictures alongside the recipe. Add egg yolk, vinegar and minimum amount water. Toss until mix begins to clump together. If it looks dry, sprinkle on more water. Form dough into ball and flatten into a 6-inch disk for single shell or divide in half and make two disks for double-crust pie.

Wrap dough and chill 1 hour or overnight. Soften to room temp, roll out for crusts. Add melted butter. Press into pie tin; bake 10 minutes. Cool before adding filling. To make filling: beat 4 oz cream cheese. Add melted dark chocolate. Beat until smooth and spread into crust. Meanwhile, microwave preserve 30 seconds or until liquid. Cool slightly and pour over chocolate layer.

Freeze until preserves are cool and have returned to gel state. Beat remaining cream cheese until smooth and add melted milk chocolate. Beat til smooth. Beat in Cool Whip. Spread over raspberry layer. Freeze until set. Garnish with Cool Whip rosettes, chocolate curls and shavings. Or by email: janice lifestylesafter Drawing Dec. Two dads and their three something sons from Boston drove Porsches and.

And this. The Exotic Driving Experience makes a great gift! Junior Rides are available, too. Reservations can be made at exoticdriving. Visit ChristmasAtGaylordPalms. Let the energy experts at Tampa Electric show you how to save on energy costs. When you participate in our free Home Energy Audit, one of our energy analysts will visit your home and identify areas where you can save valuable energy.

Visit tampaelectric. Stop at our table on January 23 at the Florida State Fairgrounds from 10 a. Office Hours By Appointment Mon. Many people have heard stories of pets dying while under anesthesia, even during simple procedures such as spays, neuters or dental cleanings. Caring For Your Pet With the advancements in anesthetics and monitoring systems today, the probability of this occurring is extremely rare, less than 0.

However, it is still normal to be nervous when your cat or dog is undergoing anesthesia. Come with me on a journey through a day in the operating room. Patty takes pride in her service to the community, celebrating more than 45 years in Brandon and Sun City Center.

Brandon Blvd. First, I perform a physical exam to screen for any obvious health problems that might increase surgical risks. These might include a heart murmur or arrhythmia, pale gums or even enlarged lymph nodes. Then blood is drawn to check for normal kidney and liver function, and to confirm that your pet is not anemic.

I call clients immediately to discuss any issues that are detected during the pre-anesthetic screening process. An intravenous catheter is placed in some animals depending on the type of procedure and their health status. Each pet is then weighed and preoperative pain medications are administered.

Next, I insert an endotracheal tube which seals the windpipe and prevents. This tube provides oxygen and anesthesia during the procedure. Monitoring of the heart rate, respiratory rate, oxygen levels in the blood and body temperature are performed continuously during and after surgery by a trained veterinary technician.

The pet is never left without direct monitoring by the veterinarian and technician. Finally, the surgery is completed and your pet is moved into recovery. They are placed on a heating pad wrapped in thick towels and then a blanket is placed over them that circulates warm air to prevent their temperature from dropping. Some pets wake up quickly and are ready for attention, while others seem to enjoy sleeping in the warmth for hours. During this time, the endotracheal tube is removed and vital signs continue to be monitored until recovery is complete.

Soon I will call to inform you on how the surgery went and when you can come to take your beloved pet home. I wanted to Vietnam War for 30 days. He knew he ing. Over was protecting us from himself. I was taking tions they were having. He said was so disaster, and I wanted to be able to proud of me. I never knew that.

I knew I Knowing that now, she wrote could stand anything for 30 days. But she called back—and wartime trauma and its aftermath. He told me about the war or four times a week, and she says, from a historical perspective. Consider focusing the holidays around family and friends in a new setting.

Instead of having family come to your house, think of going to a new place. Or schedule a family trip over the holidays so you and your loved ones can be together in a stimulating and new environment that would give them lots to see, do and talk about. I cannot afford to pay my premiums. Are there any programs that can help me pay for Medicare Part B? There are three common MSPs, and each one has different eligibility limits.

It keeps me awake at night. I used to be able to drink coffee at dinnertime and it never bothered me. Is this another age thing? Sensitivity to caffeine—the pick-me-up in coffee—tends to increase as you get older. Children metabolize caffeine quicker than adults. About 90 percent of Americans consume caffeine daily. Caffeine occurs naturally in many plants, including coffee beans, tea leaves and cocoa nuts. It is therefore found in a wide range of food products.

