Immune Thrombocytopenic Purpura in The Elderly

September is National Immune Thrombocytopenic Purpura Awareness Month. Commonly known as ITP, this immune disorder is characterized by abnormal clotting of the blood, which can cause hemorrhaging if someone suffering from it gets a cut or an injury; they will also bruise easily, and have an increased risk of infection. While this condition can develop at any age, elderly people are more likely to be affected by chronic ITP – so in order to live a longer, healthier life, find out if you are at risk for immune thrombocytopenic purpura by knowing its risk factors, signs and symptoms. 

What Is Immune Thrombocytopenic Purpura?

blood platelets flowing
ITP happens when you have a low blood platelet count.

Immune thrombocytopenic purpura means you have a low number of blood cell fragments called platelets, or thrombocytes. Normally, these platelets are made in your bone marrow along with other kinds of blood cells, and they stick together to help heal cuts or breaks in blood vessel walls to help stop bleeding; if you suffer from ITP, however, your body does not produce enough platelets, and you are more susceptible to bleeding both internally and externally. Not only that, but immune thrombocytopenic purpura actually causes your immune system to mistakenly attack and destroy your body’s platelets.

Risk Factors

ITP is not contagious and cannot be passed from one person to another. It can occur at any age, but generally acute ITP is more common in children and lasts less than 6 months, and chronic ITP is more common in adults, and lasts 6 months or longer. In children, the condition usually develops after a virus, while in adults, it usually develops over time. Elderly patients will have an increased bleeding risk compared to those who are younger, and will be more prone to thrombotic complications.

Factors that can decrease platelet production include:

  • Leukemia and other cancers
  • Anemia
  • Viral infections, such as Hepatitis C or HIV
  • Chemotherapy drugs
  • Radiation therapy
  • Heavy alcohol consumption

Symptoms

blood splatters
Prolonged bleeding from cuts is a symptom of ITP.

ITP doesn’t always have very noticeable signs or symptoms, but it will cause bleeding inside and outside of the body. Things to look out for are:

  • Purple bruises, or purpura, on the skin, which are caused by bleeding from small blood vessels.
  • Petechiae, or pinpoint, round spots that appear in clusters
  • Nosebleeds
  • Bleeding from the gums
  • Blood in urine or stool
  • Prolonged bleeding from cuts
  • Clotted blood under the skin that looks or feels like a lump

How Is It Diagnosed?

If you or your doctor suspect you have immune thrombocytopenic purpura, your doctor will:

  • Conduct a physical exam to look for signs of bleeding and infection.
  • Run diagnostic tests- Blood work will be done to evaluate your liver and kidney function and check your platelet count; your doctor might also do a blood test to check for antibodies that are attacking your platelets. 
  • Bone marrow test- If the blood test shows that your platelet count is low, a bone marrow test will be done to determine whether your bone marrow is making enough platelets. If your bone marrow is not producing enough platelets, you are most likely suffering from another issue, such as a bone marrow disease or cancer.
  • Imaging tests- Ultrasound or CT scans can check for an enlarged spleen, enlarged lymph nodes, or cirrhosis of the liver.

Treatments

Your doctor will determine your treatment based on the total number of platelets you have, as well as how often and how much you bleed. If you are older, they will want to monitor your platelet and red blood cell count, because a low red blood cell count can be a sign of internal bleeding, which will put you at risk for spontaneous bleeding in the brain and other organs. Some forms of treatment include:

  • Medications- This is often the first course of treatment. You will be prescribed corticosteroids, or steroids, such as prednisone, which will help increase your platelet count. Your doctor might also prescribe treatment given by injection, such as rituximab, immune globulin, or anti-Rh (D) immunoglobulin.
  • Splenectomy–  If the above medications don’t work for you, your doctor might order surgery to remove your spleen, an organ located in the upper left abdomen that makes antibodies that help fight infections. A splenectomy can help reduce the destruction of platelets, but it is important to note that the surgery will raise your risk of infection, so your doctor will explain what steps to take to avoid this side effect.
  • Platelet transfusions–  If you have severe bleeding, you might need a platelet transfusion to increase your platelet count, but this is only a short-term solution.

