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LYN’S LEDGER
Lyndon Thomas Insurance
July 2018
We Help You With Medicare.
Summers at the Shop
MEMORIES OF CHILDHOOD VACATIONS
M y parents met at college in Greenville, Illinois, an hour and a half east of St. Louis. They were from different states: Mom was from Michigan and Dad was from South Dakota. After they married, they moved back to the farm outside of Forestburg that Dad’s grandfather started in 1895. Mom always joked that if she had known where South Dakota was when Dad asked her to marry him, she would have said no. All kidding aside, Dad made good on his promise that he would make sure Mom got back every year to Michigan to visit her parents and family. A huge part of my growing up years were the summer trips to Albion, the southern Michigan town where Mom grew up. I loved my maternal grandparents immensely. Mixing more tenderness with love than sternness, Earl and Ruth Connor always welcomed their Dakota grandsons with open hearts and arms. Grandpa had a small barn called “The Shop,” where he worked his craftsmanship on everything he touched. After a 35-year career as a letter carrier with the United States Postal Service, The Shop was the realm where he was jack of all trades and master of none. Grandma’s kitchen was the source of so many wonderful things. We weren’t spoiled with candy, but my brother always got his box of Wheaties, and I got my Honeycomb! I’m sure that later in the day there was just the right amount of ice cream involved as well. Grandpa and Grandma worked together on a very large garden. By growing some of every kind of vegetable there, summer meals were delicious and nutritious. Grandpa was an avid fisherman and enjoyed taking his grandsons along with him for trout, bass, and bluegills, though rarely did he
take us both at the same time. The boat wasn’t big enough for the two brothers, and he did not enjoy arbitrating our sibling bickering. Individually as it was, he taught us to fish, though this prairie farm boy never really got the hang of it. Grandpa was disgusted by catching a huge carp on one fishing trip. He decided it would make better rose bush fertilizer than table fare. I remember the rose blooms being particularly spectacular a few weeks later. I learned to ride a bike there at 920 Burr Oak Street. Grandpa bought a small, used, hard-rubber-tire bicycle, suitable for 6-year-old grandsons. Since the bike had no training wheels and I had no cut-offs to wear, the right pant leg of my jeans would catch and tear on the pedal as I pushed myself. Numerous times Grandma graciously sewed the inseam on my jeans as she prayed I would learn to keep my balance. Late one afternoon, just before supper, magic happened! Without even thinking about it, my right foot matched my left foot on its pedal, and just like Bill Murray’s character in “What About Bob?” I was sa-a-ailing! Well, riding my bike. I rode it from the sidewalk along the house to the gravel driveway curving around past the other side of the house, then to the sidewalk along the street, and back to the sidewalk past the house. Round and round and round I went. I was so excited that I missed supper that night and didn’t mind going to bed hungry. It was awesome! And Grandma didn’t have to sew up any more of my pant legs! Visits with cousins, catching fireflies, boating at Uncle John and Aunt Marti’s, and so many more memories remind me that you don’t need to travel to exotic, expensive places to have an incredible summer vacation. I hope you have the chance to find yours this summer.
–Lyn Thomas
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Lyndon Thomas Insurance
THESE MALLS WERE MADE FORWALKING The Exercise Venue That Will Keep You Cool and Fit
You Asked For It …
Thank you to Elaine N. for this month’s question: Please explain the difference between Medicare HMOs and PPOs and the pros and cons of both.
Both Parts A and B must be effective to purchase Medicare Supplement and Medicare Advantage plans.