Caffeine is added artificially to many others, including a variety of beverages. The most common sources of caffeine for Americans are coffee, tea, colas, chocolate and some over-the-counter medications. But, if you are sensitive to caffeine or use certain drugs, you may want to cut down or eliminate caffeine from your diet.

Your caffeine consumption is worth discussing with your doctor. Caffeine can cause restlessness, anxiety, irritability, muscle tremors,. Some medicines and supplements interact negatively with caffeine. These include some antibiotics and bronchodilators. Talk to your doctor or pharmacist about whether caffeine might affect the medicines you take.

In the practice of medicine, caffeine is useful as a cardiac stimulant and also as a mild diuretic. Caffeine is an addictive drug. It stimulates like amphetamines, cocaine, and heroin. If you feel you have to have caffeine every day, then you are addicted to it. Eliminating caffeine suddenly can cause withdrawal symptoms, such as headaches and fatigue. These symptoms usually pass after several days. This will enable you to acclimate to less caffeine and reduce the effects of withdrawal.

Or try herbal teas, which are caffeine-free. If you can, switch to caffeine-free forms of the medications you need. A Health Plan with a Medicare contract. The benefit information provided herein is a brief summary, not a comprehensive description of benefit. For more information please contact the plan.

You must continue to pay your Part B premium. You may be able to get extra help to pay for your prescription drug premiums and costs. You can also contact Florida Healthcare Plus Customer Service Department at , we are open 7 days a week 8am to 8pm October 15, until February 14, then Monday through Friday 8am to 8pm.

This info is available for free in other languages, contact Florida Healthcare Plus for additional information. Devin is a healthy-looking guy in his late twenties and even after talking to him you would never know that he suffers from chronic pain. What you might notice, however, is the fact that Devin hides his smile. They are just crumbling away. In the past ten years Devin has undergone nine surgeries for his condition called hydrocephalus, which means that the brain does not drain its fluid properly.

Devin suffers from intense head- and neck aches. Few people are aware of the negative impact that chronic pain medications can have on your teeth. They tend to get brittle and more susceptible to decay. The fact that most pain meds can cause dry mouth only adds insult to injury. Saliva is a very important protective factor for teeth and its absence can result in rapid tooth loss. Devin is excited to get his teeth fixed so he can chew foods properly and smile again.

His front teeth are completely broken off at the gumline and lots of back teeth are severely decayed. Devin has multiple abscesses deep in bone where root tips from broken teeth had festered and his gums are in pretty bad shape as well. Devin wanted to save as many teeth as possible, but he was also prepared to lose all of them. Since there are some teeth that are still in good shape, we decided to pull all hopeless teeth, fabricate partial dentures and then anchor those with dental implants once Devin is free of infection.

Sarah Jockin lives and practices in Tampa, FL. To read more of her articles or contact her for a free consultation, visit ImplantDentistTampa. Gentle, compassionate and down-to-earth, Dr. Jockin welcomes patients of all ages to her new practice in Tampa!

Dental care is her passion. Jockin writes dental health columns for local publications. Savannah Court is an elegant yet comfortable community offering hour access to a well trained and friendly staff. The private or semi-private spacious suites offer sun filled windows, kitchenettes and full private baths.

You are always welcome! A signature property of. Supplements can help bridge the gap to ensure you are getting enough of this essential mineral.

However, choosing a supplement can be daunting. Pharmacy and health food store shelves are lined with an overwhelming number of calcium and other bonebuilding supplements.

Many claim to be superior but we have to look to science to support those claims. People are also concerned about product purity, as it was recently revealed that some supplements may be contaminated with heavy metals and other undesirable ingredients.

Here are some pros and cons of bone-health supplements:. Coral calcium: These supplements are made from limestone, which is a form of calcium carbonate. Confidence at any age 10 to 98 Get the smile you deserve — Come see our team of smile professionals. Age-related macular degeneration AMD is the leading cause of blindness in people 55 and older. It is a chronic disease affecting more than 10 million Americans, and early detection is key to saving your sight.

