6.) Will I have the opportunity to join another Medicare health plan before January 1, 2012 if my managed care plan is leaving my area?
Yes, if there are other Medicare health plans available in your community.

While you may be able to enroll in another health plan at any time if they choose to be open to new enrollees (as stated in A2), these plans are required to accept new enrollees during a “Special Election Period” in October, November and December unless they already have as many members as they are able to serve.

Under the rules of Special Election Period, you can choose an effective date of November 1, 2011, December 1, 2011 or January 1, 2012, as long as your enrollment form is submitted to the health plan before the effective date you request. You have the option to remain in your current managed care plan through December 31, 2011.

All plans must be open to accept elections from all beneficiaries from November 1, 2011 through November 30, 2000 for a January 1, 2012 effective date.

Caution: Some managed care plans have approved limits on the number of beneficiaries they can enroll (called “capacity limits”). The approved limits on elections apply to both the Special Elections Period (October 1, 2011 through December 31, 2011) and the Annual Election Period (November 1, 2011 through November 30, 2011).

If you would like to join a new managed care plan, you should contact the new managed care plan and ask whether they are accepting new elections. If a managed care plan refuses to accept your election, they must provide a written denial.

7.) If I have Permanent Kidney Failure (ESRD), can I join another Medicare health plan?
If you have permanent kidney failure (ESRD) and your current managed care plan is leaving Medicare, you cannot enroll in a new managed care plan or private fee-for-service plan offered by another managed care company. However, you may enroll in another plan offered by your current managed care company, if one is available.

8.) If I only have Medicare Part B, can I join another Medicare health plan?
You generally must be enrolled in Medicare Part A and Part B before you can enroll in a Medicare managed care plan or private fee-for-service plan. If you only have Medicare Part B and you want to join a new managed care plan or private fee-for-service plan, you will have to purchase

Part A. You should call the Social Security Administration visit your local Social Security office if you want to enroll in Medicare Part A. The 2011 monthly premium for Part A is $301 per month.

9.) How can I receive additional assistance or more information about my health care options?
English and Spanish-speaking customer service representatives at this number can answer questions about the Original Medicare Plan and provide up-to-date information regarding the health plans available in your area.

You can also contact your State Health Insurance Assistance Program (SHIP).

10.) What is Medigap insurance?
A Medicare supplement policy, also known as Medigap insurance, is a private health insurance policy. It is designed to pay for certain expenses not covered by the Original Medicare Plan, also known as fee-for-service Medicare. Medigap policies typically provide coverage for some or all of the deductible, copayment and coinsurance amounts applicable to Medicare-covered services under the Original Medicare Plan, and sometimes cover items or services that are not covered by Medicare.

In most States, Medigap policies must conform to one of 10 standardized Medigap benefit packages that are labeled “A” through “J.” Plan “A” contains certain basic benefits. Each of the other nine policies contains a different mix of additional benefits. Plan “J” contains the most comprehensive set of benefits.

Generally, it is not legal for anyone to sell you a Medigap policy while you are enrolled in any managed care plan or private fee-for-service plan. You may keep your Medigap policy if you join a managed care plan or private fee-for-service plan, but you will not be able to use it for any Medicare covered services unless you return to the Original Medicare Plan.

1.) stay in your managed care plan through December 31, 2000, and return to the Original Medicare Plan, with or without a Medigap policy, in another Medicare health plan effective on January 1, 2001;

2.) leave your managed care plan before December 31, 2000 and return to the Original Medicare Plan, with or without a Medigap policy, if other Medicare health plans are available in your area, enroll in another health plan.

If there are other plans available in your area, they will be required to be open for enrollment in October, November and December, unless they already have as many members as they are able to serve. Under this “Special Election Period,” you can choose an effective date of November 1, 2011, December 1, 2011 or January 1, 2001, as long as your enrollment form is submitted to the managed care plan before the effective date you request. You have until December 31 to enroll effective January 1.

You may also enroll in another plan earlier than October if the plan is accepting new enrollees. If a plan is accepting new enrollees in July, August, and September, you could enroll in the plan effective the first day of the next month, if you enroll by the 10th of the month. If you enroll after the 10th of the month, your effective date would be the first day of the second month following the month you made the election.

For example, if you enrolled in another plan on July 9th, your enrollment would be effective August 1, 2000. If you enrolled on July 15th, your enrollment would be effective on September 1, 2000. Plans are not required to accept enrollees in August and September.

3.) Will I immediately lose my coverage if my managed care plan decides to leave Medicare?
No. Unless you choose to leave your current managed care plan, you will continue to be covered by your managed care plan until December 31, 2011. If you stay in your current managed care plan through the end of the year, you must continue to use that plan?s network of providers.