Lifestyle Changes

There are some steps you can take to help increase your platelet count, including:

different medication pills lined up next to each other

  • Avoiding certain medications- Some medicines can lower your platelet count or cause bleeding, such as aspirin and ibuprofen. 
  • Limiting your intake of alcohol, because it can affect blood clotting.
  • Participating in low-impact activities, such as swimming, biking with a helmet, and walking, in order to decrease your risk of injury and bleeding.

Immune thrombocytopenic purpura is a disease for which there is no known cause or cure, but know that if you have ITP,  you can live for many decades with the disease, even if you have a more severe form of it. The best way to live a long, healthy life is by recognizing the symptoms of ITP, getting checked, staying on top of treatments, and making lifestyle changes. Medicare Parts A and B will pay for treatment and medication, but Part B will only pay for 80% of your expenses, leaving you to pay the remaining 20% out-of-pocket. That 20% can really add up, but if you have a Medicare Supplement Plan, your plan will cover many of these costs. 

There are 10 different Medicare Supplement Plans to choose from, so it’s important to compare each one and find the plan that suits  your medical needs and saves you money. EZ agents work with the top-rated insurance companies in the country and can compare plans for you in minutes, at no cost to you. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a licensed local agent, call 888-753-7207. No hassle or obligation!

Can a Medicare Supplement Plan Help Pay for Cancer Treatments?

A cancer diagnosis can happen to anyone at any age, but the older you are, the more likely you are to develop the disease. In fact, according to cancer.gov, the median age at diagnosis for breast cancer is 62, 67 years for colorectal cancer, 71 years for lung cancer, and 66 years for prostate cancer. If you have been diagnosed with cancer, you can fight it, but it will be tough – and expensive. The costs of treating cancer can add up quickly, even if you are enrolled in Medicare, because Medicare only covers some of your medical expenses; the rest you will be required to pay out-of-pocket. The last thing you want to worry about while battling cancer is money, but don’t worry – you don’t have to: a Medicare Supplement Plan can help cover the expenses that Medicare does not. So what kind of cancer treatments does Medicare cover, how much do they cover, and how can a Medicare Supplement Plan help?

What Does Original Medicare Cover?

doctors and nurses in scrubs in an operating room with someone on the table
Medicare will cover surgery for cancer at 100%, but only 80% of any outpatient surgeries.

Coverage For Surgery

Surgery for cancer usually involves removing a tumor and nearby lymph nodes, except in cases of blood cancer or cancers that have already spread. Medicare will cover any medically necessary surgery for cancer: Medicare Part A will cover inpatient surgery, while Medicare Part B covers 80% of any outpatient surgery. You will be responsible for the remaining 20% of the Medicare-approved outpatient amount, as well as for meeting your Part B deductible.

Coverage For Radiation

In high doses, radiation can kill cancer cells by dividing and killing them, which can help shrink tumors. Radiation therapy can be done externally or internally to treat specific parts of your body. Medicare Part A will cover radiation treatment for hospital inpatients, and Medicare Part B will cover 80% of treatment for outpatient and in clinics. You will be responsible for 20% of the Medicare-approved Part B amount, well as for meeting your Part B deductible.

Coverage For Chemotherapy

Chemotherapy is administered orally through pills, or liquids, as well as through an IV into the muscle. Medicare Part A provides coverage if you are a hospital inpatient, and Part B will cover chemotherapy in an outpatient setting, doctor’s office, or clinic. You will be responsible for 20% of the Medicare-approved amount, as well as for meeting your Part B deductible.

How Can A Medicare Supplement Plan Help?

As noted above, Medicare covers all medically-necessary cancer treatments, but not 100%. If you are getting inpatient treatment, you will have to meet your Part A deductible and pay coinsurance if your hospital stay is longer than 60 days; if you are receiving outpatient services, you will pay 20% of the Medicare-approved amount, after you meet your Part B deductible. Cancer treatment can be very expensive, so you might find you need help filling the coverage gaps in Medicare, and a Medicare Supplement Plan can do that. 