Protect your vision from fading away. Calcium carbonate: This is the least expensive and most widely found type of calcium. Calcium carbonate is quite bulky, meaning the tablets are very large and often hard to swallow. Thus chewables are preferred. Heavy metal contamination with calcium carbonate has been a recent issue. Calcium citrate: Citrate provides less elemental calcium and is more expensive than carbonate. However, it may be a better choice for those with low stomach acid.

Eggshell calcium: The latest research shows that one of the cleanest and most absorbable forms of calcium comes from eggshells. It is called ESC. Eggshell supplements are safe, natural, gentle on the stomach and do not contain contaminants. There are also products available now made with natural eggshell membrane, or NEM, to support joint health.

Both of these nutrients are essential for bone health. Likewise, boron, copper, manganese, phosphorous, vitamin K, silicon and zinc are other nutrients involved in bone formation. Final Thoughts Osteoporosis is preventable, not inevitable.

There are various ways to build strong bones and protect ourselves against osteoporosis. Retirement Living Here are some tips from ACTS Retirement-Life Communities that will put you on the right path toward finding a retirement community to best meet your needs now and for the long-term. Check the background of the community: Find out who owns and manages the community, as well as the track record of management.

Determine if the community is accredited for meeting high standards in services, operations and finances. Consider future health needs: Retirement communities today offer many amenities and services but. Use a services and amenities check list: Get a complete information packet that includes application for admission, fee schedules, floor plans and the resident contract.

Continuing care retirement communities are the only type of senior community that offers independent living, assisted living and skilled nursing care on a single campus. Some CCRCs even offer specialized programs such as memory care, home health care and adult day programs as part of their services. Get detailed information about fees: Learn what all fees do and do not include, when fees are subject to increase and under what conditions.

Ask about the average fee increase over the past five years. Consider the financial advantages and disadvantages of the contract options the community offers. Meet with residents and tour the community: Arrange an appointment to tour the community, meet with residents and staff and sample the food and the service.

Notice if the community is clean, well maintained and secure. Ask about recreational and social activities: Find out what kind of social, cultural, educational, spiritual and wellness activities are available. Is there an activities director on staff to plan entertainment, events and trips?

Is transportation available? Find out if there is a waiting list to move into the community and how it works. Retirement Living We offer a wide variety of Independent Living Options, from 1bed 1bath to 4bed 4bath, units.

Included are the following: water, garbage, basic cable, sewer and lawn service. Assisted Living Our full range of Assisted Living services are designed to help you maintain your health, so you can live as independently as possible.

Let us help you create the lifestyle you always wanted Call Us Today! Waters Ave. Tampa, FL www. The coverage for your insured auto would include the broken window and the GPS, as long as the system is permanently attached. Computers, ring: The laptop and iPad are covered up to the personal property limit of a renters or homeowners insurance policy. A personal computer endorsement can be added to those policies for special coverage for the laptop and iPad.

Since insurance coverage begins after you pay your deductible, it makes sense to add a computer endorsement to a homeowners policy, which usually has a much higher deductible than a renters policy. There are limitations for theft of jewelry under the renters and homeowners policies.

If you give cash, you need to document it. Your laptop and iPad were on the back seat, and your diamond ring was in the glove compartment.

You have auto insurance and renters insurance policies. Before the year fades away, you have plenty of options.

Here are a few that may prove convenient:. Are there other major moves that you should consider? Here are two big reasons why tax efficiency should be a priority as leads into Next year, dividend income is slated to be taxed as regular income. So tax on qualified stock dividends could nearly triple for the wealthiest Americans.

Talk with a qualified financial or tax professional today. Vow to focus on being healthy and wealthy in the New Year. Stick to Reputable Dealers The gold rush has attracted some unlikely buyers. Stick with established, reputable dealers. Look for gemologists listed on the American Gem Society website and read online reviews.

Go with Reasonable Expectations Pricing your gold is a little trickier than you might think. The value of your jewelry depends on just how pure it is. For example, karat gold is 50 percent pure and would only have a top-line value of half its gold weight. The karat purity is usually stamped somewhere on the jewelry, such as 12k or 18k.

Jewelry bought overseas may instead be stamped with a number indicating its purity: Instead of 18k, it may read , indicating 75 percent purity. Realize that whoever is buying your gold needs to make a profit, too. Shop Around The more sellers you talk to, the greater your chance of getting a better price. As a first step, call ahead and ask how much a business is currently paying per gram of gold.

