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Are you using Medicare’s free preventive services to stay healthy?

Lorraine York Edberg headshotLorraine York-EdbergPreventative services are an easy and great way to stay healthy. Medicare has been offering free preventive services for over 20 years and has increased benefits to help prevent illness. Paying attention to your body and keeping up to date on your preventive services will help find health problems early, when treatments work best. Things like exams, lab work, screenings, monitoring and counseling are all part of the services offered. Medicare provides and pays for a number of preventive services through Part B of Medicare. Many of these services are FREE whether you have traditional Medicare or a Medicare Advantage plan, like an HMO or PPO.

Free services include:

Welcome to Medicare preventive visit

Medicare covers a one-time preventive visit within the first 12 months that you have Medicare Part B.

Wellness visit

All Medicare beneficiaries are eligible for an annual preventive wellness visit. Not to be confused with full physical examinations, these are prevention-focused visits to provide an overview of your health and medical risk factors and serve as a baseline for future care. 

Colorectal cancer screening

The fecal occult blood test, flexible sigmoidoscopy or colonoscopy is available to all beneficiaries age 50 or older.

Mammograms

All women with Medicare ages 40 and older can get a free breast cancer screening mammogram every year.

Pap tests and pelvic exams

These cervical and vaginal cancer screenings are available every two years, or once a year for those at high risk.

Prostate cancer screenings

Annual PSA (prostate-specific antigen) blood tests are available to all male beneficiaries age 50 and older.

Cardiovascular screenings

Free blood tests to check cholesterol, lipid and triglyceride levels are offered every five years to all Medicare recipients.

Diabetes

Screening is available twice a year for those at risk.

Bone mass measurements

This osteoporosis test is available every two years to those at risk, or more often if medically necessary.

Abdominal aortic aneurysm screening

To check for bulging blood vessels, this test is available to men, if they are at risk due to a family history or men ages 65 to 75 who have ever smoked.

Vaccinations

An annual flu shot, a vaccination against pneumonia and the hepatitis B vaccine are all free to all beneficiaries.

In addition, Medicare also offers free smoking cessation counseling, medical nutrition therapy to help beneficiaries with diabetes or kidney disease, depression screenings, alcohol screening and counseling, obesity screening and counseling, annual cardiovascular risk reduction visits, sexually transmitted infection screening and counseling, and HIV screenings.

Click here for a complete list of free preventive services. We have the most updated copies of the “Guide to Medicare’s Preventive Services” available at our regional office and would be happy to mail a copy to those who are interested. Please contact us at the number below to get your copy.

The SHINE program (Serving Health Information Needs of Everyone…on Medicare) provides free, confidential and unbiased health insurance counseling for Medicare beneficiaries. To reach a trained and certified counselor in your area, contact the regional office at 1-800-498-4232 or 413-773-5555 or contact your local council on aging.

Revocable Living Trusts

Pam OddyAttorney Pamela OddyRevocable Living Trusts are a nifty device to avoid probate, to provide continuity of ownership and to protect the person who establishes the Trust. Anyone who is trying to establish an estate plan or who already has an estate plan but is looking to review it should seriously consider the benefits of a Revocable Living Trust.

It is called a Living Trust because it is drafted and becomes effective while the person is alive (hence, living) and it may own certain assets such as real estate or checking and savings accounts as well as some stock portfolios. Oftentimes, when the trust is drafted, the home is the most common asset that is deeded into the trust. However, vacation homes and bank accounts, including Certificates of Deposit, may be owned by the Trust as well.

The person who establishes the Trust (the settlor) is often the Trustee and the beneficiary. For tax purposes, it is a grantor trust so that any income tax deduction that the settlor received prior to the establishment of the Trust may still be claimed on the settlor's individual tax return. In other words, the Trust does not require its own separate tax identification number nor does it require its own tax return.

Succession is built into the Trust so that it is clear who becomes Trustee if the initial trustee/settlor dies or becomes incompetent. The Trust also has provisions that define how and to whom and in what proportions the trust assets are to be distributed after the death of the settlor. As part of the overall estate plan, a settlor's Will is often re-drafted to state that all assets are left to the Trust. It is called a "pour over'' Will.

The Trust is revocable so that the settlor may change the terms of the Trust, including who the successor trustee is as well as the beneficiaries. The Trustee may also add assets to the trust at any time.

There is a lot to like about this type of trust including the fact that the Trustee is in complete control of the trust and assets that are owned by the Trust avoid probate and pass on to the person(s) named as the beneficiaries in the Trust.

The most serious drawback of this Trust is that the assets owned by the Trust count toward the asset limit for most needs-based public benefits, including MassHealth.  If more than $2,000 is owned by the Trust, a person could not qualify to receive MassHealth benefits.

However, it is still worth exploring this trust with an attorney with estate planning expertise to ascertain whether or not it would be beneficial.

