Before concluding our discussion on Medicare plans to begin, we must know the fundamental thing, that what she is and what it represents. To be precise, in terms of additional insurance or Medigap is private health insurance plans for those who are already on a policy of insurance. The Medigap or supplement the health insurance plans to help the beneficiary that Medicare extra medical costs, apart from the original plans, turn left. The name of Medigap is offered because we assume that this policy is the difference between the coverage of Medicare and the original cost or the total bill bridges required. But recent studies show that in the United States about 18% of the population, the original policy of insurance to supplement goes well plans.
Tenders Medigap plans or Medicare supplement have been centers of Medicare and Medicaid Services (CMS) standardized in 1992. Let us start with Part A. Part A Medigap plan is your hospital insurance. It helps pay for medical treatment you receive in a hospital or nursing home. In addition, some home health and palliative care, if you are ill for some time. Part B is the part of the insurance covers you for medical services not covered by Part A helps pay policy. It also includes the doctor for free. It is very useful if you part of a policy. Part C is the portion of such additional insurance or health insurance plan that links the two A and B coverage. He also provides additional services. Medicare Part C plan additional insurance is available only through approved private insurance companies. The Medicare Part D prescription plan is complete coverage of your drugs. It helps pay for medication prescribed by your doctor. In this case, it is interesting to note that the policyholder, who are committed to the Part D stand-alone plan can keep the drug coverage portion of their Medigap policy. But the receiver may decide to remove the drug coverage from their current Medigap policy and retain all other benefits.
can sell in most cases, Medicare Supplement policies that standardized Medigap. It is also clear that firms have specific advantages they offer, allowing you to compare more easily the name. It is possible that every company can offer all Medigap Plans A through L, but they are required to clear information on the policy may change. But the fact is that every company must Medigap Plan A, if they want to offer other Medicare Supplement plans. However, the sale of the rest of the measures themselves should be decided by society, even if the law, they could affect offer. But even with that Medigap plans are mostly private companies, therefore, the amount of the premium payable is run entirely under consideration.
Posts Tagged ‘Choosing’
Fundamentals of Medigap health insurance plan, with some tips for choosing
Friday, August 6th, 2010Choosing Quality International Dental Care Abroad
Tuesday, June 22nd, 2010These days, the concept of medical tourism has expanded and grown in demand as escalating healthcare costs and a shaky economy prevent many Americans from seeking much-needed dental treatments and procedures in the United States.
Venturing abroad for high quality dental care has become a very viable option for many. International patients traveling to foreign destinations such as Mexico, Poland, Asia, and South America are able to save thousands of dollars on similar dental procedures in the United States. Lower costs are not at all due to less experienced providers or quality of care, but because dental providers in foreign countries are not burdened under the enormous obligation of carrying astronomical medical malpractice insurance as those found in the United States.
Choosing quality international dental care abroad takes some time and effort. Some of the most important things for consumers to look for in foreign destinations are quality in sterilization and sanitation, quality assurance, accreditation, certification, and credentialing.
Consumer information collected in easy-to-read dental guide packets or guides offer consumers information regarding the experience, technology of facilities and accreditation, experience and expertise of staff in foreign destinations. Many Americans or other citizens from around the world demand and deserve transparency in all medical and healthcare fields. Consumer information guides are especially valuable for Americans traveling south of the border for dental care.
Questions to Ask International Providers A multitude of general questions might be asked of international providers, whether you’re looking for dental work in Hungary or for teeth whitening procedures in Thailand. Some of these basic questions include but are not limited to:
Ensuring Quality when looking for foreign dental healthcare providers, consumers should look for those who have internationally respected credentials or those who have staff trained in Europe, Australia, or the United States. However, medical standards in such countries as China, Japan, Thailand and Singapore are extremely competitive and offer assurance that surgeons are highly trained and skilled. The Joint Commission International accredits many foreign hospitals, as well as those who are accredited by the International Standards Organization. Many such dentists and dental professionals have been trained and hold accreditation by the American Dental Association, or for the purposes of the examples provided, the FDI or Hungarian Dental Association, or the Dental Association of Thailand.