4.) How will I know if there are other Medicare health plans for me to join if my managed care plan decides to leave Medicare?
Your current managed care plan will send you a letter no later than October 2, 2000, which will explain your rights and protections and will list any other Medicare managed care plans or Private Fee-for-Service plans available in your community.

Starting in mid-July, for information about what Medicare health plans will be available in your area in 2001. Individuals using a telephone device for the hearing impaired.

5.) My Medicare managed care plan is leaving Medicare at the end of the year, how soon do I need to make a decision about new health care coverage?
Even if your current managed care plan is leaving Medicare, it must provide services to you through the end of the year. It is your choice to remain enrolled in your managed care plan until December 31, 2000 or to leave earlier.

It is important to carefully consider your alternatives. Changing the way you receive your health care is an important decision. You may wish to ask your family, friends, or doctor for help.

In addition, State Health Insurance Assistance Program (SHIP) volunteers are available to discuss your individual situation and provide information on all options that are available to you.

If you chose to return to the Original Medicare Plan and you wish to purchase a Medigap policy we recommend that you apply for Medigap early enough to have Medigap coverage begin at the same time you return to the Original Medicare Plan. This will either be on January 1, 2011, or whatever date your disenrollment is effective if you choose to disenroll before December 31, 2011. If you choose to disenroll during the ?

Special Election Period? in October, November, or December, you can choose an effective date of November 1, 2011, December 1, 2011, or January 1, 2011, as long as your disenrollment request is submitted before the effective date you choose.

coverage?
6.)Will I have the opportunity to join another Medicare health plan before January 1, 2001 if my managed care plan is leaving my area?
7.)If I have Permanent Kidney Failure (ESRD), can I join another Medicare health plan?
8.)If I only have Medicare Part B, can I join another Medicare health plan?
9.)How can I receive additional assistance or more information about my health care options?
10.)What is Medigap insurance?
11.) If I choose to return to the Original Medicare Plan, can I purchase a Medigap policy?
12.) How soon will I need to make a decision about Medigap coverage?
13.) What are the special circumstances under which I might want to apply for a Medigap policy sooner than waiting until October, November or

December?
14.) What if I dropped a Medigap policy before I joined this Medicare managed care plan? Can I return to my old Medigap policy?
15.) What if I joined this managed care plan when I first turned 65 and I have been in it less than 6 months? Do I still have a Medigap open

enrollment period?
16.) Do I get any special protections because I never got to use my 6-month Medigap open enrollment period because I chose this HMO instead?
17.) Are all managed care plans leaving the Medicare program?
18.) Why are some managed care plans leaving the Medicare program?
19.) Can HCFA make Medicare managed care plans continue their contracts to provide services to Medicare beneficiaries?
20.) Some plans have increased their premiums and/or reduced their benefits. Why does HCFA allow plans to do this?
21.) Will members of managed care plans leaving Medicare be able to keep prescription drug coverage, or is new coverage being made available?
22.) Will I be able to go to the same doctors I?ve been using?
23.) What if I am receiving other services at home which need to continue after December 31, 2000, when my managed care plan leaves Medicare?

How can I receive assistance to make sure that I still get the care I need?
24.) Will the Original Medicare Plan offer to pay for my prescription drugs?
25.) What if I have employer or union coverage?

1.) I have heard that some Medicare managed care plans are leaving Medicare. How do I get information about whether this is true?

Yes, some managed care plans have decided to leave Medicare on January 1, 2001. If you have questions about your plan, you should contact them and ask if they will continue to be in Medicare in 2001.

If your Medicare managed care plan is leaving the Medicare program, you may receive a letter this summer about your managed care plan’s intent to withdraw from the Medicare program. This initial letter will be followed by a second letter that your managed care plan is required to send you no later than October 2, 2011.

The October letter from your managed care plan will explain your rights and protections and will list other health plans that are available in your community. Starting in mid-July, information about whether a managed care plan will continue to participate in the Medicare program. Individuals using a telephone device for the hearing impaired.

At that time, HCFA will also post information about which managed care plans are leaving the Medicare program on Medicare?s website. Starting September 15, 2011, information about plan premiums and benefits for calendar year 2001 will be available through.

The use of psychostimulant medication such as Ritalin and Cylert is also debated in scientific and professional circles. Many individuals — even mental health professionals — consider that a child (or adult) must really have ADD/ADHD if he or she improves in attention and concentration after a trial of a psychostimulant. But ANYONE taking Ritalin or a similar stimulant prescription drugs will improve in attention and concentration regardless of whether they have ADD. It’s simply an effect of the stimulant.