They may charge you for that. Information from USAA. Be informed and sweet talk the sales associates no bullying! Open-box items? Entries will be collected by News Connection U. Drawing held the 20th of each month. Carlton Jr. Cracker Country offers a variety of opportunities to match the diverse interests of potential volunteers.

Roles such as historic interpreter, maintenance, gardening, sewing, spinning, model train displays, store clerks, office work, outreach,. We strive to have a flexible and. Lifestyles After 50 Events! Find great information, entertainment, health screenings, prizes, giveaways and more!

Call or visit our website at www. Sports Center, Free Admission. Free Bingo Games for Prizes! Walk starts at 8am; Fundraiser for Kids Science Classes.

During the Florida State Fair, museum visitors explore the grounds and interact with costumed volunteers to take part in the customs of the past. Guests can take home a newspaper printed on an antique printing press or try a taste of real sugar cane before watching its juice being boiled into syrup. Its collection of thirteen original buildings dating back from — were relocated from across the state of Florida beginning in when the museum was established by Mildred W.

Carlton, Jr. Since then the museum has played an essential role in teaching the traditions of rural Florida. Becker freshfromflorida. Take Your Class Online! Pinellas Auditions: January 16 - a. Japanese Garden Mobile Estates U. Hillsborough Auditions: January 23 - a. Participants must be at least 55 years young. A piano will be available. Audition on first-come first-serve basis. No Entry Fee to audition. Ten Acts will be chosen from the auditions to perform at the show!

Florida State Fairgrounds, Hwy. Age Name Address City. In consideration of our acceptance of this entry, I for myself, my heirs, devises, executors, administrators and assign hereby waive, release, discharge any and all claims against Florida State Fairgrounds or News Connection USA, Inc.

I hereby, grant permission for the free use of my name and pictures in any broadcast or account of this event. It may be a surprise that the fastest-growing segment of social media users are over the age of 45, and particularly, those 65 and over.

Helen Feist. New, easy-to-use technologies such as iPhones, iPads and other tablets encourage older adults to try other technologies, as well. They eventually become more comfortable with technology overall and are more willing to accept new technology into their lives and homes. The study reports that tablet technology has made it 30 percent easier for older adults to use the internet.

From Newswise. A trip back to the port can offer a trip down memory lane as well as some new adventures. Generations of men have either trained at a Navy or Marine facility in the San Diego area or shipped out on one of the ships attached to the Pacific Fleet.

The San Diego area is home to the largest military complex in the world, with an estimated , military and family members. We enjoyed the drive on Route 79 with charming mountain communities. Here are some suggestions about what to see and do:. Woodward Museum in town.

Naval Base San Diego is homeport to more than 50 ships. And you can tour the USS Midway, an aircraft carrier with a long and noble history. Hotel Del Coronado. Across a bridge from downtown, be sure to see one of the last of the great hotels, the Hotel Del Coronado.

That alone should be cause for celebration since one of the challenges seniors face is how to pay for medical treatment at a time in their lives when healthcare may matter the most. Everyone is already familiar with Medicare to some degree or another.

Medicare is the federal health insurance program for people who are 65 or older and citizens or permanent residents of the United States, certain people younger than 65 with disabilities, and those with Amyotrophic Lateral Sclerosis ALS or End-Stage Renal Disease ESRD, permanent kidney failure requiring dialysis or a transplant. Some people with higher incomes will pay a higher Part B premium.

Part C coverage is offered by private companies, with benefits that are similar to those offered by Medicare that may provide extra coverage and lower out-of-pocket costs. Once you have reached the coverage limits that Medicare covers, you will be entitled to enhanced benefits under a Medicare Advantage Plan.

Read more about part C plans here. Part D coverage benefits are available as a stand-alone plan or they may be part of a Medicare Advantage Part C plan. Depending your income level, this premium may be higher for some people. The main difference between the two is that Medicare is an insurance program and Medicaid is an assistance program. Medicare helps people pay medical bills from funds they have paid over the course of their working life.

For the most part, Medicare serves people 65 or older, with some exceptions for younger disabled and dialysis patients. Premiums are many times required for certain parts of Medicare. It is a federal program and is uniformly administered across the United States. Medicaid has no age restrictions and serves people of all ages based on income. Generally, patients are not required to pay any costs for medical services, except in a few limited circumstances.

