ACA Open Enrollment

The Affordable Care Act (ACA; aka Obamacare) Health Insurance Marketplace begins its sixth Open Enrollment period today. American healthcare consumers can sign up on the federal insurance exchange at healthcare.gov or through their state marketplaces. Last year there was increased confusion surrounding Open Enrollment due to changes (and attempted changes) made to the ACA under the Trump administration, leading to the U.S. uninsured rate to rise for the first time since 2014 and the largest single-year increase since 2008.

Open Enrollment period ran 90 days after November 1 until the end of January during the Obama administration but was cut to 45 days in 2017 unless you qualify for the Special Enrollment Period, extending the enrollment period by an additional 60 days. Further limiting access to enrollment, the healthcare.gov website has scheduled weekly 12-hour maintenance outages. Advertising and outreach budgets for Open Enrollment are also cut even more than last year.

New rules put out by the Trump administration this year allow ACA subsidies to be used for short-term, low-benefit insurance plans that can deny coverage based on pre-existing conditions. These plans often have lower premiums than plans that offer Essential Health Benefits, but these changes along with the repeal of the individual mandate have actually made premiums across the marketplace 6-16% higher than they would be otherwise. For many this drastically changes the Affordable Care Act and potentially changes the nominal Obamacare to “Trumpcare” despite protestations that any failures of the law remain the fault of the original authors regardless of the Trump administration’s enacted changes.

openPosterThumbSince federal resources are refraining from outreach, organizations such as Get America Covered are reaching out to combat misinformation and encourage enrollment. There is no longer a penalty for not having health insurance starting in 2019, but even healthy people can be faced with extraordinary costs for unforeseen health reasons—especially those without insurance. For those who have applied through insurance exchanges in previous years, they have to update their information and compare their options for 2019. If you have questions about signing up or want to talk through your options with a trained professional, free assistance can be reached by calling 1-800-318-2596 or visiting http://localhelp.healthcare.gov.

NeedyMeds will continue to provide information as the need for assistance navigating the often expensive landscape of healthcare rises. The NeedyMeds website has databases of Patient Assistance Programs (PAPs), Diagnosis-Based Assistance (DBAs), and Free/Low-cost/Sliding-scale Clinics to help those in need. The NeedyMeds Drug Discount Card can save users up to 80% off the cash price of prescription medications for those without insurance or choose to use the card instead of insurance. In addition to the plastic card, the card is available in a printable form or a smartphone app for Apple and Android devices. For more help finding information, call our toll-free helpline Monday-Friday 9am-5pm Eastern Time at 1-800-503-6897.

Breast Cancer Awareness Month

For more than 30 years, October has been National Breast Cancer Awareness Month in the U.S. Breast cancer is the second most common cancer among women, second only to skin cancer. With more than 240,000 women diagnosed each year, awareness can save lives through early detection and lowering risk.

The main risk factors of breast cancer include being a woman and being older, which means almost any woman can be diagnosed with no family history or other known risk factors. The Centers for Disease Control and Prevention (CDC) recommends healthy living habits such as maintaining a healthy weight, regular exercise, getting plenty of regular nighttime sleep, avoiding carcinogens, and encourages women to breastfeed their children. These steps may help to reduce one’s risk to breast cancer.

NBCAMThe US Preventive Service Task Force recommends that women between the ages of 50 to 74 should have a breast cancer screening called a mammogram every two years. Women in their 40s should begin consulting with a doctor about when to start and how often to get screened, often influenced by any family history of breast cancer. About 10% of breast cancer cases are found in women younger than 45 years old. Men can also get breast cancer, though it is rare; less than 1% of breast cancer diagnoses are found in men.

Breast cancer can present with a wide variety of symptoms or none at all. Symptoms can include a change in size or shape of one’s breast, pain in the area, nipple discharge other than breast milk, or a lump in the breast or underarm. These symptoms can be serious and a doctor should be consulted immediately. Mammograms cannot prevent breast cancer, but it is much easier to treat when detected early. More than 40,000 women die from breast cancer in the U.S. each year.

NeedyMeds has over 200 national, state, and local programs that help individuals diagnosed with or at risk for breast cancer.  These Diagnosis-Based Assistance programs provide financial assistance, mammogram screenings, medical equipment, prostheses, and more. We have a Diagnosis Information Page for Breast Cancer, a collaborative effort between NeedyMeds and the American Breast Cancer Foundation (ABCF). We also have records on more than 4,500 free, low-cost, or sliding scale medical clinics that offer women’s health services. Search your ZIP code and check for “Women’s Health” listed by Services to find locations near you. For assistance finding help near you, check the NeedyMeds website or call our toll-free helpline at 1-800-503-6897.

Improving Health Education & Literacy

Since 1999, October is Health Literacy Month. This week is also National Health Education Week. Health literacy is defined as the degree to which an individual has the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Being able to comprehend health information allows people to navigate the healthcare system, keep track of their medical history, competently engage in self-care, and understand probability of health risks.