Let’s start with Original Medicare, also known as “Fee for Service.” Original Medicare is administered directly by the federal government, and the Medicare card is used at any provider in the U.S. that contracts with Medicare. Providers bill Medicare directly and receive payment after services have been delivered and cover inpatient and outpatient medical expenses. A Medicare Supplement Policy may be teamed with Original Medicare. A Medicare Supplement Policy (a.k.a. “Medigap” policy) dovetails with Medicare and pays for all of what Medicare doesn’t pay (Supplement F) or pays for most of what Medicare doesn’t pay (Supplement Plans G and N). Supplements are “secondary” to Medicare and will pay only when Medicare first approves and pays its portion for services. Medigap policies are often referred to as PPOs. A PPO is a type of insurance policy that affords the member the ability to access providers without a referral or approval from a network. With Original Medicare and Supplements, “PPO-like” flexibility of provider access is enjoyed because any provider throughout the U.S. that contracts with Medicare is available, even though Medicare and Supplements are not PPO insurance. Medigap policies do not include the Part D Prescription Drug Program. Part D Prescription Drug Coverage When using Original Medicare with or without a Supplement, a prescription drug coverage is provided by purchasing a Part D Drug Plan from a private insurance company. Original Medicare, plus a Supplement, plus a Stand Alone Part D is what I refer to as the “a la carte health plan,” as the member carries three ID cards, each of which fulfills a specific role in one’s health coverage, affording the member a remarkable degree of flexibility in provider access, premium, and low out- of-pocket expense. Medicare Advantage Plans Under the terms of the Medicare Advantage program, insurance companies contract with and are regulated by Medicare to provide all the benefits and services covered under Part A and Part B. A Medicare beneficiary enrolls their Medicare into the healthplan they join, and Medicare pays before services are received via a payment each month for that calendar year. Most Advantage plans in California are HMOs and build in the Part D to provide prescription coverage and are known as MA-PDs. Providers receive payments via the healthplan
If you’re young at heart and looking to stay (or get) in shape this summer, consider taking a trip to the mall. No, not to pick up some hot new exercise product or dietary supplement, but to walk a few laps. Safe and convenient, “mall walking” has become one of the biggest trends in senior fitness. COOL IN THE SUMMER, WARM IN THE WINTER This time of year, heatstroke can be a real concern when exercising outside. But that doesn’t mean you have to be a homebody. Because malls are spacious and climate-controlled, they make great year-round walking venues, especially when summer temperatures spike. You don’t even need to put on sunscreen! REST STOPS ABOUND While the average American shopping center isn’t as scenic as the Appalachian Trail, they are far more convenient. Replete with bathrooms, cool drinking water, and plenty of benches, the mall lets you focus on exercising and removes all of the “what ifs” that come with aging. Most malls are also outfitted with EMT kits in the event of a medical emergency. SQUEEZE IN SOME SHOPPING It is still a mall, after all. Why not check a few items off your shopping list or reward yourself with a new pair of sneakers? Getting things done as you exercise makes the experience that much more rewarding. Just remember not to overdo it. Carrying too many shopping bags can place undue stress on your back — and your wallet. YOU WON’T BE ALONE Today, malls are the second-most popular places to walk in America, after neighborhoods. Mall walking has become so big that many communities and senior living centers have put together official groups to stride together. Your local mall may already open early to accommodate walkers. So if you’re looking to make friends in an active, fun-loving community, do some research. Chances are there’s a mall- walking club near you!
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2 216-B E. Matilija St., Ojai, CA 93023 www.LT-ins.com CA# 0D96309
We Help You With Medicare.
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• More paperwork; member receives statements from four directions: Medicare, the Supplement company, the provider, and the prescription drug company.
and network, NOT from Medicare. HMOs or “managed care plans” require referrals from the network or medical group to see specialists and receive services beyond their Primary Care Physician. I refer to this approach as the “all on one card” plan because the member uses the healthplan ID card for all medical services and prescription drugs. Which approach is best depends on each individual’s situation. There is no one-size-fits-all solution. Let’s review the pros and cons of each approach.
Pros of Medicare Advantage:
• Low monthly premium (Ventura County, 2018, $41 or less) and out-of-pocket expense (copays) only if you have medical activity.
• “All on one card” simplicity, meaning less paperwork.
Pros of Original Medicare + Supplement + Part D Prescription Drug Program:
• Plan may provide additional services, such as optometry, hearing, dental, and transportation.
• Member has “go anywhere” flexibility without needing a medical group approval or network referral.