Medicaid follows federal guidelines, but it is administered by state and local governments. Medigap is a supplemental insurance policy sold by private companies that helps pay for some health care costs not covered by Original Medicare. This can include copayments, coinsurance, and deductibles.

Unlike Medicare, Medigap policies cover medical care when you travel outside the United States. If you do not have a qualifying disability or medical condition that allows you to enroll in Medicare before you turn 65, then you can enroll in Medicare when you turn If you already get Social Security or railroad retirement benefits, you will be contacted about three months before you turn If you live in one of the 50 states, Washington, D. Virgin Islands, you will automatically be enrolled in Parts A and B.

Because you have to pay a premium for Part B, you will be given the opportunity to opt out of that coverage. If you are not already getting Social Security or railroad retirement benefits, you can enroll in Medicare during the Initial Coverage Election Period. This will allow you to avoid paying penalties or a being subjected to a gap in your health care coverage.

The Initial Coverage Election Period is a seven-month period beginning three months before the month you turn 65 and ending three months after your 65th birthday. Your coverage begins on July 1 of the year you enroll. Be aware that you may have to pay a late enrollment penalty for as long as you have Part B coverage. If you are in a Medicare Advantage plan and want to switch to Original Medicare, you can do so between January 1 and February If you do switch, you will also have until February 14 to join a Part D plan as well.

Your coverage begins the first day of the month after your enrollment form is received. You should do this about three months before you turn 65, otherwise you will not be enrolled in Medicare in a timely manner.

You should carry your Medicare card on you so that when you need medical services, you can produce it just like you would for other forms of insurance. If you forget or lose your card, a health care provider may be able to look up your Medicare number and information online. If you have a Medicare Advantage plan, you will be given a separate card that will be used for the services offered by your plan. Be sure to present the right card when you are being treated so that the right program can be billed for services.

In April , Medicare began mailing new Medicare cards to more than 57 million participants as part of a fraud and identity theft prevention strategy. New cards do not have Social Security numbers on them. The deadline for replacing all Medicare cards must take place by April There will also be a month transition period that will run through December 31, If you are not automatically enrolled, then there are three ways to apply for Medicare Parts A and B:.

You can also contact the provider and get a paper enrollment form and return it by mail. All plans are required to offer a paper enrollment option. To learn the steps you need to take to enroll in the various Medicare programs, go to www.

You are eligible for premium-free Part A coverage at age 65 if you or your spouse worked and paid Medicare taxes for at least 10 years. You get premium-free Part A if you are already getting retirement benefits from Social Security or the Railroad Retirement Board or if you are eligible to get Social Security or Railroad benefits, but you have not yet filed for them.

You can also get premium-free coverage if you or your spouse had Medicare covered government employment. Keep in mind that while many people get free Part A benefits, everyone who wants Part B coverage must pay for it. Medicare has an eligibility and premium calculator that you can access here to see if you qualify for free Part A coverage.

If you sign up for coverage during the first three months of your Initial Enrollment Period, then your coverage starts the first day of the month you turn 65, unless your birthday is on the first day of the month. If your birthday is on the first day of the month, your coverage starts the first day of the prior month. But if you do not sign up during the Initial Enrollment Period your health care coverage may lapse.

In addition, if you sign up at a later date, you may have to pay additional penalties for the duration of the time that you are signed up. You need to be careful when shopping for Medicare plans online. Charges can vary widely from plan to plan and from market to market. In a recent Consumer Reports article investigating Part D drug plans, the watchdog found that mistakes in the sign-up process could cost beneficiaries hundreds of dollars a year.

Their advice based on the input of an industry expert was this:. There is a wealth of other information out there that you may also tap into as well. The best of this may be The State Health Insurance Assistance Programs SHIP , a national network that provides trustworthy, unbiased and one-on-one counseling and assistance for individuals and families who are seeking help with Medicare insurance plans.

Another smart move is to work with a local independent agent in your area. In addition to being licensed to sell insurance in a specific state, an agent must also pass an annual American Health Insurance Plans AHIP certification exam to sell Medicare plans. Agents are required to demonstrate specialized Medicare knowledge to pass the exam. Available Medicare plans vary by market and metro area, so having a local expert working for you gives you the best opportunity to compare the pros and cons of plans that you can actually purchase.

