You just got a letter from your doctor announcing "major news": He or she is converting the office to a “concierge” practice. Rather than caring for a thousand patients or more, the physician is cutting back to a few hundred, who will now get more of his or her time and attention. To become one of these patients, you’ll have to pay an annual retainer, or fee, of about $1,500. If you can’t or won’t pay, you may have to find a new doctor.
 
If you love your doctor and can afford the fee, you may just shrug and pay up. If you require frequent, in-depth appointments, you might even welcome the switch. With concierge care, doctors can promise greater availability, longer appointments, quicker lab results and personal hospital visits.
Some physicians believe that concierge care takes them back to the way they used to be able to interact with patients, before financial pressures forced them to see ever more patients and give each less time. But even the most dedicated doctors are pursuing their own interests as much as yours when they switch to concierge practice, also known as boutique, VIP, retainer-based or direct-pay medicine.
The number of such practices in the U.S. is still fairly small — an estimated 4,400, according to the American Academy of Private Physicians, a trade group. But that number is growing quickly as more physicians, aggravated by cost squeezes in the system, seek ways to maintain or increase their incomes while streamlining their workloads.
(MORE: Will There Be a Geriatrician for You When You Need One?)
Is Concierge Care Right for You?
A concierge practice can have benefits, but before signing on with your doctor, you need to understand exactly what you’ll be getting. Management advisers such as MDVIP and Concierge Choice Physicians offer doctors who join their networks a blueprint for their revamping their practice. But there is no standard model. The annual fee that can range from a few hundred dollars to several thousand, and what you receive in exchange for that money may vary widely.
The additional fee might only buy you the right to keep seeing your doctor, with quicker appointments and more time set aside for in-depth consultations. It may cover the cost of some or all standard office visits and tests, as well as house calls in some practices, but that's not always the case. In some practices, concierge patients receive an annual exam at no extra charge, or perks like unlimited email or cell phone contact with the doctor or a thumb drive containing personal medical records.
The concierge model often promotes “patient-centered wellness care," with an emphasis on avoiding health problems or better managing existing ones through medical monitoring and preventive services. MDVIP claims that hospitalization rates among patients in its practices are more than 70 percent lower than in non-concierge offices. The company reports that 180,000 patients, with an average age of 55, see physicians in its network.
 
Insurance, of course, is a major variable in anyone's decision to join a concierge practice. Some doctors continue to accept insurance after they make the switch, but many do not. Either way, says Susan Pisano, a spokesperson for the industry trade group America’s Health Insurance Plans, “I don’t know of any insurer who reimburses a retainer." If the doctor no longer accepts private insurance, patients are faced with paying out of pocket for services not covered by the retainer and filing claims to seek reimbursement.
Medicare restricts what physicians can charge for covered benefits, like office visits. The federal program will not cover any doctor's concierge fee, but has yet to establish whether charging such a fee for extra time and attention, even when it’s not billed to Medicare, still violates the program's payment limits. To avoid any potential conflict, some concierge physicians drop out of Medicare altogether, in which case their Medicare patients must pay the doctor directly for all services, with no reimbursement from the program.
 
Even if cost is not a major issue for you, you may be uncomfortable with the idea of your doctor imposing a fee for access. Some concierge physicians continue to serve a small number of patients who can’t afford the fee, and a number of “hybrid” practices have two tiers of patients, with those who decline to pay the fee getting no extra benefits.
(MORE: 7 Questions to Ask About Every New Prescription)
Does concierge care make sense for you? Here are some factors to consider:

		What's the value? Patients with complex or chronic medical conditions are likely to get the most out of better access and more attention from their doctors. For those with less frequent or serious needs, the promise of seeing the doctor more quickly and having longer appointments may not be worth paying an annual retainer, especially if your doctor also stops taking your insurance.
		How different will my care really be? Consider the care you’re already entitled to, with or without concierge service. The federal health reform law, for example, now covers virtually all insured patients for free preventive screenings; Medicare beneficiaries also get a free annual exam.
		How much more will it cost? If you stay with a practice that no longer accepts your insurance, you will have to begin filing your own claims or even pay out of pocket.
		Can I get a test drive? Some concierge practices charge by the month, and others will prorate a refund based on an annual fee. So you could try a program to see if it seems worthwhile.