Dentists and dental facilities who have undergone quality assurance audits by United States-based insurance carriers offer peace of mind. Many health insurance policies are beginning to offer coverage or reimbursement for beyond-borders medical care in many fields including dental care. Dental offices that carry malpractice insurance are especially popular in Mexico and South America.
Knowledge of Dental Association certification, labs, education and training, and state-of-the-art equipment and procedures approved of in international destinations may take some of the concern and worry out of international travel for dental needs for many Americans and other international travelers.
Resources Take the time to access resources such as the FDI World Dental Federation or the International and Foreign Directories provided by the American Dental Association that will display dentists around the world who belong to the ADA.
Choosing a disinfectant for hospital environments
Wednesday, March 3rd, 2010IAQ in Healthcare Environments – Transition Healthcare Challenges (Choosing a disinfectant for hospital environments)
As the economy heads further down the slippery slope of what promises to be a deep recession, and our healthcare infrastructure continues to grow and age, it is a natural progression to see more and more IAQ professionals turn to what some believe is a recession resistant market. From ambulatory facilities to long term care, the buildings that make up our healthcare infrastructure are constantly in need of renovations and repair. This new and promising opportunity for IAQ pros offers many long term rewards but is not without new and complex challenges that must be addressed.
Every IEP realizes the importance of appropriate use of antimicrobials, containment barriers and personal protection. Though often times IEPs find the regulations and guidelines they encounter in healthcare facilities to be daunting to say the least. In traditional remediation environments the focus is to ultimately provide an environment free of dangerous pathogens or contaminants. While attention is give to the methodology, often times the end results dwarf the means of acquiring those results. With a host of accepted methods to address indoor air quality in businesses, homes and public spaces the contractor finds themselves able to select from a variety of methods to deal with each issue. In the end it is the air clearance that counts, not so much which method was used to obtain it.
While the end results are just as, if not more important in healthcare environments; far more attention must be paid to the processes used. As many occupants of a healthcare facility cannot be moved and are highly susceptible to infection, there are very specific guidelines in place that govern all maintenance, repair and renovation work in a healthcare facility. Organizations like CDC, APIC and JCAHO have placed standards that apply to all activities that may have an impact on a healthcare environment. This is done with good reason considering the number HAIs (Hospital Acquired Infections) reported annually due to airborne pathogens like Aspergillus, which is disturbed during common daily maintenance. Nosocomial infections caused from routine maintenance reach into the hundreds of thousands each year. These guidelines and regulations are enforced in a facility by ICPs or infection control professionals.
Hospitals continually adapt to new, more stringent CMS guidelines limiting what medical treatments are reimbursable through Medicare or Medicaid, this has caused hospital administration to look more closely at every aspect of infection control in their facility. Beginning in October of 2008, Medicare and Medicaid began limiting payments made to facilities for the treatment of preventable nosocomial infections or conditions. These new CMS guidelines are driven by Section 5001(c) of the Deficit Reduction Act, which could mean that as deficits climb the list of non-reimbursable conditions are likely to grow. Infections like Aspergillosis, which is caused by airborne A.Fumigatus, are common in healthcare facilities. Aspergillus is one airborne pathogen that is commonly disturbed and distributed throughout a facility after maintenance work or renovations. The argument could be made that Aspergillosis is a preventable condition by ensuring appropriate containment and disinfection of disturbed areas.
Infection control professionals in healthcare environments have become increasingly diligent in monitoring the actions of contractors that work in their facilities. It is ICP’s responsibility to ensure all components of the infection control risk assessment are adhered to. While these key people can complicate the lives of the contractors working in healthcare facilities they are also actively saving lives by doing so. ICP’s will monitor and log details about each project to ensure that all compliance issues are being addressed. Two primary issues that impact infection control and prevention in healthcare settings are disinfection of contaminated surfaces with broad spectrum EPA registered disinfectants and appropriate containment of airborne particulate and pathogens.
