This and that: ObamaCare, emergency devices, advanced directives


It’s the 21st day of April. We’ve made it past the Ides of March, April Fool’s Day and the deadline for income taxes. If the latter is news to you, stop right here, right now and go deal with that. We’ll wait.

Back? Good! How about we just take it easy today and answer a few of the questions that some of you have been shooting my way, OK? A little of this, a little of that…

Q: I’m hearing all kinds of things about “ObamaCare” and mandated health insurance and something called an “Exchange” and and and…Is there something I need to do?

A: Not if you live in the Medicare world, no — nothing has changed and nothing radical is on the brink of changing, so just continue your fearless and intrepid navigation of Medicare, and sleep peacefully.

If you aren’t Medicare-eligible, this touches you: Yes, “ObamaCare” mandates health insurance, with a few exceptions, but we won’t go there today; and, of course, if you already have health insurance (probably through your employer), no worries. If you don’t, you’re going to have to get it, and that’s where the “Exchange” comes in.

This refers to a “Health Benefit Exchange” (every state will have one and Washington is working feverishly on its own), which is really a fancy phrase for a health insurance marketplace. It will be a website where you can go in, put in your information (like income, number in household, etc) and it will tell you if (a) you’re eligible for health insurance through expanded Medicaid, (b) you’re eligible to purchase health insurance with the financial assistance of a government subsidy, or (c) no subsidy, but you can purchase insurance. They will show you what your options are, how good, how much, etc.

If you’re at all familiar with the Medicare Part D drill, this looks a lot like it and, yes, we’ll be around to help, if you want it or need it, but it won’t kick in until October 1, for coverage beginning January 1, 2014, so don’t get too excited just yet; again, if you’re on Medicare (or will be in the next 6 months), just forget all of this and start planning your May Day party.

Q: What’s all this I’m hearing about amazing little “personal emergency” devices that do all kinds of things?

A: I have no idea what you’re hearing, but I do know what I think you’re talking about. For years, we’ve had these cool little “panic button” gizmos (e.g. LifeLine, LifeAlert, etc) that we could wear around our necks or as bracelets, so if we fell (or whatever) we could summon help. THESE THINGS SAVE LIVES! The only downsides were that (a) we had to actually wear them, (b) we had to actually use them, and (c) they were tied into our landline phones, so if we did something irresponsible, like go to the store or church or wherever — Oops! We’re on our own.

Those devices/systems are still around, but they’ve become a whole lot more sophisticated, and some of you may recall my predicting such things quite a while back, but my abject humility forbids me from pointing that out. Now, the emergency alert (“panic button”) can work from anywhere, and instantly turn into a two-way speakerphone! Now, you can add “medication reminders” that can hold up to a week’s supply and the correct compartment will flash when it’s time to take that dose. Then if you don’t take it, there will be an “auditory prompt” and/or a phone call from the call center or a text message or an e-mail. If you still don’t do what you’re supposed to do, it will snitch you off to your family or caregiver, then watch out.

You can add motion sensors and “vital sign” monitoring (Yes, even that!) and your family can use it to send you photos or emails or whatever AND it will walk the dog! (…ok, I’m kidding about that part…); obviously, you can pick-and-choose what functions you want and want to pay for, but it isn’t as outrageously expensive as we might assume. For those of us who live alone and/or family is a ways away, these could be hugely helpful. Care to go shopping? OK, do a web search for “personal emergency response systems” and watch what comes up. No? OK, call any of the numbers at the end of this column and go from there.

Q: I got a call from Social Security wanting to verify my Social Security number…

A: No, you didn’t — You got a call from somebody who wanted to get your Social Security number! Social Security will NEVER do that!

Q: My son says I have to get something called an “advance directive” — Is he right?

A: No, because you don’t “have to” do anything! An “advance directive” is a legal document in which you state what “heroic measures” you do or don’t want, in the event that something medically bad happens to you and you can’t speak for yourself. Do I think these are a good idea? Yes, but only because they allow us to speak for ourselves when we can’t speak for ourselves, but do you “have to?” No; and, by the way, if you want all of the heroic measures in the event of an event, then doing nothing is exactly the right thing to do.

Q: What does the phrase “dual-eligible” mean?

A: It refers to someone who is eligible for both Medicare and Medicaid at the same time.

Q: Do I have to have a will? I don’t have much of anything.

A: This comes up all the time: No, there is no law that forces you to make a will. Do I think we all should? Yes! — Because we’ve all got stuff, and if we don’t decide who-gets-what before we go tripping into the next phase, somebody (and probably somebody we claimed we love) is going to have to clean up after us or leave it to the State of Washington to do. If that’s the legacy you want to leave…

Q: Will you tell my mother that she should put me on her checking account?

A: No.

The end.

Mark Harvey is the director of Senior Information and Assistance for Olympic Area Agency on Aging. He can be reached at harvemb@dshs.wa.gov or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information & Assistance.