Doctor’s Choice Names New Chief Operating Officer

Warwick, RI (August 11, 2017) – Doctor’s Choice, a Rhode Island-based company dedicated to educating consumers about Medicare, has named Leah Luo, R.N., Esq., Chief Operating Officer. Leah’s unique background in both nursing and law position her to manage daily operations in this complex field, as well as to direct the company’s strategic plan going forward.

Prior to assuming the role of Chief Operating Officer, Leah has experience as a nurse that developed a strong sense of triaging patient needs. “This translates nicely to managing business operations, as prioritizing tasks in a company isn’t all that different from the work I did in the health center,” Leah notes. “Instead of assessing conditions and implementing treatments on patients, now the business is my patient.”

Dr. John Luo, founder of Doctor’s Choice, is pleased to see Leah’s role within the company expand even further: “Leah has always been a valued member of the Doctor’s Choice team,” he said, adding, “In addition to her exceptional legal experience, her years spent as a nurse have helped her understand the complexities of the health care industry. She exhibits a tremendous amount of compassion and dedication to her profession and I know she will strive to put her knowledge and training to work for the betterment of our clients.” Leah had previously held the position of In-House Counsel and VP of Operations at Doctor’s Choice.

“I am excited to utilize my passion for improving health care delivery and wellness education for the clients of Doctor’s Choice,” said Leah. “This organization was formed out of a desire to empower consumers to take control of their future health care expenses by matching them to the plan that fits their needs. Through education, I believe we can create efficiency in how health care is delivered and paid for to maximize health outcomes for everyone involved.”

Leah received her Juris Doctor from Roger Williams University, where she graduated magna cum laude. She studied Nursing and French at the University of Rhode Island receiving a dual degree BSN/BA, summa cum laude. Leah is member of the Rhode Island Bar and is a licensed Registered Nurse. Leah resides in South Kingstown with her husband and their 2-year old son.

Aging2.0 Global Startup Search Comes to Rhode Island

San Francisco Organization Seeks the Best Aging-Focused Startups in the World

Aging2.0, a San Francisco-based global innovation platform that seeks to improve the quality of life for older people around the world, announced today that one of their 40+ Global Startup Search Pitch Events will take place in Providence, RI. The event will be hosted at the Social Enterprise Greenhouse (10 Davol Square, Unit 100) in Downtown Providence from 6:00-8:00pm on April 5, 2017.

"Last year's Aging2.0 pitch competition connected promising local startups with local corporate partners to create the relationships necessary to build companies in Rhode Island. We're excited to continue and expand on this initiative again." - Dr. John Luo of Doctor’s Choice, Rhode Island Ambassador for Aging2.0.

The pitch event will feature six local startups that are working to develop their products in the aging space. The pitches will be judged by an expert panel of judges along with a “people’s choice” vote. The winning company will win a chance to move onto the next round of competition and receive a complimentary full access pass to Aging2.0 Optimize, taking place in San Francisco November 13-15.

Aging2.0 Providence now resides within Social Enterprise Greenhouse and will continue the momentum of “Tapping into the Silver Economy” conference held in January. The Aging2.0 Providence event series will convene likeminded stakeholders designing, building, and thinking about the future of our aging population. This work is a collaboration between Doctor’s Choice, Social Enterprise Greenhouse, the City of Providence and a conglomeration of academia, corporate, and not for profit entities who aim to harness Rhode Island’s capacity to be on the forefront of aging innovation.

Kelly Ramirez, CEO of Social Enterprise Greenhouse, is thrilled to be partnering with Aging2.0. "Our organizations share a common mission to help spur innovation that improves the lives of our aging population. The partnership is building a community of entrepreneurs who are designing solutions to improve the future of aging."

Aging2.0 Providence is grateful for the support of Premier Sponsor Blue Cross & Blue Shield of Rhode Island, Platinum Sponsors PACE Organization of Rhode Island, Neighborhood Health Plan of Rhode Island and University Orthopedics as well as Gold Sponsors Moo, Slater Technology Fund, City of Providence, and Optimity Advisors.

