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What is the International Pricing Index?

You may be hearing a lot about prescription drug prices in the news recently, with many of these discussions surrounding proposals from the Administration and members of Congress about ways to change Medicare. Although proposals to improve the Medicare system are always welcome, one recent method of choice for Part B, international referencing pricing, could harm seniors.

Part B is the part of Medicare that covers physician-administered treatments and outpatient hospital care, as well as other services. This is a very important part of the Medicare program and one that we want to preserve in order to protect seniors’ access to a full range of care options.

International referencing pricing proposals, including the Administration’s proposed International Pricing Index, would use the prices of medications in different countries to set the prices and reimbursement rates of Part B medications here in the United States. This may sound workable in theory, but in practice, history shows it could significantly undermine incentives in our healthcare system that increase access and patient choice.

In fact, many of the countries that would be used under this proposal – countries that have implemented reference pricing, already experience access issues.

If these types of policies are implemented, our current treatment plans, plans that we have carefully created with our doctors, could be disrupted in favor of more generalized treatment plans that value cost-saving over value-based care.

As seniors, it is critical that we advocate for the ability to receive the treatments that we know work best for our unique needs. International reference pricing could increase government involvement in our personalized health care plans, limit patient choice, and reduce seniors’ access to the variety of health care options we deserve!

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The Importance of Medicare Part D’s Non-Interference Clause

We often stress the importance of being knowledgeable about Medicare in order to best advocate for our health care needs. That’s why it is important not only to know about the different parts of Medicare, but also be up-to-date on legislative provisions that could have an impact on critical aspects of this program.

Under Medicare Part D, which covers prescription medications, plans are offered by insurance companies, and seniors select the plans during open enrollment period each fall. Last year, 43 million of the 60 million people with Medicare were enrolled in Part D coverage, a testament to the immense value the program provides for patients.

Unfortunately, Medicare Part D is facing a serious threat that could undermine the competitive marketplace structure of the program that helps improve affordability and patient choice. This threat involves proposals that would repeal an important feature of Part D called the non-interference clause, which prevents the government from entering into the private market negotiations that drug manufacturers and insurance companies engage in to provide patients with a wide variety of coverage options. This clause protects seniors by encouraging competition between plans, ultimately leading to better access to crucial prescription drugs for seniors.

Medicare beneficiaries deserve to be able to select the plans that best address our health care needs. Because of the free-market principles that the non-interference clause relies on, beneficiaries are able to save money on their prescription medications because they are empowered to shop around for plans without government influence on prices or availability.

Recent proposals to repeal the non-interference clause are dangerous and harmful to seniors, and it is critical that we urge lawmakers not to repeal this important provision of Medicare Part D. As seniors, we have the collective voice to make a difference, and should feel empowered to advocate for our needs. We encourage you to share your thoughts with us on our Facebook and Twitter pages, and urge you to tell lawmakers not to repeal the non-interference clause!

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March is National Kidney Month!

March is officially National Kidney Month! Now is a great time to remind ourselves about the importance of kidney health, a subject that may be often overlooked or forgotten. As seniors, we cannot let our health fall by the wayside, and that includes the health of each one of our critical organs. Currently, 1 in 3 American adults is at risk for kidney disease, and one of the biggest risk factors for developing kidney disease is being age 60 or older.

Although there are other risk factors for developing kidney disease, such as having diabetes, high blood pressure, or a family history, the simple fact is—as we age, so do our kidneys! And, since kidney disease usually has no symptoms, it can advance rapidly and remain undetected if we don’t make a concerted effort to regularly check on our kidney function. Luckily, a simple urine test is all you need to determine if you have kidney disease, which can allow you to take steps early on to slow the disease’s progression.

The kidneys are important for removing waste and excess fluid from the body, which regulates the body’s salt, potassium, and acid contents. The kidneys are also responsible for some hormone production and regulation, which can affect other organs in the body, blood cell count quality, and bone health. Fortunately, ensuring that you are taking steps to reduce your risk for other diseases like diabetes and high blood pressure can also prevent kidney disease or slow its progression.

Medicare, a program which many of us rely on as seniors, helps cover much of the costs that may be associated with testing and treating kidney disease. Medicare Part B helps pay for important services for beneficiaries with kidney disease, like doctors’ visits and dialysis. Additionally, Medicare Part D can help cover the cost of immunosuppressant drugs, which help prevent and treat kidney disease. In fact, immunosuppressants to prevent organ rejection for transplant patients are one of the six protected classes of medicine under Part D, which means Part D plans are required to cover “all or substantially all” drugs that fall under that therapeutic class.