Cons:
• Monthly costs are more predictable. While Medigap premiums are higher, out-of-pocket expenses at time of service are greatly reduced (G & N) or eliminated (F).
• Member must receive medical group/network approval for all services beyond Primary Care (Preventative services not included). • Out-of-pocket expenses; copays vary month to month with an annual Maximum Out-of-Pocket limit. Medicare Advantage plans may not be available in all areas. Thank you, Elaine, for asking these questions! This article may have answered some questions and raised others. Never hesitate to contact Lyndon Thomas Insurance for a personal benefits consultation.
Cons:
• Monthly Supplement premiums are higher, are age-rated, and increase each year.
• No coordination of services; duplicate or conflicting treatments may result from using multiple doctors.
SUDOKU
KIELBASA KABOBS
This take on the classic Italian sausage and peppers uses fully cooked Polish kielbasa so you can prep the kabobs and bring them to your next cookout.
Ingredients
• • • •
3 red bell peppers
• • •
2 pounds fully cooked smoked kielbasa
2 cloves garlic, minced
2 large onions
1/4 cup olive oil
2 green bell peppers
Salt and pepper, to taste
Instructions
5. Brush with oil mixture and grill, covered, 10–12 minutes. [NOTE: If using bamboo skewers, soak in water for 30 minutes before threading to prevent burning.]
1. Heat grill to medium. 2. In a small bowl, combine oil, garlic, and a pinch of salt and pepper. 3. Cut pepper, onion, and kielbasa into 1-inch chunks. 4. Thread onto skewers, alternating ingredients.
Inspired by Good Housekeeping
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CA# 0D96309
805-646-6409
Lyndon Thomas Insurance
PRST STD US POSTAGE PAID BOISE, ID PERMIT 411
PO Box 207 Ojai, CA 93024
INSIDE
CA# 0D96309 | www.LT-ins.com | 805-646-6409
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Summers at the Shop
The Benefits of Mall Walking You Asked For It…
Kielbasa Kabobs
The History of Hot Dogs and Burgers
THIS AMERICANGRUB HOWHOT DOGS AND HAMBURGERS BECAME NATIONAL TREASURES
Depression made them the perfect food for a nation suddenly living on a tight budget. By the 1930s, hot dogs had become so unquestionably American that Franklin Roosevelt famously served them to King George VI during his royal visit in 1939. THE BURGER Like the hot dog, the exact origin of the beef patty’s eventual “sandwiching” is lost to history. Once again, it was German immigrants who brought their recipes for “Hamburg steak” with them across the Atlantic, but reports vary as to who first sold the meat patty inside a bun. Multiple diners and fairgrounds across America claim to be the home of the first hamburger. All of these claims date to the turn of the 20th century, a time when our nation was faced with feeding a growing working class quickly and cheaply. By the 1950s, the burger had become a symbol of the American everyman. Both the hot dog and hamburger embody the history of our nation. Immigrant traditions merged with blue-collar needs to create two uniquely American foods. It’s fitting that we celebrate America’s birthday with the grub that has grown along with it.
If your plans for this Independence Day involve firing up the barbecue, you’ll probably be cooking two American classics: hot dogs and hamburgers. Come the Fourth of July, families will be grilling up burgers and dogs from sea to shining sea, but it wasn’t always this way. The story of how beef patties and sausages became culinary symbols of our nation will give you plenty of food for thought. THE HOT DOG It was German immigrants who brought the “frankfurter” and the “wienerwurst” to American soil in the 1800s. There is much debate over who first decided to place one of these franks in a bun, but by the opening of the 20th century, hot dog stands had popped up all over the Eastern Seaboard. We do know the identity of the man who took the hot dog’s popularity to a national level: Nathan Handwerker. A Jewish immigrant from Poland, Nathan sliced buns for a hot dog stand on Coney Island. After scraping together enough money, he quit his job and opened a stand of his own, undercutting his former employer’s prices by half. Not only did Nathan’s hot dogs outsell the competition, the Great
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216-B E. Matilija St., Ojai, CA 93023
Published by The Newsletter Pro • www.NewsletterPro.com
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