The Pros and Cons of Concierge Care

Lani Luciano

The military has always been an important part of Dee Hughes' life. Her six uncles served in the military, and her father wanted to but couldn't because of a disability. Hughes' husband is an Army Veteran, and she's a Gold Star mom, having lost her son, Keith, a Marine who served in the Persian Gulf. 
Hughes feels the work she does now as Southeast Regional Veteran Executive for Humana helps fulfill her son's goal in life to improve the lives of Veterans and their families. 
"One of the last conversations I had with Keith, he spoke passionately about wanting to dedicate himself to making a difference in the lives of our military families on a grand scale," Hughes said. "Joining Humana's Veterans team when it was first established in 2011, I felt it was my destiny to carry out Keith's mission, and my work has allowed me to do that." 
Educating Veterans and families about Medicare 
Those who have served in the military sacrifice a tremendous amount for their nation. Veterans disproportionately experience mental health and substance abuse disorders compared to other Americans. One-third of Veterans are diagnosed with at least one mental health condition, and they have higher rates of chronic disease than nonveterans. 
To help ensure Veterans receive the healthcare services they need, Hughes and Humana's Veterans Channel team educate Medicare eligible Veterans and their spouses about the various health care plans and programs they are entitled to but may not be aware of. There are several different types of plans that Veterans and their spouses may be eligible to enroll in including traditional Medicare, TRICARE for Life, CHAMPVA and Medicare Advantage plans. 
But it can be challenging to understand their best choice or how it may affect their benefits and providers when enrolled in more than one plan. For example, if you have TRICARE for Life or CHAMPVA and decide to enroll in a Medicare Advantage plan, the Medicare Advantage plan will become your primary coverage and you will only be able to see providers in the Medicare Advantage plan network. In addition, enrolling in a Medicare Advantage plan would require TRICARE for Life or CHAMPVA to be responsible for coordinating billing and claims information with their provider. CHAMPVA is available to the spouse or child of a Veteran who has died or been permanently disabled during their service and it provides additional coverage for beneficiaries. 
"Spouses of recently deceased Vets are dealing with grief, loss of income and often spending more than they can afford on healthcare. They talk to us through their tears," Hughes said. "Besides providing comfort, we help to find the right solution for their specific situation, which may or may not include a Humana plan."
Combating hunger and homelessness 
The work of the Humana Veterans team extends far beyond health coverage to serve the needs of the community. With one in six military and Veteran families experiencing food insecurity or hunger last year, Humana, the Veterans of Foreign Wars (VFW) and Feeding America are collaborating on the Uniting to Combat Hunger initiative, which has served more than 3 million meals in communities with high concentrations of Veterans since it launched in 2018. 
Homelessness is also prevalent among Veterans, who make up 12% of the homeless population. Part of Hughes' role has been to train Humana agents on issues impacting Veterans including recognizing the signs of homelessness and connecting Veterans with services. She is particularly heartened by one story of an agent who, after attending one of Hughes' sessions, saw a man asking for money who was holding a sign stating he was a Veteran. Instead of driving by, she pulled over, started a conversation and got him connected with a Veterans Service Officer who was able to enroll the Veteran in Medicare and get him income for his disability. With those resources, he was able to get off the streets and into housing. 
In another example of living up to their motto, "Doing well by doing good," a Humana agent in Louisiana recognized the need and created a Warrior Closet at a Veterans Administration (VA) medical center  ̶ securing space on the campus and clothing donations from local retailers to provide Veterans with a new set of clothes to wear when discharged from the hospital. 
A source of strength and comfort 
While focused on helping the Veteran community, the Veterans team has also been an important source of strength and comfort for each other. Made up almost entirely of Veterans or military family members, they spend time sharing their stories with one another. Sometimes, it's the first time they've been comfortable talking about those experiences. 
For Hughes, the work she does on a daily basis is far more than a job, it's continuing the mission her son committed to many years ago but wasn't able to finish. It's her way of keeping Keith alive. 
During the upcoming Medicare Annual Election Period, which runs Oct. 15 - Dec. 7, eligible beneficiaries — including individuals ages 65 and over and those living with disabilities — will have the opportunity to sign-up for Medicare Advantage plans that, unlike traditional Medicare, offer benefits that can include access to fitness programs. 
If you are eligible for Medicare, take the time to evaluate your options to find the one that best fits your health needs. There are resources available such as Medicare.gov, which allows you to compare plans and estimate costs based on what a typical enrollee experiences. You also can visit www.Humana.com/Medicare/Veterans or call toll-free 1-888-372-2614, 8 a.m. – 8 p.m. local time, seven days a week, to speak to Humana licensed sales agents. In addition, current Humana members can call toll-free 1-888-372-2614, 8 a.m. – 8 p.m. local time, seven days a week to speak with Customer Care specialists who are Veterans themselves and have collaborated with USAA to receive special training to serve the unique healthcare needs of Veterans. Humana Honor plans are available to anyone eligible for Medicare and Veterans should consider all their health plan options. 
Humana is a Medicare Advantage HMO, HMO SNP, PPO, PPO SNP, and PFFS organization with a Medicare contract. Enrollment in any Humana plan depends on plan renewal.  
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Gold Star Mom Keeps Her Son’s Dream Alive by Helping Improve the Lives of Veterans and Their Families