Medicare Supplement Plans can cover your Part A deductible, and coinsurance costs, as well as your Medicare Part B copayment, coinsurance, and deductible. There are 10 different plans to choose from, and depending on which plan you choose, you could get anywhere from 75% coverage of your medical expenses all the way up to 100%. Each plan offers a range of coverage at different price points; if you are battling cancer, your best option is to get the plan with the most coverage possible, so you will only have to worry about paying your Medicare Supplement Plan monthly premiums. money bags, one green and the other two tan coloredMedicare Supplement Plans can help save you money and keep you from stressing over medical bills for your cancer treatments, leaving you with more time and energy to focus on your health. EZ can compare all 10 Medicare Supplement Plans and find the one that will meet your financial and medical needs. Our agents work with the top-rated insurance companies in the nation, which makes comparing plans easy, quick, and free – our services come at no cost to you, because we just want to help you save more money so you can focus on your health. To get free instant quotes on plans that cover your doctors, simply enter your zip code in the bar above, or to speak to a local licensed agent, call 888-753-7207.

Will I Have to Answer Questions About My Health When Applying for a Medicare Supplement Plan?

Medicare Supplement Plans can help you save hundreds, or even thousands of dollars on medical expenses every year, but you do need to know the best way to apply for a plan, and that includes knowing when to apply. While you can get a Medicare Supplement Plan at any time, the best time to do so is during your Open Enrollment Period: if you apply at this time, you will receive a waiver for health question requirements, but if you miss it, or want to change your plan outside of your guaranteed issue time frame, you will have to undergo the underwriting process, and will be asked a series of questions about your health in order to qualify for coverage.

Guaranteed Issue Explained

a clock next to a form with a pencil checking off a box
If you miss your Open Enrollment Period, then you will no longer have guaranteed issue right, and have to undergo the underwriting process.

If you choose to buy a Medicare Supplement Plan during your Open Enrollment Period, you will be given guaranteed issue, meaning you will not have to undergo the underwriting process. Your Open Enrollment Period starts three months before you enroll in Medicare Part B, and continues through the month you turn 65 and the 3 months after you turn 65. During this time you will not have to answer any questions about your health, and will be guaranteed approval for a Medicare Supplement Plan, regardless of your health status. 

If you do have to undergo the underwriting process because you do not qualify for guaranteed issue, you should know that every insurance carrier will ask you health-related questions on your application. Each company will have a different set of questions: one might ask if you have ever had a certain health condition, while another might ask you about your more recent health status. 

Common Health Questions

If you are generally in good health, and can answer “no” to most of the questions about having certain health conditions, you will most likely be approved for a plan. On the other hand, the more you answer “yes” to these health questions, the more likely you are to be denied by most insurance companies. 

Some of the health questions you will most likely be asked include:

  • Are you confined to a wheelchair or motorized mobility device?
  • Do you have any minor health issues such as arthritis, cholesterol or high blood pressure? You can still be approved for a plan if you answer “yes” to this question, as long as the minor health issue is not accompanied by a more serious problem. In addition, you can still get approved even if you are slightly overweight, as long as you are not considered morbidly obese. 
  • Have you been advised to undergo any medical treatments in the past 2 years, or are you scheduled to have surgery? Insurance companies will not want to take you on as a risk if you are undergoing treatments for serious medical conditions, or if you are planning to have surgery. Most will want you to complete your treatments and undergo surgery first before you apply for a Medicare Supplement Plan. 
  • Do you currently have any lung or respiratory disorders or are you currently using tobacco products? older adult in a wheelchair with a person holding their arm
  • Are you currently hospitalized, or are you confined to a nursing home or assisted living facility? If you have received home health care services two or more times within the last couple of years, insurance companies might deny your application; in addition, if you live in a nursing home, you will most likely not get approved. 
  • Do you currently have or have you had cancer? If you have had cancer, most insurance companies will want you to be cancer-free for at least 2 years before they will consider covering you; you must be in remission, and be a few years past any surgeries. 
  • In the past 2 years, have you been treated for or been advised by a doctor to have treatment for any of the following? Having chronic lung problems, dementia, immune deficiency disorders, Parkinson’s disease, osteoporosis, stents, strokes, heart attack, pacemakers, or congestive heart failure will mean that you will probably be denied.different medication pills in a pile.
  • What medications are you currently taking? Some insurers have a list of medications that result in automatic denials. 
  • Do you have diabetes with complications including neuropathy, or any heart disorder? If you have diabetes, some insurers will ask specific questions to determine how serious it is. For example, they might ask: Do you have diabetes with high blood pressure and require three or more medications to control your blood pressure? Or: Does your diabetes require more than 50 units of insulin each day to control?