Choosing the best disinfectant is one way to ensure the best possible level of microbial control during any abatement project in a facility. Healthcare facilities present the IEP with a unique set of challenges in regards to pathogens beyond the standard fungal and bacterial flora. Many of these pathogens can be highly infectious as well as drug resistant making them far more dangerous to the many immunocompromised patients housed in a healthcare facility. When selecting a hospital grade disinfecting it is imperative to keep several things in mind.
Does your disinfectant have sufficient kill claims to address the microbes you might encounter?
While no disinfectant can list every possible organism, it is important to find a disinfectant with the most possible EPA registered kill claims. Look for efficacy data. Disinfectants that do not show efficacy & testing data often have few or irrelevant kill claims and are not sufficient for the challenges found in healthcare facilities. It is also a positive if your disinfectant has EPA approved efficacy in the presence of 98% soil load as opposed to 5% which is required by the EPA. This higher soil load represents real world conditions. Beyond fungicidal kill claims, other claims that you might require involve infectious pathogens like MRSA, E-coli, HIV, Salmonella and Avian Influenza. You may also want to look for a product that can be used on both porous and non-porous surfaces and has disinfectant and sanitizing claims.
Understand what the active ingredients are in your disinfectant
It is essential to know what type of disinfectant is appropriate. Most common disinfectants are formulated using Alcohol, Phenol, Chlorine or a Quaternary Amine Base. There are arguments for each type of disinfectant and it is important to know the facts about the products you are working with. Each has advantages, but some have dramatic disadvantages that might make you think twice about using them.
Quaternary Ammonium Chloride (Quats) –
Examples Shockwave Disinfectant/Sanitizer, IAQ 2000/2500
Quats are often considered easier to use and safer than other disinfectant bases because they are less corrosive, non-carcinogenic and maintain efficacy for extended periods of time. Not all quat based disinfectants are equal though. There are a variety of products with EPA registered kill claims ranging from just a few all the way to over 130. In a healthcare environment it is important to seek out the latter, as the spectrum of microbes likely encountered in a hospital will be much broader than in common remediation situations. Unlike many other disinfectants quats based disinfectants are excellent cleaners making them ideal for surfaces with a large amount of biomaterial like fungi, blood or human waste. As many MDROs like C-DIFF, MRSA and VRE are transmitted by contaminated bodily fluids and waste this is an important factor in the equation to finding the ideal disinfectant for healthcare environments. Quats are highly stable and maintain efficacy even in the presences of high soil load. This makes them ideal for mold remediation as well as blood or bodily fluid spills.
Many IEPs as well as ICPs prefer the use of a quats because they not only offer a broad spectrum of kill claims, but are easy to work with and more cost effective than other options. In addition most quats do not have the drawbacks associated with chlorine, alcohol or phenol based products on the market.
Alcohol
While not as user friendly as quats, alcohol based disinfectants are considered by many to be easier to use than chlorine or phenol based products. High concentration alcohol based disinfectants can however be dangerous in a healthcare environment because of its tendency to open pores and dry skin. This can create openings for microbes to enter the body if not properly protected.
Though high concentration alcohol based disinfectants are generally highly effective against lipophilic viruses they are less active against non-lipid viruses and ineffective against bacterial spores. Generally alcohol disinfectants are not used for equipment immersion due to diminishing efficacy as the alcohol volatilizes. Alcohol disinfectants cannot be used as cleaners thus making them less effective for practical use on many surfaces. Even though some Alcohol based disinfectants can offer a broad spectrum of kill claims, it can be difficult to maintain appropriate wet contact time due to the rapid evaporation rate.
Chlorine
These corrosive oxidizers are known for cidal action against a wide variety of gram-negative and gram-positive bacteria as well as many viruses. Difficult to work with, these disinfectants are rapidly neutralized in the presence of organic matter making them less than ideal for healthcare and remediation environments.
