Long Term Care Planning: Bridging Home and Community

We were invited to write a series of brief articles for the monthly newsletter of our friends at MDK Insurance Services, describing the continuum of long term care, and how to navigate oneself through it. You can sign up for the newsletter on their website, and each month we provide a copy of the article here as well. Please share the information with someone you know who is thinking ahead about how to plan for (and pay for) their own or a loved one's long term care.

Volume V: Bridging Home and Community

In previous issues, we’ve outlined the resources that are available when planning for the care at home of a disabled elder. It’s important to remember that those who lose connections with friends, community organizations and social groups, or who fail to build new connections and participate in engaging activities are at risk of social isolation, known to negatively impact physical and mental health. Fortunately there are community-based programs available to help those living at home with physical or cognitive impairments to remain socially connected, physically active, and mentally stimulated well into their old age.

Adult day health care programs are licensed centers that provide medical services and a variety of therapies, social services, and stimulating activities, as well as meals for the participants, who usually attend the program between 4-8 hours per day, several days per week. Adult social day care provides a similar structure, but does not offer skilled medical services and emphasizes socially, physically, and intellectually stimulating activity. Senior centers are neighborhood-based facilities that offer an array of social and educational opportunities, often offered on a drop-in basis. Many provide exercise programs and nutritious meals for participants on the days that they attend. For those who are no longer driving, it is essential to plan for transportation alternatives, to ensure access to all of the types of services that have been described. To find transportation and other resources in your community, contact your local Area Agency on Aging, or log on to the national Eldercare Locator: www.eldercare.gov.

The above resources can supplement a care plan that provides safety and support at home while keeping the elder connected and engaged. Next month, we’ll discuss the different levels of community care that are available for those who are considering making a move from a private home.

How to Save Money on Prescription Drugs

Everyone is looking for ways to economize, and the medicine cabinet is a great place to begin. According to Cigna Healthcare, people over 65 make up just 13 percent of the population of the United States, but they account for 30 percent of the prescriptions filled. That's a lot of money being spent on medications.

Below are some ways that Elder Care Guides helps our clients to evaluate their prescription drug costs and take action to save money.

1) Ask for generics - This may seem obvious, but it turns out that some physicians prescribe medications without discussing with the patient whether they would prefer generics. Not all prescriptions have a generic available, but there is usually a significant cost savings if you "go generic" so it is worth inquiring. Cigna estimates a cost savings of approximately $250 per year for those seniors who switch to generics. Ask your doctor or pharmacist to review your medication list with you then ask your physician to re-write any prescriptions that have a generic option.

2) Check for over-the-counter options - There are many medications that used to be "prescription only" that are now available over-the-counter (OTC). Examples include ranitidine (brand name Zantac) and loratadine (Claritin). Check with your pharmacist to determine if the dose you need is available in non-prescription form. Don't rely on your doctor to tell you if your prescribed medication is also available over the counter. You are your own best advocate, so ask!

3) Look into retailer discounts - Major retailers including Wal-Mart and Target offer a host of generic prescriptions for as little as $4 per month, and $10 for a 3 month supply. These are the costs without insurance. Go to each retailer's websites where they publish current lists of the drugs available for lower prices.

4) Go postal! - Many insurance plans offer mail-order pharmacy options where you can purchase a 90-day supply of medications at a lower cost than if you were to pay a monthly co-payment at your local pharmacy. Call your insurance company to find out if they offer this.

5) Evaluate your Medicare D plan - Not all prescription drug plans under Part D are created equal. Do your homework to find out if you plan is the best one given your prescription needs. The Medicare website offers a "formula finder" feature where you can enter your medication list and it will produce a list of the plans that cover your specific prescriptions. You then need to call each plan to discuss the premiums and co-pays.

If you have not enrolled in a prescription drug plan under Medicare Part D, you can enroll during the Annual Election Period which begins each year on November 15 and ends on December 31. Coverage begins the following January 1. Health Insurance Counseling and Advocacy Program (HICAP) has a great website and a toll-free hotline staffed with knowledgeable volunteers who can answer your questions about Medicare, including prescription drug plans. If you have a Part D plan and are trying to manage your out-of-pocket costs, AARP has a "doughnut hole" calculator that helps you to determine when and how much you might have to pay.

6) Reduce consumption - Ask your doctor what lifestyle or dietary changes might help you to reduce your need for certain medications. I have a client who was able to discontinue three of her blood pressure medications through daily monitoring of her blood pressure (the charts were given to her doctor for regular review); stress reduction techniques; exercise; and menu planning. The more medication you take, the more potential for side effects and drug interactions, so reducing the drugs you take may help your health as well as your wallet.