So this March, celebrate National Kidney Month by booking an appointment with your doctor for a simple test of your kidney function, and encourage family and friends of all ages to do the same. Small actions can make a big difference when it comes to your health!

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It’s Time for a Springtime Medicare Refresher!

The lingering cold weather is slowly warming up, which can only mean one thing: Spring has sprung! Spring is a great time to reset physically and mentally, so we have prepared some easy explanatory Medicare materials for you to review to make sure you are informed throughout the rest of the year. Staying informed about your health is a year-round responsibility, and as we age it is important for us to educate ourselves on the programs and care options we can utilize.

As you may know, Medicare is a federal health insurance program that provides coverage for seniors aged 65 and older, as well as for certain individuals with disabilities. Medicare, through the years, has incorporated certain updates and changes to ensure that it is consistently working to promote the health of seniors as impactfully as possible, including the addition of different aspects, or “parts” to the program. Making sure you are knowledgeable about the Medicare program is important, as it can help you make decisions about which plan is right for you. Many people have heard about Medicare Parts A, B, C, and D, but don’t know what they necessarily mean. Medicare Today’s helpful infographic, provided below, highlights each fundamental aspect of the Medicare program and what each part of the program does.

Another helpful resource we want to highlight for seniors is a Medicare 101 informative video, which you can watch here, and see below. Take a minute to watch this short video, which gives a helpful snapshot of the Medicare program, what it does, and how it works. Warmer weather usually means busier schedules, and helpful explainer videos can be a great resource for getting the information you need quickly and efficiently. For more Medicare related video content click here.

Before we know it, the fall open enrollment period will be here, and it will be time to make changes or adjustments to our Medicare plans. Planning early and choosing the right plan for you based on your needs is very important, and brushing up on Medicare resources is a helpful way to prepare. You can enter the Spring season with an extra pep in your step knowing you are informed about the Medicare program!

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March is Brain Injury Awareness Month

For over thirty years, the Brain Injury Association of America (BIAA) has led the charge in promoting the observance of Brain Injury Awareness Month in March. The theme for this campaign is, very fittingly, Change Your Mind, which advocates for increased education about brain injuries. As seniors, we know just how important it is it to protect our brain function and promote healthy practices, but this March, learning more about brain injuries themselves is very important not only for older Americans, but for all Americans.

The brain is such an important and complex organ, and injuries can affect the way we think, the way we act, and the way we feel. The #ChangeYourMind campaign was created to provide a platform for educating the public about brain injury, just how common these injuries are, and what we can do to support our family members and friends who may suffer from a brain injury.

There are two types of acquired brain injuries—traumatic, and non-traumatic. The difference in these types of brain injuries is that traumatic brain injury is caused by an external force, such as a fall or car accident, and non-traumatic brain injury is caused by an internal force, like a strokes or seizure. The CDC reports that for older Americans, falls are the most common cause of traumatic brain injuries, so make sure to take measures to prevent falls around the house. Recovering from a brain injury can take time, and no two brain injuries are the same. Unfortunately, there isn’t much available research on aging with a brain injury, which is why supporting initiatives like #ChangeYourMind is so important for encouraging research into treatments.

Many doctors are now treating brain injury as a disease, rather than as a single event, due to potentially-lingering side effects. Brain injury is also thought to increase the likelihood of developing certain diseases that tend to affect seniors, like dementia, Alzheimer’s Disease, and cognitive decline more generally. Luckily, Medicare programs cover many testing and treatment options for older Americans who suffer from a brain injury. As always, it is critical that we as seniors make sure we know exactly what our specific Medicare plan covers, including inpatient treatments and prescription medications. You can learn more about coverage options here, and ensure that you are informed!

Make sure to get involved this March in Brain Injury Awareness Month by participating in the #ChangeYourMind campaign! Check out resources, ways to support the cause, and other informational items here, and make sure that this month, you #ChangeYourMind about brain injury patients and survivors!

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Do You Know About These Threats to Medicare?

As seniors, we know just how important Medicare programs are to our health and wellbeing. Unfortunately, there are currently some government proposals that would affect Medicare’s ability to provide accessible, affordable care for seniors. We have outlined some of the major threats below, because the first step in making a difference is being informed!