Make sure that you answer all the questions truthfully, because insurance companies will see a copy of your medical records to confirm your health status. And remember, even if you do get denied by one insurer, you might still be able to find another insurer that will cover you. The best way to find out if you qualify for a Medicare Supplement Plan is to work with an EZ agent: our agents work with the top-rated insurance companies in the country, so they will be able to compare all plans from different insurance carriers to find one that does cover your medical needs. You do not have to go through this process alone! To get free instant quotes of plans that covers your doctors, simply enter your zip code in the bar above, or to speak to an agent, call 888-753-7207.

Democrats Want to Expand Medicare Benefits Through Spending Bill

Medicare has now been providing much-needed medical benefits for Americans aged 65 and older for well over half a century: the entitlement program turned 56 on July 30th. To illustrate just how important Medicare has been for seniors in this country, consider this: before Medicare, almost half of Americans 65 or older couldn’t afford health insurance. But as great as Medicare has been, it still falls a little short for many people; for example, vision, dental, and hearing are not covered as essential benefits. But there might be good news on that front! Democrats plan to use their multi-trillion-dollar spending proposal to expand Medicare benefits, and the Center for Medicare and Medicaid Services (CMS) is hoping to continue the expansion of telehealth. 

Crafting The Spending Bill

Congressional Democrats are currently planning to use their multi-trillion-dollar spending proposal to finally expand Medicare for seniors. Senate Majority Leader Chuck Schumer stated that the Budget Committee’s $3.5 trillion plan will include hearing, dental, and vision coverage for the first time ever. 

older caucasian man getting his ear checked by a dotor
Studies from 2018 show that 75% of seniors who needed a hearing aid did not get one due to lack of coverage.

“We have ways that we can expand Medicare services, and in fact, we must because we know it’s to our own benefit to provide these preventative services as early as possible to our seniors,” Health and Human Services Secretary Xavier Becerra said at the Senate Finance Committee hearing, noting that reducing prescription drug prices should be considered as well. “So we’re looking forward to working with you to make sure that we continue to make Medicare even better and where we go, I know that really will depend on Congress, but we’re ready. We want to make it work.”

This is a much-needed expansion, because thousands of older Americans struggle with vision, hearing, and dental issues. In fact, based on a 2018 Commonwealth Fund report:

  • 43% of seniors with vision issues did not have an eye exam in the past year
  • 75% who needed a hearing aid did not get one
  • 70% who have difficulty eating because of dental problems had not visited a dentist in the past year

Expanding Telehealth

caucasian woman with a white coat on and stethoscope over her neck looking at a laptop screen
The CMS plans to extend Medicare telehealth services to determine if it should be permanently covered. 

In addition to the expansions that Congress is proposing, the CMS is also proposing expanding until the end of 2023 Medicare coverage for the telehealth services that were in use during the Covid-19 crisis, in order to determine if the services should be permanently covered.

“Over the past year, the public health emergency has highlighted the disparities in the U.S. healthcare system, while at the same time demonstrating the positive impact of innovative policies to reduce these disparities,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “CMS aims to take the lessons learned during this time and move forward toward a system where no patient is left out and everyone has access to comprehensive quality health services.”

CMS also wants mental health care to be provided on an audio-only basis moving forward, as a test case to determine how efficient this care could be for helping seniors with mental health issues, as well as to determine whether it would result in better health equity. Lawmakers and patient advocates support the change, but would like to see it become a permanent situation. 

Big changes are hopefully coming in the near future for older Americans, many of whom have been silently suffering due to insufficient health care coverage.

Does Medicare Cover Atrial Fibrillation Treatments?