Glenna Hecht vividly remembers the first time she saw Up with People in her high school auditorium in Skokie, Illinois in 1973. "They were so vibrant and alive and electric," she said. "I was enthralled."
"Uppies" were high school or college aged students, many of whom left home for the first time to join one of several Up with People casts that traveled around the world each year. If you're a boomer, it's likely you too remember Up with People, the peppy, fresh-faced young people who smiled, sang and danced their way through cities and small towns around the world beginning in the 1960s. And there's a good chance their earworm of a theme song ("Up! Up with people!/You meet 'em wherever you go") is still in your head.
"The message was, 'Let's think positive, let's think up with people instead.'"
But for those who were part of Up with People, it was life changing. "One of the best experiences of my life," said Hecht, a cast member in the mid-1970s.
"Uppies" were high school or college aged students, many of whom left home for the first time to join one of several casts that traveled simultaneously each year. They came from around the world, and performed for monarchs, popes and presidents, in prisons, in high school auditoriums and at sporting events like the Indianapolis 500 and the Super Bowl. They traveled to places that were off-limits to most Americans in the 1970s including Northern Ireland, the Soviet Union and the People's Republic of China.
Who Were the 'Uppies'?
Cast members lived out of suitcases, traveling by bus from town to town. In addition to performing, they set up and struck the set for each show. Some continued their education on the road, studying and taking classes with teachers or professors who traveled with them.  
King Baudoin and Queen Fabiola of Belgium meet Up with People cast, 1969Marcie Lipschutz Ward first encountered Up with People in her hometown in Louisville, Kentucky in 1970. At a time when protestors were clamoring "Down with this" or "Down with that," Up with People felt like a fresh alternative.
"The message was, 'Let's think positive, let's think up with people instead,'" said Ward. "This was earth-changing stuff."
When Mary Lou Evans received a letter announcing her acceptance to Up with People, it made news in her hometown newspaper in Leavenworth, Kansas. The Rotary and other organizations provided sponsorships. She traveled to Los Angeles to learn the show, then joined a cast in 1973 and met fellow cast member Robert Evans, a bass guitarist from Ohio. After their tour concluded at Expo '74 in Spokane, they married in 1975.
"We feel so fortunate that we got to travel the world and meet so many wonderful people, many of whom we're still in touch with," Mary Lou Evans said.
Mary Lou and Robert EvansUp with People may seem Pollyannaish to modern audiences, admits Kathy Burch, but in the turbulent 1970s, the message felt urgent.
"There was a lot of political tension," said Burch, a cast member from 1973-1975. "We were trying to bring people together regardless of their political beliefs or religion. It was people engaging with other people through music."
Although initially supported financially by a spiritual group called Moral Rearmament, Up with People had no religious or political affiliation. Shows promoted messages of unity, with songs like "What Color is God's Skin?" and "Everybody Needs Everybody." In 1968, Up with People was the only performing group invited to both the Republican National Convention in Miami and Democratic National Convention in Chicago.
Robert Thompson, director of the Bleier Center for Television and Popular Culture at Syracuse University, compares the appeal in Up with People's early days to the success of the Apple TV comedy "Ted Lasso." Just as Ted Lasso's guileless optimism appealed in a politically divisive time, Up with People resonated in a time of civil unrest and racial strife.
"Up with People shows were nothing if not sincere."
"Ted Lasso had that old school kind of sincerity to it," he said. "And as sincerity becomes more and more of a rare commodity, it becomes more precious. And Up with People shows were nothing if not sincere."