First, there have been various proposals to repeal the non-interference (NI) clause of the Medicare Part D program. This clause prohibits the government from interfering in negotiations between manufacturers and insurers that result in rebates and discounts. The proposals seek to repeal that clause and allow the government to negotiate medicine prices under Medicare Part D, but studies have shown the only way the government could negotiated lower prices is if they severely restricted access to medicines. As seniors, it is vital that we support protecting Part D’s private marketplace structure that is in place to keep medications accessible and affordable. You can find an informative video about this issue here.

Another recent proposal that could threaten Medicare Part D relates to coverage of medicines within the six protected classes. Currently, Medicare Part D plans are required to cover “all or substantially all” medicines within these six classes—which include medicines that help those suffering with mental illnesses, HIV, cancer, and organ transplant rejection. The Centers for Medicare and Medicaid Services (CMS) has proposed making changes to these protections, which could harm some of America’s most vulnerable patients. Ensuring that seniors are able to receive the specific medications our doctors prescribe us is very important, and this proposal could threaten that ability.

Finally, another threat to Part D is the upcoming out-of-pocket cliff. This explainer video provides more information about this issue, as does this informative graphic from Medicare Today. If not addressed, the dollar value necessary to reach catastrophic coverage, which helps cover prescription medications for seniors once they have already spent a substantial amount out of pocket, is set to increase in 2020. It is vital that we advocate for seniors’ health by urging Congress to address this impending out-of-pocket cliff, and ultimately help patients save more money at the pharmacy counter.

In addition to Part D threats, the Administration has recently proposed some changes to Medicare Part B, the program within Medicare that covers outpatient physician-administered medicines, as well as outpatient services like doctor visits and ambulance services. The Department of Health and Human Services’ (HHS) International Pricing Index proposal could harm seniors and patients with chronic conditions by inserting middlemen into the doctor-patient relationship, which will create new administrative barriers that could hinder a doctor’s ability to provide care. The proposal would also open U.S. borders to price controls from socialized health care systems and could severely limit access to existing and new treatment options.

The American health care landscape is always changing, so it is critical that we keep informed about current proposals and challenges facing Medicare—a program that provides us with so many benefits and reliable, affordable access to care. The more we know as seniors, the better we can advocate for our friends, our families, and ourselves.

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New Year, New Medicine Approvals!

Just in time for the New Year, the U.S. Food & Drug Administration (FDA) released their annual guide on medicine approvals and therapy recommendations, and 2018 marked another year with a strong focus on approving new treatments for diseases that impact the lives of patients every day, as well as encouraging new treatment innovations to better patients’ quality of life.

The report, Advancing Health Through Innovation: New Drug Therapy Approvals, outlines the work that the FDA’s Center for Drug Evaluation and Research (CDER) has done during the past year in reviewing these innovative medicines. The goal of approving new uses for medicines and encouraging innovative therapies is undoubtedly to help patients in need and inspire medical innovation for years to come.

FDA’s Center for Drug Evaluation and Research approved new treatments for rare diseases and infectious disease, but also focused their attention on approving treatments for many health conditions that patients face every day, including neurological disorders, heart, lung, and circulatory diseases, cancer and blood disorders, and women’s health disorders.

For many seniors, these approvals are great news! There are new formulations of medicines that have been approved to be taken on an empty stomach rather than with food, allowing for easier adherence to medical direction. There are also medications that have been approved in chewable forms for patients who aren’t able to easily swallow pills, which is helpful for many seniors. Medications were also approved that specifically affect seniors, like one drug that can be used in combination with a type of chemotherapy to treat acute myeloid leukemia in adults who are 75 years of age or older with multiple health conditions, in addition to many other cancer drugs which can be used as part of an overall course of treatment.

New approvals allow increased access to treatment options and medications for patients who may have been lacking a best-fit treatment in the past. Talk to your doctor about these new treatment options and if they could work for you! And always make sure you know what medicines are covered under your Medicare plan as treatments continue to evolve and improve, and drug formularies change. We can’t wait to see what medical progress 2019 brings!

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February 14th is National Donor Day!

February 14th is most frequently celebrated as Valentine’s Day, but did you know that it also commemorates National Donor Day? This annual celebration aims to raise awareness about the lifesaving benefits of organ donation while encouraging conversations around this very important topic. As of August 2017, there were more than 114,000 men, women, and children on the national organ transplant waiting list, and every 10 minutes, another person is added to that waiting list. This is an issue that affects Americans of all ages every day, and a topic that is not discussed frequently enough.