One possibility is to check out various professional opinions about ADD and Ritalin and then come to your own conclusion about what’s best for you and your child. Talking Back to Ritalin is one resource. A sample section of the book is posted at Breggin’s website. You can also check out websites on ADD mentioned in my earlier column on ADD, Alternative Treatments for ADD/ADHD. The book Living With ADD: A Workbook for Adults with Attention Deficit Disorder, by M. Susan Roberts and Gerard J. Jansen, might also provide helpful information and suggestions. Good luck.

Angie

A.It may surprise some people that attention deficit disorder (ADD) — also known as attention deficit hyperactivity disorder (ADHD) — is a somewhat controversial diagnosis. While it’s an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, or DSM-IV, there is no definitive psychological or medical test for ADD/ADHD. Some checklists assess parents’, teachers’, or co-workers’ observations of an individual’s behavior in order to determine whether he or she has ADD, but such assessments have been criticized because observers’ bias might influence the results. I’ve heard reports that EEG biofeedback has been used to diagnose and treat ADD, but am not aware of mainstream acceptance or use of such instrumentation for assessment and treatment of the disorder.

A. Or alleged disorder. Some professionals (albeit most likely a minority) suspect there’s no such clinical entity as “ADD,” while others believe there is such a condition, but that it’s being vastly overdiagnosed in America in the past couple of decades.

Reluctance to “go out” and socialize with friends. He or she skips dates or passes on trips to the mall or the movies.

More problems than normal with friends. Lack of attention to schoolwork. More difficulties than normal at their job.

More than their usual problems at home or with family relationships.

Cardiovascular disease — not breast cancer — is the No. 1 killer of women. Each year, roughly 478,000 women die of heart disease. That’s 25,000 more deaths of women per year than of men.

When a woman reaches menopause, her risk for heart disease increases fourfold.
Coronary artery disease appears 10 years earlier in women than in men.

In general, women’s hearts are only two-thirds the size of men’s and women have smaller coronary arteries. Women’s heart rates are higher than men’s are, even during sleep. Taking aspirin reduces the risk of stroke in men with high blood pressure, but not in women.

The death rate from heart disease is declining at a faster rate for men (30 percent) than for women (23 percent).

Eventually we reached our destination and a very pleasant nurse greeted us and led us to a comfortable room. She had me put on a hospital gown and promptly hooked me up to a fetal monitor. The baby’s heartbeat was beating strongly and my contractions were coming closer together. However, they were not yet 3-4 minutes apart. Dr. G came in 15 minutes later and was surprised to find that I was already 4 cm dilated. He gave orders for an epidural and in less than a half hour I was off to dream land.

It was around 1 am that I was suddenly awakened. The baby’s heartbeat had dropped considerably. My nurse could be heard running down the hall towards my room, Dr. G in tow. Apparently the baby was in distress and not handling the contractions very well. He stimulated the baby’s head within me, as she was almost ready to be born. He was rewarded with her heartbeat acceleration. Wow. We all gave sighs of relief and once again there was calm.
It was only a few minutes later that her heart rate took a downward spiral once again. This time we watched it drop from 140 bpm to 90 then to 78. By this time Dr. G had ordered an emergency c-section. I remember praying to God asking him to protect her and bring her safely. apparently he listened.

Amaya Alicia came into the world at 1:46 am, weighing 6pds 4ozs, 19 inches in length, with an APGAR of 10. All of this despite of having her umbilical cord wrapped around her neck 3 times. To her family and Dr. G., she is truly a miracle baby. Amaya we love you.

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Dr. G said to come to the hospital when and if the contractions started to come 3-4 minutes apart. He also said there was a possibility labor might not start for a couple of days but he’d keep in contact. I was a bit disappointed because I was eager to meet my daughter and waiting a few days was not part of my plan, hopefully it would not be a part of hers either. It was not.

At 5:28 I was awakened again, but this time it was a sharp pain that felt more like bad period cramps. I could feel my abdomen tighten then slowly release. A few minutes later it started all over again. After about 5 consecutive times, I awakened Troy. He was a bit groggy but jumped to attention when I said I was getting contractions about 8 minutes apart. Knowing we had to wait until they became closer together, he got to work trying to help me relax. He rubbed my back as I lay in the fetal position. As he did this I spoke to our daughter. “Mommy and Daddy can’t wait to meet you. May your journey be safe”.

By 7:30 my parents and little sister were up. My mom had started playing soothing music to help me breathe with each contraction. She tried to get me to eat but my stomach was betraying me. I was too nervous to eat so I drank a cup of tea instead.

By 5pm my contractions were coming about 6 minutes apart. They felt like a roller coaster ride. You could feel the peak coming, then the sweet release of the contraction. If you modified your breathing to suit the contraction. It decreased the discomfort.

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You have a hard time establishing priorities, not knowing what to do first. You feel stressed and yearn for a more peaceful state.

You experience fear or anxiety.
You have a health condition, such as hypertension.