Many young people today know Up with People only by way of parody, like the singing group "Hooray for Everything" that turns up occasionally on the animated TV show, "The Simpsons." That spoof depicts a group that's uniformly white, but Hecht argues the Up with People casts were diverse for their time.
"My closest friends were Native Americans, Eskimos and people from Europe and other backgrounds – people I would've never met in Skokie," she said.
For many alumni, Up with People was a formative experience. Ward credits Up with People for her ease in working with people from all backgrounds, including VIPs, in her career as a private aviation interior designer.
Elaine Crepeau, a 1968 cast member, taught high school students in the cast; the experience gave her confidence to make her own decisions, something her parents had handled for her until then. That confidence served her well in her career as a research archivist, including a recent stint with the Up with People Archive at the University of Arizona.
A Visit With Host Families
Cast members stayed with host families in the places they performed. Many are still in touch with the families that hosted them.
Pat Miner remembers what a big deal it was when Up with People rolled into his hometown of Fallon, Nevada, in 1971. His family hosted two high-school aged cast members.
"Not a lot of touring groups came through Fallon," he said. "The boys were friendly and showed interest in our town and schools." Miner jokes that he wanted to join until he learned that homework was involved.
"By the time Up with People performed in the Super Bowl, they already were something of an anachronism." 
At a tour stop in Morocco, Burch had dinner in the gigantic palace of a prince, then slept that night at a host family's humble, one-room home with a pit toilet.
"I met this remarkable kaleidoscope of people of all backgrounds," Burch said. Host families "were people who were giving of their time, who opened their homes and shared their food with us."
After each show, audience members interested in joining were invited to meet the cast. Auditions weren't required; applicants were selected based on their interest and personalities. But the process was very selective.  
Not everyone in every cast was on stage. John Ernst was part of the sound crew for a cast that performed with Black Sabbath in Palermo, Sicily in 1971.  
"I can't sing worth a darn, but I could lift boxes and set up lights," Ernst said.
Today, Up with People counts more than 22,000 alumni in 139 countries. The Up with People International Alumni Association organizes annual reunions; the next is in Limerick, Ireland in August 2024.  
Memorable Moments
One of Robert Evans's most memorable moments came in Munich in 1972. After terrorists killed 11 Israeli athletes, Olympic leaders debated over whether to cancel the games. At the urging of Olympic gold medalist Jesse Owens – an Up with People board member – the cast was invited to perform for the athletes to help raise morale.
Robert and Mary Lou EvansThe small venue in the Olympic Village was packed. Emotions were high. 
"We played a global medley, and we got everybody up on their feet," Robert Evans said. "Athletes in the audience were linking arms and singing a Belgian beer drinking song with us. It was unbelievable."
Some credit Up with People with "inventing" the modern Super Bowl halftime; their 1976 show was the first without a marching band. Up with People performed in three more halftime shows in 1980, 1982 and 1986.
However, public taste began changing in the 1980s, according to Thompson. Comedians like David Letterman "injected lethal doses of irony" into the culture, he said. 
"By the time Up with People performed in the Super Bowl, they already were something of an anachronism," Thompson said.  
Up with People continued into the 1990s and then ceased operations briefly in 2000. It still exists today, on a smaller scale, for youth ages 18-24 who continue to tour and perform community service in places around the world.   
"It was a very positive thing at a turbulent time," Ernst said. "People came to see it because of its positivity. It wasn't pie in the sky. We believed it and that came through."