"Rhode Island has the highest population of residents over 85 years old in the country, so it's critical that we come together to make healthcare simpler and more affordable for our state's seniors," said Corey McCarty, Vice President Consumer Segment, Blue Cross & Blue Shield of Rhode Island.  "We are thrilled to continue our partnership with Aging2.0 as a unique way to improve healthcare for aging Rhode Islanders while boosting local innovation."

For more information and to register, please visit: https://www.aging2.com/events/

For complimentary press passes, please contact providence@aging2.com

MEET THE PROVIDENCE AGING2.0 2017 PITCH COMPETITORS

EveryBill helps companies accept and manage payments. Helping patients see, manage, and pay all of their medical bills in one place.

Portela Soni Medical is a medical device company that is focused on infection reduction. Their patent-pending urinary catheter has been redesigned to reduce the growth of biofilm, that in turn reduces infections and decreases a patient's risk of complications. The PSM catheter is bringing innovation to a stagnated market through simple innovations to reduce infections while improving patient outcomes and experiences.

CareConnect is a cross platform that simplifies communication between elderly caregivers and family members. It takes a variety of logged data, and creates personal summaries for different family members depending on their concerns and schedules. By simplifying the transfer of information, caregivers can focus more on providing quality care, and family members receive a greater peace of mind.

Aging Parent Resources those caring for an elder are often faced with situations that are uncharted territory. APR understands the importance of getting information to people who have little time to research on their own. Their mission is to provide the most respected and best resources and support for caregivers and elders providing them with the answers to difficult questions.

URI’s Wearable Biosensing Lab will present Woven Internet-of-things: Smart Textiles for Elderly with Neurological Conditions including Parkinson’s and stroke. Their smart textiles are transformative telemedicine solutions to intervene patients remotely. Telemedicine data from their smart textiles produce a precise, temporal picture of the patient's’ response to the prescribed treatments, enabling physicians to make data-driven informed decisions. They partner with top neurologists and clinical scientists from RI Hospital, Butler Hospital, Providence VA Medical Center, and Ryan Institute for Neuroscience who work with them to validate and improve the smart textile technologies, fitting to the demands imposed by the growing population suffering from neurological disorders.

FallCall Solutions creates simplified telemonitoring solutions for elders, caregivers, and care providers built for the Apple ecosystem. They will be presenting their second application currently in prototype: FallCall Now: the first “smart” fall detector built exclusively for Apple Watch.

About Aging2.0

Aging2.0 is a global organization on a mission to accelerate innovation to improve the lives of older adults around the world. Aging2.0 connects, educates and supports innovators through its 30 city chapter network, Alliance and Leaders Circle corporate partner programs, Global Startup Search and Optimize Conference. For additional information, visit http://www.aging2.com.

About Dr. John Luo

Dr. John Luo, is the President and Founder of Doctor’s Choice, a Rhode Island-based company that educates employers and retirees on Medicare. Luo is a graduate of the Warren Alpert Medical School of Brown University. He worked as a Fellow for the Slater Technology Fund in Providence, evaluating business strategy for seed stage health and biomedical companies.

What You Need to Know About HSAs and Medicare

A Health Savings Account (HSA) allows you to save money to spend towards future health expenses. Typically, an HSA is paired with a health insurance plan with a high deductible. Contributions to your HSA and deductions from your HSA (assuming the money is to be spent on health-related expenses) are tax-free. Unlike Flexible Spending Accounts (FSA), you are able to keep your HSA as you move from one employer to another or retire.

Signing up for Part A, however, prohibits you from contributing to your HSA tax-free so, if you’re turning 65 or are retiring, this is something to keep in mind. Once you sign up for Part A, there is a 6-month look-back period in which you will be taxed for any contributions made to your HSA.   

What You Can Do

If you like your HSA and are fully covered under an employer, you can delay signing up for Part A until you’ve retired, regardless of your age. You do not need to fill out any forms or make any calls in order to delay signing up for Part A - simply do not do anything.

If you would like to sign up for Part A while employed or need to sign up due to retirement and you have an HSA, keep in mind the 6-month look-back period.

How To Select A Drug Plan - The Doctor's Choice Way!