While chlorine disinfectants are currently used in many facilities, future use of halogens is expected to decline as options like quats and alcohols become more abundant with appropriate kill claims. Sodium hypochlorite is known for causing significant corrosion to metals and other common materials. Chlorine disinfectants are considered toxic, and in 1994 the Clinton Administration called for the ban of all chlorine and chlorine based products.
Phenol
Phenol is one of the oldest known disinfectants still in use today and is both commercially manufactured and naturally occurring. Phenols are often effective for use on vegetative bacterial, lipid containing viruses and Mycobacterium tuberculosis but have limited or no efficacy for use against spores or non-lipid viruses. While these disinfectants are effective over a relatively large PH range, their limited solubility makes product residue difficult to clean. These disinfectants cannot be used on food contact surfaces and often require additional PPE like goggles, face shields gloves and protective clothing for application. Phenols cannot be used in many parts of a healthcare facility like neonatal, pediatric ICU or any infant contact surface due to toxic residue. Reports of eye irritation, contact dermatitis/utricaria, and depigmentation of the skin have been tied to phenol and phenol residue contact.
Phenols are commonly found in a host of consumer products and are not dangerous in very low concentrations. Disinfectant strength phenols however are considered a health risk by EPA and NIOSH. OSHA recommendations state that employee exposure to phenol in the work place should be controlled to less than 20 mg/cu m in air determined as a time-weighted average (TWA) concentration for up to a 10 hour work day or 40 hour work week. The NIOSH guidelines also limit exposure to phenols to 60 mg phenol/cu m of air as a ceiling concentration for any 15 minute period. Phenols generally enter the blood stream via ingestion, respiration or skin contact. NIOSH recommendations are just one indicator of the need for PPE when using Phenolic disinfectants. Disinfectants with a concentration of 1% phenol or greater are considered an extreme skin and inhalation hazard and are moderately combustible.
Containment plays a key roll in infection prevention.
While disinfection of surfaces, equipment and touch points plays one of the most critical roles for infection control in a health care facility; another primary responsibility of the IEP working in a healthcare facility is containment. The containment of harmful pathogens and particulate during work in a healthcare facility is essential, especially when working in areas near immunocompromised patients.
Regulations set by CDC & Joint Commission are clear in dictating specific criteria for the elimination of airborne Aspergillus, asbestos and dust. A term that IEPs will hear all to frequently as they make their transition into a healthcare environment is ICRA or infection control risk assessment. These operating guidelines are critical to any maintenance work done in a healthcare facility. APIC has developed guidelines assisting healthcare facilities in developing their ICRA to specifically mandate that dust and airborne particulate must be contained under negative pressure in Kontrol Kube like containment or by using other solid barrier methods.
For many years hospitals were forced to either temporarily close an entire wing or build temporary solid barriers during mold remediation or asbestos abatement jobs to prevent airborne particulate from escaping the work area. In recent years a new method of mobile containment has been made available making daily remediation, repair and renovation faster and far more cost effective. Kontrol Kube type containment essentially revolutionized the way hospital maintenance was being done by allowing an IEP to quickly roll tools, ladders, chemicals and other equipment into a location and then isolate that area for the duration of the work.
Infection control professionals prefer contractors to use methods like portable containment when possible for several reasons. Mobile containment units are easy to set up and inspect, this not only makes use of the unit easier for the IEP but also makes the inspection process much faster and efficient for the ICP. Knowing that all materials are fire rated and meet NFPA 701 is also important with any sort of temporary barrier material you use. Fire codes and standards are extremely critical in healthcare situations and are a focal point during Joint Commission inspections.
When selecting a mobile containment unit be sure to consider if the unit is made of durable components that will hold up under rigorous daily use. It is also important to know that the unit is easily cleaned and is capable of providing all the functionality needed. Will the unit accommodate an eight foot ladder effectively? Does the unit have a solid yet mobile working platform? Is it highly adjustable, durable and lightweight?
