Open enrollment for Medicare ends on Dec 7. The federal health insurance program is for anyone aged 65 or older. Some people younger than 65 with certain disabilities or conditions, limited income and resources can also get coverage.
Health research organization KFF reports 43% of Illinoisans have Medicare Advantage and 57% opted for traditional Medicare coverage.
Stephani Becker, associate director of health care justice at the Shriver Center on Poverty Law in Illinois, explained the program.
"It covers inpatient care in hospitals, services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and many preventive services," Becker outlined. "That's your Medicare Part A and Part B. Then there's a part D, which is a drug-coverage program."
KFF also noted in 2025, Medicare beneficiaries will pay no more than $2,000 out of pocket for prescription drugs covered under Part D, Medicare's outpatient drug benefit, due to a provision in the Inflation Reduction Act of 2022.
Another important distinction to know is the difference between the original Medicare and Medicare Advantage. Traditional Medicare does not cover dental, vision and hearing insurance. However, many Medicare Advantage programs do. Becker emphasized it is important to review all documentation carefully to understand exactly what is in private plan coverage.
"One is the premium, which is what you pay monthly to your health insurance company," Becker pointed out. "Then the second is your out-of-pocket costs, so things like copays and coinsurance and deductibles, and that's the type of payment that you use when you use your insurance."
JustPlainClear.com and MedicareMadeClear.com are good websites to explain various health care plans for members and caregivers.
Becker adds someone who is self-employed and not eligible for Medicare can buy a plan for themselves on the marketplace and may be eligible for premium assistance. A slightly larger business with two or more employees, for example, can work with a broker and buy a small group health plan.
Meanwhile, open enrollment dates vary for other types of health plans. People with employer-sponsored coverage typically select a plan during a two-to-three week period between September and December. And open enrollment for plans on the Health Insurance Marketplace generally runs from November 1 to January 15 in most states. More information is available at www.UHCOpenEnrollment.com.
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Community Health Centers are stepping up to meet a critical need for dental care across Tennessee.
Dental visits at these clinics have increased by 19% and patient numbers have risen by nearly 16%, underscoring the importance of these services.
Libby Thurman, CEO of the Tennessee Primary Care Association, said the demand has grown, especially as more people have gained dental coverage through TennCare, the state's Medicaid program. Thurman explains TennCare did not cover dental services for adults until recently, although it did cover children.
"In 2023, the state expanded access to dental services under TennCare for adults," Thurman noted. "We have had some challenges keeping up with that demand, and that really stems from just making sure we have enough dentists to serve all of those patients."
In 2023, Community Health Centers in the state provided more than 79,000 dental visits to more than 35,000 patients. Across the state, 24 of the 30 health centers now offer dental health services.
Thurman stressed the importance of having access to dental care, since it is so closely tied to a person's overall health. She added the clinics integrate dental services into their broader mission of providing whole-person care.
"Dental care, aside from just oral health, actually has a lot of links to systemic health," Thurman explained. "It's linked to a lot of chronic disease management - so, if your oral health care is unmanaged, likely your chronic disease could be worsened."
Thurman emphasized Community Health Centers provide care to all, regardless of a person's insurance or income status. They also have a sliding-fee scale, so patients are often able to get dental care at a lower cost than they might find elsewhere.
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Groups across the state are working to reduce overdose deaths among minority populations.
According to state data, overdose deaths are on the decline but among Black residents, there were around 68 deaths per 100,000 people last year; more than 51% greater than the overall rate of deaths.
Matt Johnson, board member of the nonprofit CARES Coalition in Franklin County, said the county is struggling with a lack of emergency shelter and medical services for undocumented individuals. The coalition's Community Connectors Project aims to go door-to-door in neighborhoods to help residents access the services they need.
"People who don't necessarily have a visa or a green card, or even health insurance," Johnson outlined. "We need them to be able to go and receive services; for kids to be able to see dentists, especially within our minority population has been a challenge."
The coalition is one of 10 organizations awarded $50,000 grants from the Foundation for a Healthy Kentucky's Funding for Recovery Equity and Expansion program, a partnership with the Cabinet for Health and Family Services' Kentucky Overdose Response Effort.
In Western Kentucky, the Four Rivers Foundation has expanded mental health and health care services in underserved schools.
Dr. Alex Wright, CEO of Wright Medical who works with the foundation, said gaps in access often result in students either not receiving or experiencing long delays in care. He noted so far, more than 3,000 students have been served in the classroom.
"In some of our districts, we estimated up to 50% of children were lacking any continuity of health care," Wright reported. "Many of these children haven't had a pediatrician or primary care provider, usually since they were an infant or a toddler."
Research points to increased stigma surrounding substance use disorder and mental health in communities of color. According to the Yale School of Medicine, treatment inequities persist. Nationwide in 2018, the majority of Black and Hispanic people diagnosed with the substance use disorder did not receive treatment.
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By Cat Sandoval for WISH-TV.
Broadcast version by Joe Ulery for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration
Respiratory syncytial virus (RSV) is on the rise in Indiana, according to the Centers for Disease Control and Prevention, and it's forcing some hospitals to implement visitor restrictions.
Dr. Christopher Doehring, of Franciscan Health in Indianapolis, spoke with News 8 about why this respiratory virus increases during winter months and what hospitals are doing to prevent its spread.
"Like most of the respiratory viruses, as the weather turns cooler and people spend more time inside and around each other, its a just a highly contagious respiratory virus," Doehring said. "Like all respiratory viruses, we tend to see an increase in cases this time of year."
Holiday get-togethers can help spread the virus.
"You start to see around Thanksgiving time, you start having families coming together," Doehring said. "They're spending times in doors and it's multiple generations together. It's a natural epidemiologic phenomenon."
According to medical experts, RSV causes infections in the lungs. In healthy adults and older children, symptoms are mild, similar to the common cold.
RSV can be prevented by using good hygiene, such as washing hands and avoiding touching one's face.
Doehring said babies, premature babies, and immunocompromised elderly adults can experience severe cough, shortness of breath, and pneumonia, or even death. Doehring recommends getting vaccinated.
"Once you have the symptoms or are under the weather, take the time to recover, heal, and minimize exposing others as best as you can," Doehring said.
At Franciscan Health Hospital, masks and hand sanitizers stations are readily available to prevent the spread. Those under the age of 18 because younger visitors are more likely to spread respiratory viruses. Other hospitals in Marion County are doing the same.
Doehring says he has seen an increase of RSV cases, which is typical this time of year, but it's not alarming.
"Certainly in our hospitals and around other hospitals in central Indiana, we're not at a point where we're overrun or overcrowded in our ICUs or emergency department," Doehring said.
Cat Sandoval wrote this article for WISH-TV.
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