3 Things Every HR Department Should Know About Medicare

1 in 10 Baby Boomers are still working so, odds are, some of your employees are Baby Boomers. When it comes to Medicare, there are a few things to keep in mind as you help transition employees into retirement:  

  1. COBRA → many organizations offer COBRA (Consolidated Omnibus Budget Reconciliation Act) health insurance, which allows employees --and often their spouses and dependents-- the ability to continue to have health insurance through the employer for up to 18 months after retirement. While this is a great perk to have, Medicare does not count COBRA as credible coverage. What You Need To Do: Once you’ve started COBRA, you have 8 months to sign up for Part B. If you do not sign up for Part B in time, you may get locked out of the system until the next enrollment period between January 1st and March 31st with coverage beginning on July 1st.

2. Part B forms  If an employee is turning 65, there are 3 main ways to sign up for Part B:

  1. Call the Social Security Administration;

  2. Visit ssa.gov/medicare and enroll online; or

  3. Visit your local Social Security Administration

If an employee is over 65 and working, leaving work coverage opens up a Special Election period (SEP) allowing you to enroll in Part B after work coverage ends.  However, you will need to submit 2 paper forms:

  1. CMS 40B → this form simply asks for basic identifying information: your name, address, social security number, and signature

  2. CMS L564 → this form needs to be filled out by the employer verifying that the employee had healthcare coverage under your employ; this form is necessary in order for the employee to avoid any Part B penalties. These forms should be sent to Medicare through Social Security.  

3. HSAs → an employee cannot contribute to an HSA account for up to 6 months prior to signing up for Part A due to a 6-month lookback period (the lookback does not go before age 65). If they do contribute, they may be taxed on their contribution. If an employee wants to continue contributing to their HSA but does not want to be taxed, they may delay signing up for Part A.      

Star Ratings

Medicare rates the drug plans using a five-star system; plans with five stars are rated as “excellent” and plans with one star are rated as “poor”. Medicare use four main categories to determine how to rate a plan:

  1. How well the drug plan manages customer inquiries

  2. How members of the plan itself rate their satisfaction with the plan

  3. How well the drug plan has performed in previous years and whether or not the plan has progressed in its star ratings from previous years

  4. How accurately the prices of the drugs listed by the drug plan are and whether or not the drug plan covers a wide range of medications for a wide range of medical conditions

At Doctor’s Choice, we prefer plans with a star rating of 3.5 or higher. Keep these ratings in mind when selecting your drug plan!

 

Reasons You’re Paying Too Much

The vast majority of the most common prescriptions taken by people on Medicare are covered but there are always exceptions, some of which can be pricey. Here are the main reasons your prescriptions are not covered by your plan and what you can do:

  • You’re taking a medication that simply isn’t part of the approved formulary. Formularies can change on a yearly basis so it’s important to make sure you’re well-covered for the upcoming year. The best time to do so is during the Open Enrollment Period between October 15th and December 7th.
    • If you know ahead of time which medications you will be taking, make sure your drug plan covers them, or
    • Speak with your healthcare provider about switching to a medication that is covered by your plan
  • You need prior authorization from your healthcare provider
  •  Someone made a mistake → maybe your prescription got sent to the wrong pharmacy or you were given a prescription for a generic instead of a brand name

As usual, there is an exception to the rule. If your medication is not covered by your Medicare-approved drug insurance plan, you can request an exception be made. 

3 Reasons why Medicaid is surging in RI

More jobs are added to the RI economy and yet the number of individuals on Medicaid is expanding. Here are 3 observations we're seeing as we work with individuals on a day-to-day basis as to why.

1. The obvious reason is Medicaid expansion

In RI, Medicaid expansion has increased the Medicaid threshold for more Rhode Islanders. More people qualify = more people enrolled. 

  • Adults with incomes up to 133% of poverty 
  • Pregnant women with household incomes up to 253% of poverty 
  • Children with household incomes up to 261% of poverty 
  • Women with household incomes up to 250% of poverty 

Source: https://www.healthinsurance.org/rhode-island-medicaid/ 

2. Lack of high paying jobs

There may be more jobs but there is still a lack of high paying jobs. If you're employed at $11/hour, you're still going to qualify for Medicaid. Many low paying employers (especially small businesses) are not offering health insurance because it's cheaper for them to have everyone go on Medicaid. 