The views expressed in this column represent general information. To address your particular and specific needs consult your own attorney. If you need help with referral to an attorney, contact the Franklin County Bar Association at (413) 773-9839 or the Worcester County Bar Association at (978) 752-1311. Elder law resources may be found through the National Academy of Elder Law Attorneys, Massachusetts Chapter, at massnaela.com or 617-566-5640.

Community Legal Aid (CLA) provides legal services free to people age 60 and older for civil legal matters with an emphasis on access to health care coverage (MassHealth and Medicare) and public benefits as well as tenants’ rights. A request for legal assistance can be made by phone at 413-774-3747 or toll-free 1-855-252-5342 during their intake hours (Monday, Tuesday, Thursday, and Friday from 9:30 a.m. to 12:15 p.m. and Wednesday from 1:30 p.m. to 4:15 p.m.) or any time online by visiting www.communitylegal.org.

It’s natural to be afraid after something scary or dangerous happens. When you feel you’re in danger, your body responds with a rush of chemicals that make you more alert. This is called the “flight or fight” response. It helps us survive life-threatening events.

illustration woman talking mental health professional NIHTalking with others about your feelings after a trauma can help you to recover. You may wish to talk with a mental health professional if your symptoms persist.But the brain’s response to frightening events can also lead to chronic problems. This can include trouble sleeping; feeling on edge frequently; being very easily startled, anxious, or jumpy; having flashbacks; or avoiding things that remind you of the event.

Sometimes these symptoms go away after a few weeks. But sometimes they last much longer. If symptoms last more than a month and become severe enough to interfere with relationships or work, it may be a sign of post-traumatic stress disorder, or PTSD.

“There are real neurobiological consequences of trauma that are associated with PTSD,” explains Dr. Farris Tuma, who oversees the National Institutes of Health (NIH) traumatic stress research program. NIH-funded researchers are uncovering the biology behind these brain changes and looking for ways to prevent and treat PTSD.

What is trauma?

“Most people associate post-traumatic stress symptoms with veterans and combat situations,” says Dr. Amit Etkin, an NIH-funded mental health expert at Stanford University. “However, all sorts of trauma happen during one’s life that can lead to post-traumatic stress disorder and post-traumatic stress disorder-like symptoms.”

This includes people who have been through a physical or sexual assault, abuse, an accident, a disaster, or many other serious events.

Anyone can develop PTSD, at any age. According to the National Center for Post-Traumatic Stress Disorder, about 7 or 8 out of every 100 people will experience PTSD at some point in their lives.

“We don’t have a blood test that would tell you or question you can ask somebody to know if they’re in the highest risk group for developing PTSD,” Tuma says. “But we do know that there are some things that increase risk in general and some things that protect against it.”

Biology of traumatic stress

Researchers are looking into what puts people at risk for PTSD. One team, led by Dr. Samuel McLean, a trauma expert at the University of North Carolina, is investigating how post-traumatic stress symptoms develop in the brain. They will be following 5,000 trauma survivors for one year.

“We’re enrolling people who visit trauma centers immediately after a trauma because evidence suggests that a lot of the important biological changes that lead to persistent symptoms happen in the early aftermath of the trauma,” McLean says.

They’re gathering information about life history prior to trauma, identifying post-traumatic symptoms, collecting genetic and other types of biological data, and performing brain scans. The study is also using smart watches and smartphone apps to measure the body’s response to trauma. These tools will help researchers uncover how trauma affects people’s daily lives, such as their activity, sleep, and mood.

“Our goal is that there will be a time when trauma survivors come in for care and receive screening and interventions to prevent PTSD, just in the same way that they would be screened with X-rays to set broken bones,” McLean explains.

Coping with trauma

How you react when something traumatic happens, and shortly afterward, can help or delay your recovery.

“It’s important to have a coping strategy for getting through the bad feelings of a traumatic event,” Tuma says. A good coping strategy, he explains, is finding somebody to talk with about your feelings. A bad coping strategy would be turning to alcohol or drugs.

Having a positive coping strategy and learning something from the situation can help you recover from a traumatic event. So can seeking support from friends, family, or a support group.

Talking with a mental health professional can help someone with post-traumatic stress symptoms learn to cope. It’s important for anyone with PTSD-like symptoms to be treated by a mental health professional who is trained in trauma-focused therapy.

A self-help website and apps developed by the U.S. Department of Veterans Affairs can also provide support when you need it following a trauma.

“For those who start therapy and go through it, a large percentage of those will get better and will get some relief,” Tuma says. Some medications can help treat certain symptoms, too.

PTSD affects people differently, so a treatment that works for one person may not work for another. Some people with PTSD need to try different treatments to find what works for their symptoms.

Here are several tips that may help with trauma recovery:

  • Talk with others about how you feel. Don’t isolate yourself.
  • Calm yourself. Try meditation or deep breathing exercises. Do physical activity, like walking or yoga.
  • Take care of yourself. Get plenty of sleep. Eat a healthy diet. Drink enough water.
  • Avoid using alcohol, drugs, and tobacco.
  • Get back to your daily routine. Do the things you would normally do, even if you don’t feel like it.
  • Get involved in your community. Volunteering is a great way to create a sense of meaning.
  • Get help if symptoms persist. Talk with a mental health professional.
  • If you’re trying to help a friend, listen and find out where they are in the coping process. Try to accept their feelings and help in any way you can.

