Insufficient Evidence to recommend: IE

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Tips for Prevention in Men
Men are generally less apt to go to see a doctor annually than women.  They are more likely to be involved in mishaps involving automobile accidents, drowning, guns and fire so that accidents are the 3^rd leading cause of death in men.  They tend to be unaware of the symptoms of diabetes: thirst, fatigue, weight loss & frequent urination so that about 20,000 preventable deaths from diabetes occur in men.

Bold underlined screens are partially paid for by Medicare for eligible patients.  The general guidelines for primary care and prevention listed above for women, generally apply where appropriate to men, as well.  

*The American Cancer Society (click for site information on prostate) recommends that health care providers offer the prostate-specific antigen (PSA) blood test and digital rectal examination (DRE) yearly, beginning at age 50 years, to men who have at least a 10-year life expectancy, and to younger men who are at high risk.  Medicare will begin coverage of DRE & PSA for prostate cancer screening in January 2000.
Tip:  The PSA test can be viewed as a cost item in primary care/HMOs.  Your caregiver may not include a PSA in your check-up and/or discourage you from wanting one.  The Medicare Administration feels strongly enough that this screening test saves lives that it now includes it in the services that it covers.  You should be aggressive in demanding that your healthcare provider be at least as comprehensive as Medicare.  Recommendations are similar by the Consumer Information Center.   Excellent information on prostate cancer can be found on the Johns Hopkins Brady Urologic Institute page.  Information on prostate cancer support groups can be found on UsToo.com.

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Tips for Vegetarians
Long-term vegetarianism may eventually lead to depletion of vitamins, nutrients and co-factors that can only be obtained from meat.
Vitamin B12 is an example of a something that is not available in vegetarian diets and will eventually be depleted from the body causing Vitamin B12 insufficiency with severe mental and physical impairment.
To protect yourself against this possibility, you should take vitamin supplements if you are a vegetarian.  

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Tips for Taking Vitamins
The observations that more people are eating more fast foods has led to the assertions that we are not eating properly and not getting enough vitamins.
If milk and breakfast cereals are in your diet, this is probably NOT true for you because you are getting the minimal daily vitamin requirements as supplements in milk and cereals..
Vitamin supplementation to meet minimum daily requirements should be considered a personal choice and not a necessity if you are eating properly.  It is ultimately wiser to adjust your diet than to try to compensate with vitamin supplementation.

The choice of consuming more than the minimum daily vitamin requirements in terms of megavitamin usage is another issue.  In some instances there are strong indications that there are health benefits to taking higher doses of Vitamins C and E for example.  In any event, the reason for taking higher doses should be to achieve some endpoint or protection and not because you feel your diet is vitamin-deficient.

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Tips About Health Plans

Report cards on Health Plans can be obtained from the HEDIS (the Health Plan Data & Information Set) provided by the NCQA (National Committee for Quality Assurance).
Click on Report cards and enter your City and State for the easiest way to get an answer.

Generally, health plans can be viewed as shown below.  Your satisfaction with the plan may be a trade-off between upfront premiums, co-payments, completion of forms and quality of care.

I:    Any doctor or hospital
II:   Any doctor or hospital on an approved list, may not cover prevention, may have some claims
III.  Only affiliated doctors & hospitals, generally has preventive care & no claims (must select primary care provider)
IV.   Financial incentives for affiliated doctors and hospitals, but member may use any provider, usually with higher co-payments (some claim forms); preventive care may be limited.
V.    Offered by HMO to allow choice beyond the HMO.  Higher premiums than HMO, limited benefits outside the HMO.  Patient may be responsible for charges above HMO fee schedule.

American Veterans are eligible for a variety of medical benefits which can supplement commercial health plans.  Click on VA for more information.  Even if a VA facility is not available to you or you prefer to receive care elsewhere, you can take advantage of the prescription medicine benefit that the VA offers which pays almost all of the prescription costs.

Finding a doctor may be done by talking with friends and family.  You can also use the resources of the American Medical Association (AMA) to find doctors and check their training.  

You should compare rates on different health insurance policies or plans.  Click for quotes on Health  Insurance.

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Tips About Medicare

There are 2 parts to Medicare.  
Part A covers:
Inpatient hospital care
Care in a skilled nursing facility
Home health care
Hospice care.
Part B covers:
Physician services
Outpatient hospital care
Durable medical equipment
Laboratory tests
X-ray therapy
Mental health care
Ambulance services
Over your working years, you and your employer have prepaid Medicare Part A.  When you become eligible and need to use Medicare, all you pay is the deductible ($776).
If you are not automatically eligible for Medicare because you have worked fewer than 40 quarters, you can obtain Medicare Part A coverage by paying a monthly premium [$301 if you worked less than 30 quarter ($331.10 must be paid by those who must pay a premium surcharge for late enrollment) and $166 if you worked between 30-39 quarters ($182.60 must be paid by those who must pay a premium surcharge for late enrollment)].  

If your income is limited, your State may help pay all or part of your Medicare costs, such as your premiums, deductibles, and coinsurance. To qualify -

Your monthly income must be less than:

$947 for an individual OR $1,265 for a couple

AND

Your bank accounts, stocks, bonds, or other resources must be worth less than:

$4,000 for an individual OR $6,000 for a couple.