Organ donation can be a very complicated topic, which is why there are a multitude of resources available to us regarding eligibility, donation requirements and needs, and how exactly the process works. There are two main types of organ donation: deceased donation of organs after a patient passes away, and living donation of organs from a currently living donor. Donors can be people of all ages, including seniors, so make sure to check into some organ donation frequently asked questions to learn more about the process and how signing up to be a donor can change, or even save, someone’s life.

Organ donation is an intricate process, and relies on teams of doctors and access to specialized medications to make sure an organ transplant goes smoothly. When an organ is donated, the recipient of that organ may have to rely on immunosuppressive (antirejection) medicines, which are medications that ensure that the new organ is not rejected by the body. Medicare can help cover the cost of transplants, and if you relied on Medicare for help with an organ transplant, Medicare also covers the immunosuppressant medicines that countless American patients rely on after an organ transplant is completed.

Organ donation is a priority among all age groups, and donors and recipients come from all races, ages, and locations. This Valentine’s Day, keep organ donors and those waiting for organs in mind, and think about signing up in your state’s registry to become a donor yourself. We would love to hear from you all about how organ donation has affected your life or the lives of your loved ones, so share your stories with us on our Facebook and Twitter pages!

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Glaucoma Awareness Month

As we finish out the first month of the new year, we wanted to bring attention to a very important topic that is often overlooked: eye health. Many of us wear glasses or contacts, or even just use reading glasses occasionally, but we may take for granted the health of our eyes, which are just as prone to disease as other parts of our bodies. January of each year is Glaucoma Awareness Month, which was created in order to spread awareness about this serious disease.

Glaucoma is the leading cause of irreversible blindness, with more than 3 million Americans currently affected, and displays no symptoms. It can affect people of all ages, but the most common types usually impact older populations. Additionally, there are certain risk factors for glaucoma, including belonging to certain racial or ethnic groups or having a family history of the disease. You can read more about potential risk factors here. Beneficiaries, and especially individuals with these risk factors, should take advantage of Medicare Part B, which covers a yearly screening for glaucoma. This test is performed by your eye doctor, and can help with early detection. Learn more about how Part B covers testing options here.

There is currently no cure for glaucoma, but scientists are continuously working to develop medications and surgical techniques to slow and prevent further vision loss in those affected. Still, there are many treatment options available for patients with glaucoma, including different medications and types of eye drops. Medicare Part D may be able to cover some of the costs of these prescriptions, so make sure you are enrolled in the right plan for you and know what drugs are included in your coverage. A great resource for finding a plan that works for you is the Medicare Prescription Drug Plan Finder, a resource that may be helpful in identifying a plan that covers your health-related needs.

Eye health is extremely important, and being informed about glaucoma risks and prevention is just one aspect of keeping your eyes healthy. Regular doctor’s visits and self-monitoring are also important to making sure your eyes are functioning properly. We are optimistic for a cure for glaucoma, and in the meantime, you can help this effort by getting involved in initiatives to eradicate the disease. The Glaucoma Research Foundation has some ideas for ways to help, so take a look and make sure you are doing your part this January to help support healthy eye function for all!

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Healthy Weight Week is Here!

Healthy Weight Week is here! During the third week of January, we can take the time to ensure we are at healthy weights and taking steps to keep our bodies strong. This doesn’t mean crash dieting but rather healthy life-style choices that help us remain healthy as we age.

For seniors, our weight can be one of the key aspects of our overall health as excessive body fat can lead to conditions such as high blood pressure or diabetes. There are a number of factors to determine what a healthy weight is for you, based on your height, sex, age, body frame, and more. The CDC has some tools available here to help you determine where you are with your weight and if you should strive to make any changes. There are multiple ways to determine a healthy weight besides just looking at numbers on a scale, so check out these resource for more information about Body Mass Index (BMI) and waist circumference.

As soon as you know your healthy weight range, you can set goals to reach the optimal weight to improve your health. To help you reach this goal, eating healthy, nutrient-dense foods is very important, as is engaging in moderate exercise. Often, we may aspire to exercise more as we enter the New Year, and a great way to keep yourself accountable is by tracking your exercise. Click here for a simple worksheet to help you get started on tracking your exercise.

Remember, maintaining a healthy weight is a life-long commitment, so use Healthy Weight Week to fuel your weight loss efforts throughout the year and beyond. Also, be sure to keep your doctor informed about your weight loss, gain, or maintenance plans as you pursue this healthier lifestyle. Being at a healthy weight will undoubtedly make you feel great, so kick off the New Year with a commitment to eating, exercising, and living well!