3. Retirees are using Medicaid as an estate planning tool

The high cost of nursing homes and the astronomical hikes in long term care costs have forced many retirees to use advance estate planning tools to circumvent high nursing home costs. The trick? Put your assets in a trust, spend down whatever else you have, and on paper you look broke. You'll qualify for Medicaid with the state picking up your nursing home costs. With 10,000 baby boomers turning 65 each day, the growing Medicare population is definitely looking at Medicaid to cover those high nursing home expenses. 

The rising enrollment in Medicaid comes at no surprise to us as we continue to see a low wage recovery here in RI. 

What is the Donut Hole?

As the popular Oscar Wilde adage goes, “The optimist sees the donut, the pessimist sees the hole” (1). When it comes to Medicare and your drug plan, there’s nothing good about the donut hole so, maybe, just this time, you’re entitled to your pessimism.

The hole references a gap in drug coverage. There are several layers to the donut. Let’s use the year 2017 to illustrate how this works:

First, you have to reach your deductible. In 2017, the deductible is $400 so, before your drug plan starts covering any of your medication costs, you have to spend $400 paying for your medications yourself. (Not all plans have deductibles though, it’s just that the deductible can’t be greater than $400).

Second, you’ve reached your $400 deductible - now what? Well, if the metaphorical donut were a flotation device, you would be floating safely along the water. Once you hit your deductible (if you have one), your drug plan steps in and you’ll pay your designated co-pays (each plan has different co-pays for different drugs. Drugs are tiered with generics being typically tier 1-2 and brand name drugs being tiers 3-5)… until you reach $3,700. Yup, that means after you’ve spent $400, your drug plan will cover an average of 3/4ths of your drug costs until the combined total (what you’ve paid and what your drug plan covers) reaches the new threshold of $3,700.

Third, you and your drug plan have now spent the $3,700. Now what? This is where you fall into the donut hole or, in the case of the floatation device, this is the part where you get wet. At this point, your drug plan pulls back its coverage and leaves you, well, hanging out to dry. This is how it works in the donut hole:

  • If you’re getting generic medications → you pay 51%, your drug plan pays 49%
  • If you’re getting brand-name medications → you pay 40%, your drug plan pays 10%, the drug manufacturer pays 50%

Once you have spent a total of $4,950 of your own money, you’re back on the other side of the donut, safe and dry. At this point, Medicare steps back in to cover 80% of your drug costs, your drug plan covers 15%, and you cover the remaining 5%. Phew!  

I don’t mean to sound like an infomercial but there’s more - just a little more information to help you get through the donut hole. There are a few costs that you may be paying that won’t get you to the other side of the donut any faster. Here are the main payments you may be making that don’t get you past the hole:

  • The co-pays your pharmacy charges to dispense your medications
  • The premium you pay to have your drug plan
  • The cost of any medications that aren’t covered by your drug plan

Does it ever end?

Believe it or not, the donut hole is in the process of closing. Slowly, but it is closing and, thanks to the Affordable Care Act, the donut hole will cease to exist in 2020. As of 2020, you will pay 25% of the costs for both generic and brand name drugs.

(1) http://www.goodreads.com/quotes/363192-the-optimist-sees-the-donut-the-pessimist-sees-the-hole   

(2) https://www.medicare.gov/pubs/pdf/10050-Medicare-and-You.pdf

 

Penalties!!

Those exclamation points aren’t indicative of my excitement, they’re a representation of my petrification! Penalties... they’re everywhere. Here are some you might encounter with Medicare and, if you know what they are, you know how to avoid them (you’re welcome).

If you don’t sign up for Part B in time, you have to pay an additional 10% of the Part B premium for every 12 months you don’t have Part B. So, if you’ve missed 3 whole years, that’s an additional 30% that you have to pay. The penalty continues for as long as you have Part B.

If you don’t sign up for Part D in time, you have to pay an additional 1% of the Part D premium for every month you don’t have Part D. So, if you’ve missed 2 months, that’s an additional 2% that you have to pay. The penalty continues for as long as you have Part D.

Exception: The one exception in which the penalties actually end is if you are already signed up for Medicare because of a disability and are turning 65. Once you turn 65, the system resets.