Your best move is to work with an independent agent who represents many companies that sell Medicare plans in your area. By contrast, a captive agent will only represent one or two plans, and this may be the right resource to use if you know exactly what plan you want.

You could probably track down the same information on your own, given enough time but with a lot more effort. Medicare covers beneficiaries when they are physically located in the 50 U. In rare cases, Medicare Part A may cover medically necessary services in a foreign country when a foreign hospital is closer than a U. You can learn about these exceptions here. In some cases, Medicare Part B may cover medically necessary health care while on board a cruise ship within the territorial waters adjoining the U.

If you have a Medicare Advantage plan, you should check to see if it covers medical care abroad. If you still plan to work at age 65 and beyond, your relationship and coverage by Medicare will vary depending on your employer. You may not need to sign up for Part B right away. If Medicare is your primary provider, then you should sign up for Part B immediately. Your employer should be able to tell you who your primary provider will be.

Also, just because you have some form of health insurance coverage, it does not mean you should not sign up for Part B. Your health insurance must be from an employer where you are currently actively working. And, if your employer has less than 20 employees, you will probably still need to sign up for Part B to make sure you have adequate health coverage.

Enrolling in Medicare is one of the most important and essential things you can do when you turn 65, but there are lots of other things to think about when you reach this milestone. To retire or not to retire? That is the question. Most everything else you do plays off this critical decision. Your Social Security strategy. Do you want to retire at full retirement age or start drawing reduced benefits at an earlier age?

Or, can you want until after full retirement age up to age 70 to draw even more benefits? Consider downsizing. Start by decluttering and be unmerciful in deciding to keep only the items that are most precious to you.

Maybe you want to live closer to your children or grandchildren, enjoy a warner climate or pay less in living expenses. There are a number of reasons to make the move to simpler digs and now is a good time to assess your needs and desires. Stay healthy. It sounds obvious, but are you ready to give up smoking or limit your alcohol and food intake?

What about losing weight and exercising more? Are you making plans to also have an active social life as well? Your body is more vulnerable as you age and to get the most out of your senior years, you must do everything you can to remain as healthy and independent for as long as possible.

Are your legal documents in order? Do you have a will, a living trust and an advanced healthcare directive in place? Not having these documents in place could cost you dearly at the time you and your family need them the most. Just like going to a doctor for a check-up, you should schedule a time with your insurance agent to do a review of your coverage. Are your retirement and pension accounts in order?

Have you allocated funds in a more conservative manner consistent with what you should be doing for your age? Are you maximizing your catch-up contributions? Get a comprehensive physical. But just like a good car with a lot of miles on it, you need to take preventative steps on a regular basis to catch health issues early. As uncomfortable as it may be, you can actually save your spouse and your children a lot of anxiety by letting your end-of-life wishes be known before they become an issue.

Have this difficult conversation now so that you can focus on enjoying your long and happy golden years. Many people who lead a frugal life find it hard to cut loose and enjoy things they have held off from doing or buying for all of their lives. If you can afford it, take that vacation to Paris and London or buy that Corvette you always wanted.

For more than a decade, a debate has been growing about the state of healthcare in America. From these discussions, one of the most viable solutions gaining traction across the board has been a move toward value-based healthcare and the creation of accountable care organizations. Simply choose from any of the links below to learn more about how accountable care organizations work:. Accountable care organizations are groups of doctors, hospitals and related healthcare providers who have joined together to provide a coordinated system of care.

The overall goal is to provide a higher quality healthcare experience for patients; providing the right care at the right time and avoiding unnecessary duplications of services while also reducing treatment errors through better communication among providers. Currently, the clear majority of Americans pay for healthcare under a fee-for-service model.

This traditional model pays healthcare providers based on the quantity of tests and procedures so that a patient is exposed to multiple options to receive the best care. The fee-for-service model has been effective with patients receiving quality care and the treatments they need. However, the emphasis on quantity over quality is not a sustainable model for the healthcare industry. Enter value-based healthcare with a promise to radically transform the way healthcare will be delivered in the future.

Under this new model, the emphasis is on healing a patient as opposed to just managing their healthcare problems. To deliver on the concept of value-based healthcare , a new type of healthcare delivery system needed to be put in place.

