142 Uptown Newslette November 2016

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November 2016

Surprised by an ER Bill? -

An emergency room visit can cost plenty, even if you're fully covered by insurance. How to fight back. If the need to go to the emergency room arises, your first instinct is likely to be a 911 call. In an emergency, getting the right care fast should be the focus. "If you're having a heart attack, you're not going to ask if the doctor takes your insurance," says Karen Pollitz, a senior fellow at the Kaiser Family Foundation. But that ER visit may have a big price tag. A Kaiser-New York Times survey of insured and uninsured people who had trouble paying medical bills found that ER bills accounted for the largest portion of what they owed. WHY WE’RE GETTING BILLED. Going to a hospital that takes your insurance may not protect you from getting billed. About two-thirds of ER doctors are independent contractors who might not be in your insurance plan. Any out ofnetwork doctor (or lab) may bill you for whatever your insurance doesn't

cover, a practice called balance billing. If the ambulance company that transports you doesn't take your insurance, your cost could be more than $2,200 depending on such factors as where you live and the level of care you receive before you get to the hospital. (A breathing tube, for example, might bump up the price.) You can't completely protect yourself from ER billing problems, and you never want to put cost concerns ahead of emergency care. These strategies may help. DO THIS BEFORE YOU NEED AN ER Ask your insurer for documentation on what the plan will and won't cover if you need emergency care. (The insurer's website or handbook may not be up to date.) Your insurer can also tell you which area hospitals take your insurance. You can then ask the billing department at your hospital of choice whether its ER doctors participate in your insurance plan. And because most insurers cover medically necessary ambulance rides, know how your plan defines that-it could mean you are unconscious, bleeding heavily, or in severe pain. GOING TO THE ER When you call 911, a dispatcher will send the closest available ambulance

so you may not know whether it will be in your insurance network. And though you can request a particular hospital, it's the ambulance personnel's call and usually they will choose the closest facility that's properly equipped to treat you. Under the Affordable Care Act, if you need emergency care, your copayor coinsurance cannot be higher than your in-network rate, even at out-of-network hospitals. But the law doesn't prevent out-of-network providers from billing you for the remainder after you've received care. At the hospital, you (or the family member or friend who is with you) will fill out admission forms. This is the time, if possible, to request an in-network healthcare provider. At discharge, you or your companion should ask for all paperwork, including an itemized list of charges. WHEN YOU GET BILLED You'll probably get separate bills from each out-of-network provider involved in your ER care. Pay nothing until you get explanation of benefits (EOB) statements from your insurer; they tell you what the plan has covered and what your portion may be. Compare bills and EOBs to make sure you received the services noted and have your insurer confirm that providers who sent bills are not in your plan. (Continued on back page)

Greetings to the month of November, a month when we obs e r ve and celebrate the major holiday, Thanksgiving. It is the best loved holiday for many as we cherish Dr. Jerry Shapiro memories of a favorite meal and a traditional family gathering. Just as important is the significance of the day that, together as a country, we express gratitude. Let us all take a moment to be thankful for what we have and the loving relationships in our lives.

Let’s Talk

Thanksgiving also marks the beginning of the annual holiday season and here at Uptown we already have on display the bulk of our unique holiday gift items. We invite you to come in and peruse the selection. Please note that our sales continue to increase so we encourage you to visit us soon to have the greatest variety to choose from!

The Classic 4% Rule Can Ruin Your Retirement There’s a simple old rule to help make sure you don’t run out of money in your retirement years—withdraw 4% of your investment portfolio in the first year of retirement, then increase the dollar amount each year by the previous year’s rate of inflation. Based on market history, that gives you a 96% likelihood that the money will last 30 years. The problem is that the 4% rule is no longer dependable. That’s because, after having experienced long bull markets, bond and stock returns are likely to be lower than historical

Some popular items from previous years are beautiful cashmere scarfs along with boxed and single holiday cards. (Holiday cards are 50% off before Christmas.) Exciting new development The concept of Wellness is important all year long but especially at Thanksgiving time. Many people, including both Jo Ann and I, take numerous medications for conditions such as diabetes, high blood pressure and ulcers. While these medications are needed, were you aware that these very medications and many others actually deplete nutrients from your body, which are essential for your overall wellness? The gradual nutrient depletion that many medications cause often “flies under the radar”. There are several ways that such depletion can occur:

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Medication stimulates increased excretion of the nutrient. Some pathway is blocked that is necessary for the nutrient’s existence.

averages over the next several years. In late 1994, when the 4% rule was popularized, the yield on a 10-year Treasury bill—a key benchmark for interest rates—was nearly 8%, compared with less than 2% recently. If yields remain near their current low levels for the next 30 years, the likely failure rate of a portfolio following the 4% rule would be 57%, not 4%. And even if five years from now yields are back up to historical averages, the likely failure rate still would be a worrisome 18%. A relatively weak stock market also will hurt returns. Two alternative strategies… Based on a 50% stocks/50% bonds portfolio, you withdraw 4% the first year, but in subsequent years, don’t

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Absorption into the body is blocked.