September is National Atrial Fibrillation Awareness Month. Atrial Fibrillation, also known as AFib, is a major health concern in the United States, affecting 2.3 million Americans. It is also the most common form of arrhythmia in patients over 65; in fact, around 70% of people with atrial fibrillation are between the ages of 65 and 85 years old. If you are an older adult with this condition, you are at significantly higher risk of having a stroke, so it is important to receive the proper treatment – but are these treatments covered under Medicare? 

illustration of a heart with a red circle around it
With AFib, the heart will beat irregularly due to a change in the blood flow.

What Is Atrial Fibrillation?

Your heart has four chambers: two upper chambers called atria, and two lower chambers called ventricles. In a healthy heart, the atria beat regularly, helping blood flow to the ventricles, but if you suffer from atrial fibrillation, your atria beat irregularly, changing the blood flow, making it either too fast or too slow. If AFib is not controlled, it can lead to severe complications such as stroke, blood clots, and even death; in fact, patients with the disease are twice as likely to die as patients without AFib. 

Risk Factors

There are a number of factors that increase your risk of atrial fibrillation, including:

  • Older age 
  • Gender – Men are 1.5 times more likely to develop AFib
  • Obesity – Obese patients have a 1.5 to 2.3 times greater risk of developing AFib, and of having the condition progress to permanent AFib
  • Sleep apnea
  • Diabetes 
  • High blood pressure

Common Symptoms

illustration of a woman who is dizzy
Dizziness is a common symptom of AFib.

A person with atrial fibrillation might have no symptoms, or they might experience mild symptoms. If symptoms do occur, they can include:

  • Heart palpitations
  • Dizziness
  • Chest pain
  • Shortness of breath
  • Lightheadedness 
  • Low blood pressure
  • Extreme tiredness
  • Weakness

Medicare Coverage & Costs

Medicare covers various treatments for AFib, as long as the treatment is deemed medically necessary by your doctor. Part A will generally cover:

  • Hospital or skilled nursing facility stays brought on by your AFib
  • Pacemaker placement
  • Catheter and surgical ablation
  • Electrical cardioversion- This is a low-voltage shock that helps to regulate your heartbeat
  • Chemical cardioversion- This type of treatment involves getting medications through an IV in a hospital setting

Medicare Part B will cover any outpatient services, including doctor visits, screenings, and diagnostic exams; Part B will also cover cardiovascular disease screening every 5 years, as well as  cardiac rehabilitation programs. As with any medically necessary services, Medicare Part B will only cover up to 80% of the expenses, leaving you to pay the remaining 20%, as well as your Part B deductible, out-of-pocket.

Saving Money 

Atrial fibrillation can be a costly condition to manage because it often requires ongoing treatment and medication; in fact, according to the Center for Medicaid and Medicare Services (CMS), the management of the condition and its complications costs the U.S. healthcare system roughly $26 billion dollars each year! For individuals managing the condition, costs can add up fairly quickly, especially since Medicare Part B does not cover everything.pink piggy bank with coins stacked in front of it If you have a lot of medical expenses because of a condition like AFib, a Medicare Supplement Plan can help save you a lot of money. Most of these plans will cover many of the out-of-pocket expenses that Medicare does not, like copays and coinsurance, or even for medical care while you’re traveling. In most states, you have the choice of 10 different Medicare Supplement Plans with different levels of coverage and price points, so you’re sure to find a plan that is right for you.

If you need help finding the right Medicare Supplement Plan for you, EZ can help, because our agents work with the top-rated insurance companies in the country. You will be paired with your own agent who will compare all available plans in your area to help find a plan that meets your financial and medical needs. All of our services come at no cost to you, and there is no obligation and no hassle. To get free instant quotes, simply enter your zip code in the bar above, or to speak to one of our license agents, call 888-753-7207.