Health literacy is the main form of defense against misinformation prevalent in our society. Knowledge of the facts is key to combat the influence of those who would fly in the face of medical and scientific studies on subjects such as vaccinations or family planning services.  Dangerous pseudoscience can be avoided, saving individuals money and suffering at the hands of those who either don’t know or don’t care. Despite this, only 12% of adults have “Proficient” health literacy according to the National Assessment of Adult Literacy. This means nearly nine out of ten American adults may lack the knowledge necessary to manage their health and prevent disease. Populations most likely to experience low health literacy are the elderly, racial and ethnic minorities, people with less than a high school-equivalent education, people with low-income, non-native English speakers, and individuals with compromised health status.

 

NeedyMeds’ BeMedWise Program also recognizes October as Talk About Your Medicines Month (TAYMM) as an opportunity to focus attention on the value that better medicine communication. For over 30 years, TAYMM has been a time to stimulate conversations between patients and their healthcare providers about all the types of medicines they may take, with a focus on what to know about a medication in terms of expected health outcomes, possible side effects, benefits and potential risks.

The primary responsibility of improving health literacy lies with health officials and the healthcare and public health systems. When faced with one’s own health or the health of a loved one, a person can inform themselves and hold a more active role in their health education. NeedyMeds has Diagnosis Information Pages to help individuals learn about conditions that they or a loved one have been diagnosed with. Many of our Diagnosis Information Pages are co-sponsored by partner organizations, offering their expertise to the information we offer and ensuring accurate and up-to-date resources for the diagnoses they focus on. We also list free and low-cost clinics, some of which offer health education services. Search your ZIP code for locations near you that offer Health Education under the Details column. For more information, call our toll-free helpline at 1-800-503-6897 Monday through Friday 9am to 5pm Eastern Time.

Mental Illness Awareness Week

For over 25 years, the first full week of October has been Mental Illness Awareness Week. One in five, or 20% of the population, live with some kind of mental health condition, with one in 25 living with a serious mental illness that substantially limits one’s life activities. Those living with mental illness fight stigma while trying to survive under internal duress. Awareness is important so that resources are made available to those who need them and the stigma and misconceptions surrounding mental illnesses can be reduced.

Everyone has stress and difficult emotions on occasion, and this is completely normal. Mental illness, however, is any condition that makes it difficult to function in daily life. It can affect relationships or job performance, and is caused by any number of complex interactions within the human brain. Mental illness can range from anxiety or mood disorders like depression, psychotic disorders like schizophrenia, to eating disorders or addictive behaviors.

Screen Shot 2014-04-23 at 2.39.30 PMDepression is the leading cause of disability in the world and includes 16 million American adults living with major depression. Eighteen percent of adults in the US experience anxiety disorders such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and/or specific phobias ranging from a fear of spiders to a fear of pickled vegetables.

Mental illnesses do not just present in adults. More than one out of five adolecents aged 13-18 (21.4%) have experienced a severe mental disorder at some point during their life, with 13% of children 8-15 experiencing the same. Seventy percent of the youth in the juvenile justice system have at least one mental health condition and at least 20% live with serious mental illness. Half of all chronic mental illnesses begin by age 14.

Mental illness is prevalent in homeless populations, with an estimated 26% of adults staying in shelters living with serious mental health conditions and approximately 46% with both mental illness and/or substance abuse. One in five state prisoners have a recent history of mental illness. Mood disorders such as depression or bipolar disorder are the third most common cause of hospitalizations in the US across ages 18-44. Serious mental illness costs America $193.2 billion in lost earnings per year.

HealthWeb Navigator has a collection of the most accurate websites for mental health resources NeedyMeds has Diagnosis Information Pages for various mental illnesses including depression, obsessive-compulsive disorder, and schizophrenia. We also have information for over 3,000 free, low-cost, or sliding-scale clinics throughout the country that offer counseling or mental health services. Search your ZIP code for clinics that may offer Counseling/Mental Health Services near you, or call our toll-free helpline for information at 1-800-503-6897 (open Monday through Friday, 9am to 5pm ET).

We encourage everyone to educate themselves, strive to understand the difficulties people around us live with, and to replace stigma with hope and support. If you or someone you know is suffering from a mental illness, it is important to know that no one is alone in their struggle. Call for assistance, whether help is needed immediately or long-term.

National Suicide Prevention Lifeline, available 24/7: 1-800-273-TALK (8255)

How Do I Boost My Immune System?

by Richard Sagall, M.D.

 

With colder weather fast approaching everyone is concerned over coming down with colds, the flu, or other winter-time illnesses. It makes sense to take steps to stay healthy. The idea of “boosting your immune system” sounds inviting. But what does this really mean, and can it be done?

 

What is the Immune System?

The immune system consists of the parts of the body that fight infections. There are three body parts generally considered part of the immune system.

·   The lymphatic system consists of lymph nodes that filter the lymph fluid and lymph vessels that carry away waste materials. Lymphocytes also enter the lymph fluid and destroy bacteria, viruses and other foreign substances.