Disinfectants and Kontrol Kube type containment are used in almost every type of daily work an IEP might encounter in a healthcare facility; both are key components to any comprehensive infection control plan. For the individual contractor working in a healthcare facility, understanding what is expected of you could make all the difference between winning a bid and being passed over. The knowledge and expertise shown while in the facility can also ensure future jobs in that facility.
As IEPs progress into the healthcare arena to reap the benefits of this relatively protected market they are not only assuming the role of IAQ professional; they are also assuming the role of infection control professional helping to maintain safe, clean and infection free environments. While the challenges they face are unique and in some cases daunting, the benefits exceed a simple increase in business. When we stop to consider the impact of the work they do in the facilities that care for our sick, our elderly and our very young we can see how each of us does our part to win the battle against infection and disease. With proper education and training, IEPs can make the leap from the private or public sector into the highly lucrative and relatively stable market of healthcare remediation, abatement and repair with ease. Knowing the facts about not only the rules and regulations in healthcare facilities, but also the tools available can help ensure a successful transition into IAQ in healthcare environments.
John Pierson is Manager of Infection Control Products for Fiberlock Technologies, manufacturer of Shockwave EPA registered Disinfectant/Sanitizer and Kontrol Kube Mobile Containment Solutions, based in Andover, MA. He can be reached by email at jpierson@fiberlock.com or phone at 800-342-3755 x236.
This article was published in Indoor Environment Connections Volume 10, Issue 6 – April 2009 Also available on http://www.fiberlock.com
California individual health insurance: Choosing the right health insurance coverage
Monday, February 15th, 2010Today, there are many options for California individual health insurance available that will match every possile need. The choices for health insurance in CA are just as initially overwhelming as the premiums. Remember that choosing the wrong health plan will cost you a lot on unnecessary fees. Do not make this mistake. Make sure that you do your homework and select the plan that will best suit your needs. How do you know which health insurance coverage is perfect for you?Contrary to what usually happens, the first thing you need to do when looking for a health care policy is to forget about the cost and the premiums. You have to begin by finding out what your idea of a California health insurance plan is, and what kind of health care you exactly need. You should keep in mind that health insurance policies do not cover all forms of medical needs. If it does, it would surely cost an arm and a leg. Health insurance in CA also has the same imposed limits. There will be a list of hospitals and medical practitioners covered, maximum limit for hospital stays, maximum coverage for procedures. Some insurance plans involve co-pay where some medical care are not covered at all. This might surprise you at first, but all California individual health insurance plans are operated in this way.There are three types of California individual health insurance plans available. The traditional form, known as the indemnity or fee-for-service plan, is not designed to pay for everyda medical health costs but provides for unexpected illnesses and accidents. Although this type has been around the longest, it is not as popular today as it had been. Then there is the managed care plan, which includes the popular HMOs (Health Maintenance Organization). HMO health insurance in CA aims to reduce your overall medical expenses by paying attention to everyday medical care and maintenance. It provides coverage such as routine medical care and checkups, which can spot potential illnesses at an earlier stage – hence, more treatable – avoiding high treatment costs for serious untreated health problems. Even more popular today are PPO California individual health insurance which essentially is the amalgamation of the two aforementioned health coverage types. Under PPO, medical care will be provided as in the HMO plan but you get more freedom over the medical practitioners you see and when to see them.Which of these California individual health insurance do you need? It is mainly a matter of personal choice depending on your needs. For example, if you are single, fit and living a health lifestyle, an idemnity plan may be a good option. However, if you have dependents and a famly history of serious medical conditions, everday medical care may be a better choice. Choosing from the three types of available health insurance in CA is a decision that only you can decide on best. Whatever circumstance you are in, you should look beyond the cost of health coverage but concentrate more on getting the type of coverage you need.