Cardiac Rehabilitation & Medicare

According to the CDC, 21.7% of adults aged 65 years and older have been diagnosed with coronary heart disease (CHD); not only that, but a full 12% of those 60-69 have experienced heart failure, and that number rises to almost 20% when looking at people over 80. To help this large number of seniors with serious heart issues, Medicare covers cardiac rehabilitation programs to aid in recovery after heart surgery, heart failure, or a heart attack. These programs are meant to improve quality of life for those with heart disease, and reduce risk factors to prevent heart problems from worsening, but it seems that far too few Medicare beneficiaries are taking part in them. If you are dealing with heart issues, you should know about these programs and what criteria you need to meet in order for Medicare to cover your treatment, so you can make the most of your recovery.

Cardiac Rehabilitation Explained

pink kettle bells with sneakers in the background
The cardiac rehabilitation program will help seniors exercise and work towards a healthier lifestyle.

There are 2 types of cardiac rehab programs typically prescribed to patients who have suffered a heart attack, been diagnosed with a heart condition, or had surgery on their heart: general cardiac rehab and intensive cardiac rehab. Each program is offered at the hospital by healthcare providers or a special rehab team, who will customize a plan to help you make better lifestyle choices, manage your heart condition, and prevent any new issues. 

These programs usually include:

  • Exercise – Because exercise helps maintain a healthy heart, a large portion of these programs is dedicated to moving your body. Over time, the exercises given to you by your team will grow in intensity to challenge you and improve your health. 
  • Education on healthier lifestyle choices – Your team will talk to you about following a heart healthy diet, how to reduce stress, and more. 
  • Counseling – Your rehabilitation program can include counseling  to help you deal with issues that have come up during your illness, as well as help you change your behaviors for the better. 

These programs are extremely beneficial, and can help you improve the quality of your life, as well as lengthen your life. Unfortunately, though, many Medicare beneficiaries do not seek help or utilize any of these cardiac rehabilitation programs: one study found that only around 10% of patients 85 and older participated, compared to around 32% of those 65 to 74. They also found that participation among women was lower than among men, which is disappointing considering that women are more likely than men to have heart disease, and that it is the leading cause of death for women in the U.S. 

“Cardiac rehabilitation has strong evidence demonstrating its lifesaving and life-enhancing benefits, and Medicare Part B provides coverage for the program,” lead study author Matthew D. Ritchey, a researcher at the Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention, said in a news release. “The low participation and completion rates observed translate to upwards of 7 million missed opportunities in this study.”

Medicare Coverage For Cardiac Rehabilitation

black and white picture of a man holding his chest
If you had a heart attack in the past 12 months, or experience chest pain, then Medicare will cover rehabilitation. 

As a Medicare beneficiary, you have access to cardiac rehab coverage through Medicare, as long as you meet certain requirements. Medicare Part B covers these programs if you have had at least one of the following conditions:

  • A heart attack in the last 12 months
  • Coronary artery bypass surgery
  • Chest pain
  • A heart valve repair or replacement
  • A coronary angioplasty (a procedure to open a blocked artery)
  • A coronary stent (a procedure to keep an artery open)
  • A heart or heart-lung transplant
  • Stable chronic heart failure

For general cardiac rehab, Medicare will cover up to two one-hour sessions per day and a total of 36 sessions; if deemed medically necessary, Medicare might cover an additional 36 sessions. For intensive cardiac rehab, patients are eligible to receive coverage for up to six one-hour sessions per day and a total of 72 sessions; however, these sessions must be completed over an 18-week period.

Medicare will pay for 80% of the Medicare-approved amount of this program, which leaves you responsible for the remaining 20%, as well as for meeting your annual deductible. 

Saving Money

Medicare requires that you pay a 20% coinsurance for each qualified medical expense you incur, but there is a way that you can avoid these expenses and save money: Medicare Supplement Plans will pay for the coinsurance and then some, depending on the plan. There are 10 different plans to choose from, so there is sure to be one that meets your medical needs, as well as fits your budget.  We know that being on a fixed income means that saving money is a must, and a Medicare Supplement Plan is a great way to help you save money throughout the year.

Not sure where to begin? EZ.insure can help you save the most money possible by comparing all available Medicare Supplement Plans in your area – and to help you save even more money, we offer our services for free! Our highly trained agents will assess your needs, compare plans, and find the one that is best for you. To get free quotes, simply enter your zip code in the bar above, or to speak to a local agent, call 888-753-7207.

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