The actual physicians and team that implement the strategy of value based care to improve the patient experience and have better cost containment. This program pioneered the launch of ACOs and spelled out the broad terms of value-based healthcare, making providers jointly accountable for the health of their patients and providing financial incentives to save money by cooperating with each other. In , the U. Department of Health and Human Services proposed an initial set of guidelines for accountable care organizations under the Medicare Shared Savings Program.

For the accountable care organization concept to work, a system would have to be created to seamlessly share information. Doing so would create efficiencies and save money while making it easier to hit quality care targets. ACOs that accomplished these goals would get to keep a portion of the savings. In other words, many providers will assume primary responsibility for the care of a patient.

As part of the overall need to reform healthcare, another value-based healthcare model has emerged that also focuses on the same goals as ACOs. The Patient-Centered Medical Home model PCMH also strives for improved care through coordination with healthcare professionals, but instead of many homes, the PCMH focuses on a primary care physician as the single home for a patient.

The primary provider takes a much more front and center role than under the ACO model. The primary care physician provides continuous care and refers the patient to other specialists and hospitals as needed. Under the PCMH plan, all providers may be given bonuses for improvements in primary care services for each patient, providing an additional incentive to offer quality care.

The concept behind accountable care organizations is simple: Teams of healthcare providers come together to share patient data, focus on prevention and better coordinate patient care. Following are the benefits for a patient:. The model for accountable care organizations places financial responsibility on the doctors.

With the goal of improving care and limiting unnecessary tests and procedures, ACOs can save money by giving incentives to doctors, hospitals and other providers to form connections and facilitate coordinated delivery of healthcare. By coordinating care, unnecessary medical care and improved outcomes will reduce the overall amount of care a patient needs. When this happens, cost savings are achieved.

By early measures under the ACO model, it was estimated that Medicare savings of about a half billion dollars were realized from With a traditional fee-for-service model, doctors and hospitals are paid for each test and procedure, rewarding providers for doing more even when it is not needed and, consequently, driving up costs.

Accountable care organizations create incentives to be more efficient and meet specific quality of care benchmarks by focusing on prevention and more closely managing patients with chronic diseases. ACO providers get paid more for keeping their patients healthier and out of hospitals. Accountable care organizations are incentivized to save money and may have to pay a penalty if they do not meet their performance and savings benchmarks. Most ACOs have not opted to take on that amount of risk yet, preferring smaller payouts in exchange for not participating in downside risk.

Some ACOs can actually receive payments in advance to help them build out their infrastructures that are necessary for coordinated care. It is not unusual for an ACO to have multiple contracts with payers including several private insurance companies and Medicare. Medicare offers three main accountable care organization options, each with varying degrees of risk for the ACO:. Medicare also has a targeted Comprehensive End-Stage Renal Disease Care ACO Model which is focused exclusively on dialysis facilities, nephrologists, and other kidney care professionals.

Large dialysis organizations with more than facilities can receive shared savings payments, but also are liable for shared losses. They also share in greater levels of risk than their smaller counterparts. Originally, small dialysis organizations could receive shared savings payments, but were not liable for shared losses.

Beginning in , they were able to include the option of assuming downside financial risk, accompanied by the opportunity for greater shared savings. Based on the success of the Medicare ACOs, private healthcare systems began to realize there could be benefits and efficiencies found in shared data as a means of rewarding cost control and benchmarked quality healthcare. Based on an American Journal of Managed Care study, it was determined that the private sector had three primary motivations for developing their own accountable care organizations.

These included the opportunity to improve the quality and efficiency of healthcare services, to jumpstart population health improvement, and to accept that changes in how medical payments are going to be made was an inevitable change coming to the healthcare marketplace. In many markets, private ACOs are now starting to engage patient populations as the trend toward value-based healthcare gains wider acceptance.

Accountable care organizations and the concept of value-based healthcare are a significant departure from the fee-for-service model. While there are many reasons to like the ACO model, there are also several challenges to overcome. When all healthcare providers in an accountable care organization work together to ensure a better outcome for patients, they can combine their resources and analytics to create a single and comprehensive snapshot of care that results in better care.

With a greater collective approach, errors are less likely to happen. Costs can be further reduced if better care reduces malpractice suits. Because there is a shift to improving the baseline health of patients backed by financial incentives, providers in accountable care organizations are more likely to implement preventative strategies instead of managing illnesses and conditions.