Finding treatments

“While we currently diagnose this as one disorder in psychiatry, in truth, there’s a lot of variation between people and the kinds of symptoms that they have,” Etkin says.

These differences can make it difficult to find a treatment that works. Etkin’s team is trying to understand why some people’s brains respond to treatment and others do not.

“PTSD is very common. But the variety of ways that it manifests in the brain is vast,” Etkin explains. “We don’t know how many underlying conditions there are, or distinct brain problems there are, that lead to PTSD. So we’re trying to figure that part out.”

His team has identified brain circuits that show when therapy is working. They’ve found a separate brain circuit that can predict who will respond to treatment.

His group is now testing a technique called noninvasive brain stimulation for people who don’t respond to treatment. They hope that stimulating certain brain circuits will make therapy more effective.

Most people recover naturally from trauma. But it can take time. If you’re having symptoms for too long—or that are too intense—talk with your healthcare provider or a mental health professional. In times of crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or visit the emergency room.

“PTSD is real. This is not a weakness in any way,” Tuma explains. “People shouldn’t struggle alone and in silence.”

Article adapted from the National Institutes of Health June 2018 News in Health, available online.

Village Neighbors, a volunteer non-profit community of neighbors in Shutesbury, Wendell, Leverett, and New Salem, will begin offering services by October 2018 to help elders live independently at home. Village Neighbors welcomes new friends to become helpful volunteers, to be members, as well as to join one of the supportive committees.

Volunteers will provide assistance to members with occasional household tasks, yard work, or minor home repair, as well as technical support for electronic devices and simple computer problems. They will also provide transportation to various appointments, visits with friends, social and cultural events, or grocery or other shopping trips. Additionally, Village Neighbors will provide referrals to vendors such as landscapers, house cleaners, repair persons or home health providers. A simple phone call to a central number will allow members to request a service. Subsidized and waivered membership will be available where there is a need.

Representatives from Village Neighbors will be available at the following events:

  • Saturday, July 21, 10 a.m. to 2 p.m.: New Salem Old Home Day
  • Saturday, September 29, 10 a.m. to 2 p.m.: Celebrate Shutesbury

Village Neighbors belongs to the national Village to Village Network and works closely with the nonprofit social services agency, LifePath, in Greenfield and local councils on aging.

For additional information, call 413-345-6894, This email address is being protected from spambots. You need JavaScript enabled to view it. or visit Village Neighbors online.

Standing up for elders and people with disabilities

Warren Official PortraitSenator Elizabeth WarrenOne of my top priorities in the U.S. Senate is working to strengthen the economic security of seniors and people with disabilities in Massachusetts. But today, some in Washington are trying to tear apart critical programs that help people live their lives with dignity.

Last year, President Trump and congressional Republicans tried to repeal the Affordable Care Act and gut the Medicaid program that helps millions of seniors stay in their homes and live independently, and also helps pay for nursing home care for loved ones. We fought back tooth and nail and saved those critical programs. We also stopped an effort to slash the budget of the already cash-strapped agency that runs Social Security. Budget cuts have forced the Social Security Administration to cut thousands of jobs and close 64 field offices since 2010 in towns like Greenfield, leading to outrageously long wait times and leaving many older people and Americans with disabilities struggling to get their benefits. We stood up against additional cuts – and in the last budget, I helped get a $480 million increase for the agency. This was the first increase to the Social Security Administration’s operating budget in eight years.

But the fight isn’t over. President Trump’s new proposed budget is a direct attack on older Americans and people with disabilities. It contains deep cuts to the SNAP program, which helps elderly people put food on the table. It would also eliminate the Low Income Home Energy Assistance Program, which helps low-income people – including the elderly – stay warm during winters in the Commonwealth. It cuts tens of billions from Social Security’s disability benefits and guts Medicaid once again, threatening health care for low-income seniors and people with disabilities. Meanwhile, efforts continue in Washington to privatize and cut benefits for millions of seniors who rely on Social Security to survive.

At the same time the president has proposed these cuts, Congress recently voted to award $1.5 trillion in tax breaks to billionaires and giant corporations. These are exactly the wrong priorities for our country. The federal government should be investing in America’s families, and it should make sure we keep the promises we’ve made to seniors, families, and people with disabilities.

I will fight to preserve and strengthen programs like Medicare, Social Security, and Medicaid. People in Massachusetts deserve a Washington that works for them, and I’m committed to doing my part in the Senate to ensure that all Americans can retire and live with dignity.

If you would like to contact me about any issues you’re concerned about, or if you need help with a federal agency, please don’t hesitate to call my Western Massachusetts office in Springfield at 413-788-2690 or email me.