Izzy’s Sound News

from 2023-04-15 - The Manchester Times

Put Their Painting Skills To The Test

Presented By: Isidore Kirsh, Ph.D., F.A.A.A. (N.J. Lic. #678)

Dr. Isidore Kirsh Ph.D., F.A.A.A.

Medicare Advantage Plans May Be A Disadvantage!

The carnival barking celebrities are relentless on television. They attempt to persuade you to call to check your zip code with a promise of getting money put back into your monthly social security check when you sign up for the XYZ Medicare Advantage Plan.

Extra benefits are touted over and above regular Medicare at no cost to you. The problem is the taxpayer price tag is enormous and quality of benefits is putrid.

A couple decades ago, Federal legislation was passed to improve quality of health care and lower the cost through Medicare Advantage plans. Insurance companies are required to report fi nancial data to State regulators. Today, it is estimated close to fifty percent of Medicare eligible policyholders have signed up for a Medicare Advantage (MA) plan.

An investigative article was published in the October 22nd, 2022 The New York Times. It was reported that nine out of ten MA providers were found to have committed and been accused of fraud. These private sector MA alternatives were supposed to be better than regular Medicare. They are not.

The MA companies inflated profits and received more money from the Federal government by reporting many patients more sick (increased number of diagnosis codes) with these over-diagnoses garnering higher payments. The Federal government spends as much on MA payouts as in funding the Army and Navy. The $12-25 billion in overpayments are enough to cover hearing and vision for all individuals over the age of 65.

Federal expenditures for MA total more than budgeted for NASA, CHIP (children’s insurance), U.S. Customs & Border Protection, FBI, EPA, and the Federal prison system.

MA limits choice of physicians, specialists, and hospitals within a smaller network for coverage and payment. Additionally, policyholders must jump through hoops to acquire required care for their anomaly. Annual profit per enrollee for MA insurer is close to $2300. The MA program looks to pay out less money, restrict access to care, and gives providers a lower reimbursement.

For hearing aid benefits, an MA plan utilizes a third-party administrator. This company lowers the rate of reimbursement to audiologists to the bare minimum. This administrative company receives money from the Federal government through your Medicare payment and your co- pay of $700 to $1000 per device, issues the hearing aids to the audiologist for your fitting, and 60-90 days later mails a service reimbursement of about 14% from the entire amount they collected. My own investigative inquiries with MA plans and administrative contractors, the actual dollar amount they pay is LESS THAN what is paid by medical assistance (MEDICAID) for the same service given to the indigent.

The MA model of providing hearing aids to policyholders encourages audiologists to get that handicapped patient in and out of their oﬃce quickly and sacrifices required care, counseling, aural rehabilitation, and computerized adjustments for patient success. “Best practices” are thrown out the door because dispensing audiologists cannot aff ord to spend the same amount of time for the 3rd party patient. The MA plan doesn’t typically have all manufacturers available and limits choice of product to be considered in patient fitting. Often it is a basic level hearing aid fitted with minimal care. From a business perspective, it is a churn and burn model emphasizing quantity versus quality.

Hearing handicapped patients are sacrificed. Dispensing audiologists are forced to severely reduce service and time to patients. In the MA model, policyholders are forced to lower their expectations because this is a race to the bottom mentality where the patient is neglected in product and continuity of continuing service.

Out of the delayed and low reimbursement (below the medical assistance fee schedule), to dispensing audiologists, they must pay taxes, rent, utilities, oﬃce costs, and attempt to make a profit to cover a salary. The patient may have 1-3 visits included during the first year of service. After this time period is up, the provider is permitted to charge $60 to $125 to $225 for every single oﬃce appointment lasting about fi fteen minutes. The MA policyholder/patient may think they are getting a deal in hearing benefits. However, they will pay even more in the long run or avoid seeking the required hearing care due to the future cost. Your Medicare ADVANTAGE plan may ultimately place you at a DISADVANTAGE.

Dr. Izzy and his Staff are always available to provide you with informative information about your hearing care needs. Please visit us at www.gardenstatehearing.com or call 732-818-3610 (Toms River/Whiting) or 609-978-8946 (Manahawkin).

Suzy Cohen, R. Ph.

The Power Of Lemon Juice: 7 Ways It Improves Your Health

By Suzy Cohen, R. Ph.

Lemon juice is a natural and versatile ingredient that offers numerous health benefits. In my article today, we will explore some of the many benefits of lemon juice. Most people enjoy a squeeze of lemon in their water and while refreshing, that only provides 1-2 mg of vitamin C. Lemons are thought to be a cross between the sour orange and a citron - two fruits brought to Europe from other countries. Here are 7 ways it helps you feel better:

1. Boosts immune system: Lemon juice is a great source of vitamin C, which is essential for a healthy immune system. Vitamin C helps to stimulate the production of more white blood cells to help you fight off infections and diseases.

2. Aids digestion: Lemon juice contains citric acid, which helps to stimulate the production of more digestive juices in your stomach. This can mitigate indigestion, bloating, and other digestive issues which in turn will improve hydration and energy.

3. Hydrates the body: Lemon juice is a natural diuretic, which means that it helps to increase urine production and flush out toxins from the body. Even though it’s a weak effect, it can help you prevent dehydration.

4. Helps to alkalize the body: Alkaline minerals such as potassium, calcium, and magnesium. By alkalizing the body, lemon juice is thought to help prevent the development of acid reflux, heartburn, and other digestive problems. That said, lemon is sometimes a trigger for people with esophagitis and heartburn.

5. Supports weight loss: Lemon juice contains pectin, a type of soluble fiber that can help to reduce appetite and promote feelings of fullness. It can also help to improve metabolism and increase fat burning, making it an effective aid for weight loss. This will directly improve energy.

6. Improves heart health: Lemon juice is a good source of potassium, which is essential for maintaining a healthy heart. Potassium helps to regulate blood pressure, reduce the risk of stroke, and improve energy.

7. Boosts energy levels: Lemon juice has a direct effect on energy levels. It supplies your body with a natural source of electrolytes such as potassium, calcium, and magnesium. These electrolytes can help to replenish energy levels and prevent fatigue.

In addition to these health benefits, there are many other uses for lemon juice. For example, it can be used as a natural household cleaner, a natural skin brightener, and a natural insect repellent.

Overall, lemon juice is a natural and versatile ingredient that offers numerous health benefits and can be used in a variety of different ways. I love to make Agave Lemonade in the summer. That recipe is at my website under the “recipes” tab. Anyway, by incorporating lemon juice into your diet and daily routine, you can enjoy its many benefits and improve your overall health and well-being.

(This information is not intended to treat, cure or diagnose your condition. Suzy Cohen is the author of “The 24-Hour Pharmacist” and “Real Solutions.” For more information, visit www.SuzyCohen.com) ©2022 SUZY COHEN, RPH. DISTRIBUTED BY DEAR PHARMACIST, INC.

Board Certified in Cardiology, Nuclear Cardiology & Echocardiography

Asu Rustenli, M.D. FACC

Board Certified in Cardiology, Nuclear Cardiology, Echocardiography, Cardiovascular CT, Vascular Medicine & Vascular Interpretation (RPVI) Invasive & Non-Invasive

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