Because efficiency is the goal, patients will only receive the medically necessary treatments and procedures they need. When an accountable care organization meets its goals of delivering more efficient treatment with a greater emphasis on wellness, patients have a better healthcare experience and are more satisfied with their healthcare.

When patients are happy with their treatment, that translates into the healthcare industry being seen in a more positive light. When it all works, the healthcare industry is more fiscally solvent and healthy as well. When people spend less money on healthcare, this frees up money that can be put back into the economy for other purposes. The current fee-for-service model is rapidly becoming outdated. Value-based healthcare is the preferred model for the future, and accountable care organizations will deliver that model in a way that best provides for a healthy and sustainable healthcare industry.

Private healthcare providers are coming to this realization and they have started to embrace value-based healthcare and ACOs as a long-term viable solution. Many providers have started pilot programs on their own, and others are seeking guidance from Medicare to make sure there is a coordinated effort.

To many people, accountable care organizations sound much like health maintenance organizations. But the biggest difference with an ACO is that a patient is not required to stay in the network. ACOs are trying to replicate the HMO model but without limiting patient options that created a consumer backlash a few years back. ACOs are also required to meet a long list of quality measures to make sure they are not saving money by delivering substandard care.

Many providers are profiting nicely from the current fee-for-service model and are apathetic when it comes to implementing a new system that may put less money into their pockets. The U. This will require significant time, resources and financial commitments to remake a system and integrate accountable care organizations into the healthcare fabric.

The other big challenge facing a makeover is trying to set policies that everyone in the system can agree on. Accountable care organizations are already in place and operating on a somewhat limited basis. They are continuing to gain traction but sharing patient information on a global scale among ACOs will be problematic given the fractured nature of American healthcare. Changing to value-based healthcare and creating many more accountable care organizations is expected to save money in the long-term, but short-term it is expected to cost quite a bit more.

Although they will be rewarded in a better way after the transition period, getting through that period will be a cause for concern. The other big cost will be implementing a new billing system, because bundling payments will be the new norm in the future instead of payments for individual services.

There are also concerns when trying to decide what costs of services should be among various providers because there will be varied structural costs based on each individual provider. Accountable care organizations will be judged and paid based on patient outcomes. Determining how to measure those outcomes is sure to cause debate until standards can be put in place.

The criteria to judge success for doctors and hospitals under a fee-for-service system is quite different than under a value-based system.

Accountable care organizations will need to implement different criteria based on a new kind of measured outcome to be able to get paid. A lack of experience with this type of measurement system will create reluctance to implement value-based healthcare among some current providers. Private practice doctors are finding it necessary to consider joining ACOs as a means of having their private practice survive. Many fear this consolidation could have a long-term negative effect on the healthcare industry.

They may be regional or as in the case of United Healthcare and Aetna, they have created a nationwide ACO serving many markets throughout the United States. In many cases accountable care organizations are funded by the providers, but in some instances, as an incentive to create more ACOs, Medicare will fund them through its ACO Investment Model. The goal is to make the barrier to entry into an accountable care organization much lower, providing funding to build coordinated care infrastructure, especially in rural and underserved areas.

It is also designed to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk.

In a study conducted by Leavitt Partners, in January , there were public and private accountable care organizations in the United States. In , almost , physicians participated in Medicare ACOs across the country. It is also estimated that in , between Medicare and private accountable care organizations, there were more than 28 million patients who were enrolled in ACOs.

The number of beneficiaries in these ACOs in is Shared Savings ACOs receive a portion of any financial savings if they meet quality and cost benchmarks. Providers can also choose to share in losses in exchange for receiving a higher percentage of savings.

CMS also announced that 58 ACOs will participate in the Next Generation ACO model which gives participants the opportunity to take on even higher levels of financial risk, up to percent. While many challenges remain, the promise of the ACO model represents a big step forward in providing sustainable healthcare for millions of Americans in the future. There will be growing pains as ACOs take hold but in the long-term this is a viable solution that will have a number of positive impacts on Americans and their health for years to come.

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You may want to switch Medigap policies if:. You may need to switch Medigap policies if you are eligible for one of the following guaranteed issue rights. If you qualify for one of the above situations guaranteed issue rights , then you may switch Medigap policies outside of your Medigap open enrollment period.

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