Medicare Part B is available for a monthly premium of $45.50.  If you don't enroll immediately when you become eligible, the premium costs 10% more for each year that you delay enrolling.
Medicare will not pay for all your medical expenses.  
It will not pay for:
Long-term care in the home
Long-term nursing home care
Prescriptions taken outside a hospital
Private nursing
Cosmetic surgery
Hospital phone or TV
Care outside the US
A private room
Acupuncture
Hearing aids
Eye exams & glasses
Experimental procedures
Preventive care
Routine physicals
Dental care
Occupational therapy
Physical therapy
Routine foot care
Chiropractic care
Medicare will pay for:
flu shots
pneumococcal vacination

Medicare Benefits - 2000

Part A

*Pay is per benefit period.  Upon admission to a hospital a benefit period begins that ends when the patient is out of the hospital or skilled nursing facility for 60 consecutive days.
**"Lifetime reserve days": are not renewable and apply after a beneficiary exhausts Medicare coverage through day 90.  They do not have to be used all at once and can carry forward.

Part B

Part B also helps pay for:
X-rays
Speech language pathology services
Artificial limbs & eyes
Arm, leg, back & neck braces
Kidney dialysis & kidney transplants
Under limited circumstances, heart/lung/liver transplants in a Medicare-approved facility
Very limited outpatient drugs
Emergency care
Limited chiropractic services
Medical supplies: ostomy bags/surgical dressings/splints/casts
Breast prosthesis after mastectomy
Limited ambulance services
Clinical psychologists, Clinical social workers & nurse practitioners
1 pair of eyeglasses after cataract surgery with an intraocular lens
Preventive services: 

Note that MEDICARE DOES NOT cover a spouse under age 65 who may lose private health insurance as a dependent when the working spouse switches to Medicare.  The younger spouse has the right to buy the former employer's  health coverage for 3 years.  Always check with the employer benefits counselor on COBRA provisions and conditions.

You can get more information by clicking on MEDICARE as well as on Health Care Financing Administration.  

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Tips About Medigap Plans

Several types of insurance cover health care expenses that Medicare covers only partly or not at all:

Medigap is specifically designed to supplement Medicare's benefits and is regulated by Federal and State law.  There are 10 standard Medigap policies labeled with the letter "A" -"J".  Plan "A" is the basic benefit (and cheapest), while Plan "J" provides the most coverage (and is the most expensive).   Some of the 10 plans pay for services not covered by Medicare like outpatient prescriptions, preventive screening and emergency medical care while traveling outside the US.  Medigap coverage generally pays for service regardless of your choice of provider.  

Comparisons between the 10 plans are shown below:

Not all Medigap plans are available in all states at all times.
All 10 plans have the basic benefits: 
Coverage for Medicare Part A coinsurance for days 61-90 in a hospital, the Medicare coinsurance for lifetime-reserve days 91-150, 100% of the cost of 365 additional lifetime hospital days after all Medicare hospital benefits are exhausted, the reasonable costs of the 1^st 3 pints of blood, and Part B coinsurance (the basic benefits make up Medigap Plan "A")
*days 21-100
** basic drug benefit with a $250 annual deductible, 50% coinsurance & $1250 maximum annual benefit
***Extended drug benefit containing $250 annual deductible, 50% coinsurance & $3000 maximum annual benefit.

Tip: Benefits are identical for all Medigap policies of the same type, but premiums may differ from one company to another and from area to area, so that it pays to comparison shop.  If you live part of the year in a region that offers a lower premium for the same Medigap policy type, it may be worthwhile to get your policy from a company in the lower cost region.
Be aware that a Medicare supplemental health insurance called Medicare SELECT is nearly the same as the standard Medigap plans.  The only differences between Medicare SELECT and standard Medigap is that you must use specific hospitals, and sometimes specific doctors.  In return Medicare SELECT policies generally have lower premiums.
Don't purchase more than one Medigap policy (it is illegal to sell duplicate policies, because you will not be able to collect from more than one policy).

Click for quotes on Medigap  Insurance.

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When you see your Doctor, it all starts with a list.

1. Before you even get there, write down all the things that are troubling you and all the questions you'd like answered. Time is short, so prioritize.

2. If you have information from magazines, the newspaper or the internet that interests or concerns you, BRING IT WITH YOU.

3. Bring a pad and pencil so that you will remember ALL of what is being said to you. If you are organized and focused the chances are much greater that your doctor will hear what's important.

Active, assertive, focused patients have better health outcomes because they are able to take home all the details of a treatment plan and stick with it.  They are less likely to be blindsided by side effects.

4. If being active and assertive to your doctor isn't your style, then bring a family member or a friend who will be able to ask questions or describe the symptoms that you have trouble with.

5. Make sure that you can get in touch with your doctor if you have further questions after you leave the office. (Nurses, physician's assistants, and other health professionals in the office can also be a good source of answers).

6. Be open with your doctor regarding your feelings about referral to specialists. It is important that your doctor will be aggressive on your behalf if you need to see specialists.

7. Ask your doctor to explain your medical chart and records because you are entitled to see these.

You can always get to this page from the NETWORD directory (http://www.netword.com) by typing in "Personal Coach".

These WEB pages and Personal Coach are personal sites created by Dr. Edward J. Pavlik, who may be contacted at ejpavlik@aol.com.