We now have a new program tied into our point of sale (register) system that will alert you when one of your medications has a tendency to deplete the nutrients you need with specific benefits of replacing these nutrients. Some of the more common drugs that cause depletion are birth control pills, statins for high cholesterol, proton pump inhibitors (Nexium®, Dexilant, Protonix) and Metformin. (Please note that we do not recommend that you stop taking these important medications.) Each time we scan one of your prescriptions our system will check to see if there is any depletion of essential nutrients that this medication may cause and can provide you with literature available about these nutrients that you could be needing. We are excited about providing this rare and valuable new service to you! From our family and staff, we wish you a great Thanksgiving with those you love!

increase the withdrawal amount if the portfolio has lost money in the previous year. This may require that you cut back on your discretionary spending after any losing years. Or, instead, to determine how much to withdraw from all your assets every year in retirement, use the same formula that the IRS uses to determine the required minimum distributions (RMDs) that you must make from your IRAs starting at age 70½. Each year, you calculate the maximum amount you can withdraw to make your money last the rest of your life based on your current life expectancy at that age and your portfolio’s current value. You can find the formula, including lifeexpectancy tables, at IRS.gov/ publications/p590b.

Let’s talk about cleaning things today:

Hints

To prevent mildew in your refrigerator wipe down the inside occasionally with white vinegar.

To clean from JoAnn underneath the fridge, fridge tie a sock around the end of a yardstick and go at it. For cleaning blenders & such, fill the container halfway with hot water & a couple of drops of dish detergent. Cover and blend; rinse and dry. Electric can opener opener: pener loosen dirt with a toothbrush & run a paper towel through the cutting assembly. Then spray with non-stick vegetable spray. To dissolve grease in a clogged drain, drain pour 1 cup salt and 1 cup baking soda down the drain followed by a large

amount of boiling water. For stainless steel sinks, sinks you can make them really shine with club soda or white vinegar. After normal use wipe with a damp cloth and dry with a soft cloth. To deep clean, wipe with a solution of ammonia and water or dish detergent and water. Dry thoroughly to avoid spots. Treat rust marks by rubbing with lighter fluid. Then wipe clean with a liquid cleaner. To clean copper pots: pots Fill a spray bottle with vinegar & 3 tablespoons of salt. Spray on the copper, let stand for a while, then rub clean. For burntburnt-on stains, stains sprinkle pots liberally with baking soda & add just enough water to moisten. Let stand for 3 hours, then lift the burned food right out of the pan! Clean your thermos by adding a few tablespoons of baking soda & filling with warm water. Let stand; rinse thoroughly.

just feel like they are perfect for harboring millions of germs. I do like the sponges with the rough side for scrubbing out hard-to-clean pots and pans, but end up throwing them out before their life cycle is over. What a waste! Instead, put them in the microwave for a couple of minutes and watch as the microbes sizzle away. Remove labels easily by adding a scoop of Oxiclean to a sink full of warm water and dumping all your labeled items in to soak. Walk away and in about 30 minutes all of the labels magically float off. Clean your iron: 1. Sprinkle a generous amount of salt onto your ironing board 2. Turn your iron to the highest setting, ensuring that the steam option is set to OFF. 3. When heated, iron over the salt-what happens is that the dirt sticks to the salt, leaving nothing but a wonderfully, shiny iron!

I kind of get grossed out by sponges. sponges I

Safer Travel With Your Pet

car. Warning: Don’t spray lavender oil onto a cat’s fur. Licking up lavender oil can cause stomach discomfort.

Are you taking a beloved pet on a road trip? Here’s some Be diligent with breaks. Pull into a rest area at least every advice to smooth out the ride… two hours to let your pet take a potty break, have a drink of Make your car car a safe place. If you’ve only had your pet out water (and maybe some food) and get some exercise for rare automobile rides to the vet (and he/she obviously outdoors (if you’re using a cat harness, be sure your cat is didn’t enjoy it), make a special effort to help your pet feel used to it before your trip)—a walk for 10 minutes or more safe and happy in your car. Play with your pet inside the is ideal. The exercise will be good for your road-weary body, vehicle with the engine turned off. Provide treats. Do this too. several times until the pet seems calm, then repeat the process with the engine on but the car stationary. Then take your pet on short drives, providing treats and comforting words along the way, before you attempt your big trip. Try lavender oil. Studies have shown that lavender can having a calming effect on nervous dogs (as it does with humans). Anecdotal evidence suggests that it works for cats, too. Mix 10 drops of lavender oil into one ounce of water in a spray bottle, then spray the inside of your vehicle approximately one hour before taking the pet on a ride. Bring the spray bottle along on your big trip, and give an additional spritz in the air if the animal shows any signs of anxiety or put a few drops on cloth strips and hang in the

(Continued from front page)

Then work on getting bills covered. Ask your insurer whether it will do so. You can also ask the healthcare providers who billed you to settle for what insurance has already paid them. "Some doctors will negotiate with you," says Pat Palmer, founder and CEO of Medical Billing Advocates of America, in Roanoke, Va. Your insurer may also negotiate on your behalf. If the insurer and health care providers won't budge, file an appeal with your insurance company. To bolster your case, ask your primary care doctor or specialist for a letter noting that your ER treatment was medically necessary. The Patient Advocate Foundation (patientadvocate.org) offers guidance at no charge. Professional claims

consultants will help for a fee or percentage of the amount reimbursed. You can find claims consultants via the National Association of Healthcare Advocacy Consultants (nahac. memberlodge.com) or Alliance of Claims Assistance Professionals (claims.org). Be aware that 23 states are working toward or already have some consumer protections against surprise medical bills. For example, in New York those bills can now go through independent dispute resolution if the health plan and provider don't agree on the payment amount. For more on state resources, go to ConsumersUnion.org/ surprise-medicalbills and click on "Get Help With a Bill."

VERY USEFUL WEBSITES

Idle Thoughts Of A Retiree's Wandering Mind • If the world were a logical place,

men would be the ones who ride horses sidesaddle. • They told me I was gullible

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don't talk about other people. •I used to be indecisive. Now I'm not

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on the ground, and I'll show you a man who can't get his pants off. • Experience is the thing you have left

when everything else is gone.

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