·   The bone marrow produces various types of white blood cells that fight infection. Red blood cells are also made in the bone marrow, but they have no role in immunity.

·   The spleen filters the blood, removing old and damaged red blood cells, white blood cells, platelets, and other foreign substances.

 

What Does the Immune System Do?

Simply put, the immune system keeps you healthy by fighting off invaders such as viruses, bacteria, fungi, parasites and other nasty organisms. When working properly, it quickly destroys the invaders, preventing illness and harm to your body.

The white blood cells are the first line of defense for invading bacteria and viruses inside infected cells. They work by killing and then removing them from the body. Antibodies are the first line of defense against viruses in the blood.

When working properly, the immune system distinguishes your cells from the invaders. However, when not working properly the immune system may overreact to harmless environmental substances such as pollen, resulting in the release of histamines which cause the symptoms associated with allergies

In other cases, the white blood cells may mistake a person’s own cells for invaders, resulting in potentially serious conditions call autoimmune diseases. A few examples are rheumatoid arthritis, lupus, celiac disease, and others.

 

How Do Antibodies and Antigens Fit into the Picture?

Antigens are substances that the body recognizes as foreign and cause an immune response – the creation of antibodies. Antigens are found on the surface of invaders and cells infected by them. Each invader has its own antigens that differ from other invader’s antigens. Even different strains of the same virus may have different antigens. The flu virus mutates or changes every year so it has different antigens. That’s why you need a flu shot every year.

Antibodies are proteins that attach to specific antigens. They help the white blood cells recognize and destroy the viruses, bacteria or fungi invading the body. In most instances, once the immune system has successfully repelled a certain type of invader, immunity develops to that specific germ. This means the immune system is “primed” in case the same invader attacks again and can effectively fight it before you get sick.

Many illnesses, such as the common cold, can be caused by hundreds or even thousand of different germs. That’s why people keep getting colds. Each is really a different illness – it’s just all have that same set of symptoms so we think it’s the same illness.

 

How Do I Keep My Immune System Working Well?

According to the Harvard Healthbeat, you should:

·     Not smoke

·     Eat a diet high in fruits and vegetables

·     Exercise regularly

·     Maintain a healthy weight

·     If you drink do so in moderation

·     Get enough sleep

 

Where, you may ask, do vitamins, supplements, and herbs fit into keeping my immune system healthy?

If your diet is well rounded and includes a variety of fruits and vegetables, then you shouldn’t need any extra vitamins. Megadoses of vitamins have not been shown to have any positive effect on health or immunity. Similarly, no studies have demonstrated any beneficial effects of dietary supplements or herbs for healthy adults. That said, your doctor may recommend supplements for particular age groups or health conditions, including calcium or other nutritional supplements.

 

Is There Anything I Can Do?

Yes – there are steps you can take to lessen your chances of getting sick this fall and winter.

First, you can take steps to avoid becoming sick. These include good handwashing. Germs can be transmitted from one person to another by contact.

Try to avoid being around sick people. The problem is that for many common illnesses a person is contagious for a day or two before they display any symptoms.

Perhaps the most important thing you can do is be fully immunized and get a flu shot every year. Vaccines work by “fooling” your immune system into thinking you are infected with a certain illness. The immune system develops antibodies for the illness and thus is “primed” to fight that specific germ if you become exposed.

You can’t get the flu from the flu vaccine because the vaccine doesn’t contain the live virus. Yet some people do get flu symptoms after receiving the vaccination. There are a couple of explanations:

  • What the person has isn’t the flu. It may a respiratory illness caused by a different virus, but not the influenza virus.
  • The person had been exposed to the flu a day or so before getting the flu and there wasn’t enough time for her body to develop immunity from the shot.
  • The flu virus is one not included in the vaccine.

Overall, the benefits of being vaccinated for flu, shingles, and other immunizations recommended by your doctor, far outweigh any risks. Medically approved information about which immunizations are appropriate for each age group (adult and pediatric) are attached. More information can be found on the Center for Disease Control & Prevention website www.cdc.gov

 

Summary

The best way to stay healthy is eat a well-rounded diet, exercise, and be up-to-date on your immunizations. That includes getting a flu shot every year. There is no proof that multiple vitamins, specific vitamins or minerals, megadoses of any vitamin, herbs or supplement affect anything except your wallet.

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Pediatric Vaccine Schedule from the CDC

All of these childhood vaccines are given in a series of 2 or more doses, at specific ages.

For some of these vaccines, a booster dose is also recommended at 4-6 years of age.

A dose of flu vaccine is recommended every winter for children 6 months old or older.

 

Rich Sagall MDRichard J. Sagall, MD, is the president and co-founder of NeedyMeds. He spent 25 years practicing family and occupational medicine. He now devotes his time to NeedyMeds and Pediatrics for Parents (www.pedsforparents.com), a children’s health newsletter.