Up with People: More Than Just a Theme Song

Mary Jacobs

The summer after my father died, my sister went missing at a James Taylor concert. By the time she turned up two hours later, bubbling with excitement because she'd been invited to sit backstage, I was unhinged.
From left, Debby and Amy in Lyon, France.Dad had disappeared barely four months earlier. He was missing seven weeks before his body surfaced in a lake a half hour from our house. I couldn't believe it never occurred to Amy that while she was having a VIP adventure, I'd be searching for her, oblivious to the music, convinced she was dead.   
"I told my friends to tell you where I was," she pleaded. "I'm so sorry."
She might have been crying. I didn't care. I swore I'd never forgive her.
All I knew was that since Dad died, the loving, funny sister I'd once adored had been replaced by a self-absorbed, sullen teen.
I had no idea what a grudge was, that I was latching onto something that would distort our relationship for decades. All I knew was that since Dad died, the loving, funny sister I'd once adored had been replaced by a self-absorbed, sullen teen. When she wasn't locked in her room blasting music, she was fighting with Mom.
Among the few things Amy and I shared after Dad died was crippling separation anxiety triggered by how he'd exited our lives. Mom's explanation was that he'd gone for a walk, slipped and drowned. When Amy and I asked for more details, she replied with aphorisms: "How he lived was more important than how he died" and "Look at the cup half full. You had 13 good years with him"—14 if she were talking to Amy.
Confused and Growing Apart 
If we kept asking, she'd get mad. That led to the other things Amy and I shared: fear of Mom and the unspoken understanding that Dad's death was a forbidden topic. Instead of airing and sharing our grief and confusion, we pretended they didn't exist.
In retrospect, Amy did nothing out of character for a teenager dealing with inexplicable loss: she simply became the safest target for my festering grief. That her behavior stemmed from the same well of pain as mine never occurred to me. I went from idolizing to despising her, which was easier than acknowledging that what I really despised was our new, fatherless life with a mother whose temper terrified me.
When I think back to those years, I see Mom, Amy, and me as satellites orbiting the untouchable planet that was Dad's death. I can't help wondering, what if we'd talked about the real reason he died? But nobody talked about suicide in 1974.
The first time I remember the subject coming up with Amy was 11 years later, when I called her before starting therapy. We still weren't close, but I didn't know anyone else who'd seen a psychologist. I wanted to know what to expect.
"How did therapy help you?" I asked.
"It helped me to accept that Dad killed himself," she replied.
I felt like she'd slapped me. I knew she wouldn't say something like that if it wasn't true, but I wasn't ready for that much truth.
I'd signed up for therapy because I was 24 and wanted a boyfriend. Clearly, Amy was in a whole different universe, one I had no interest in inhabiting.
Learning the Truth 
Often, I found myself thinking that if we weren't related, I'd have nothing to do with her. I didn't understand her and I was appalled at her choices: marrying young, moving a thousand miles from home, throwing away a college education to make babies with a man who seemed to have no respect for her.
Often, I found myself thinking that if we weren't related, I'd have nothing to do with her.
And yet she was determined to keep me close: she wrote me letters, called regularly, flew me to visit because I couldn't afford the plane fare.
A few months into therapy, I worked up the courage to push Mom for the truth about Dad's death. She told me he'd been depressed for months, that the night before he disappeared he said, "You'd all be better off without me."
I'd always suspected the accident story was fishy, but accepting the truth was harder than I expected. Even after three years in therapy I couldn't bring myself to think, much less say, "my father [died by suicide]" without feeling guilty. How had it been so easy for Amy?
Stuck between denial and acceptance, I wrote to her for advice. She responded immediately, a long, heartfelt letter reassuring me I was on the right path. I appreciated her wisdom, but it was another 10 years before the emotional wall I'd erected at the James Taylor concert crumbled.
Slowly Welcoming Her Into My Life 
By then I was a new mother. Maybe that's what gave me the insight I'd been missing for so long. All I know for sure is that when a friend said something that struck me as unfair and judgmental, I almost blurted out You have no right to think that way, which is when it hit me: I was the one who'd been unfair and judgmental, not to my friend, but to Amy, ever since the concert. It wasn't Amy I'd been mad at for abandoning me, it was Dad. Amy had been there all along.
From left, Debby and Amy in the 1960s.I called and apologized. Over the next few years I began welcoming her into my life in a way I hadn't since we were kids. Still, talking about the past was a challenge. About some things, we were in complete agreement, but others — including Amy's theory that I'd been Mom's favorite and she was Dad's — stoked old resentments.  
When Mom grew ill and moved to a senior residence in Milwaukee to be near Amy, those resentments nearly fractured our relationship for good. When I visited, I'd stay with Mom and see Amy daily. At some point during every visit, we'd have at least one huge fight. I can't remember the specifics, only that it didn't take much for us to offend each other.
After Mom moved into a nursing home, the fights escalated, reaching their nadir the day Amy complained I wasn't spending enough time with her — even though I was staying at her house.
I vented my frustration to Mom. "I'm here to see you, not her!" I exploded.
I expected her to take my side. I was in for a surprise.
"You need to spend time with Amy, too," she said.
Rebuilding Our Relationship 
Maybe she understood the extent of the damage wrought by the silence surrounding Dad's death. Or maybe, as the youngest of five children, she understood that after she was gone, Amy and I would need each other: we would be each other's institutional memories.
Instead of reverting to our defensive crouches, we listened to each other.
I started hanging out with Amy more — taking dog walks, losing to her at Scrabble, cooking. A couple of times we drove 30 hours round trip to see family and friends in central New York. Those rides gave us time to talk about Dad's death and everything surrounding it. 
Instead of reverting to our defensive crouches, we listened to each other. Instead of disputing each other's feelings, we validated them, acknowledging that even though our relationships with our parents were different, our losses were equally profound.
When Mom died in 2018, 10 days after her last surviving sister, she did so knowing that even though Amy and I live thousands of miles apart, we are closer than ever. We'll never recover those years lost to misdirected anger and unacknowledged grief, so instead I focus on what we do have: an ever-deepening bond. Our relationship is a gift, hard-won.  


After My Father Died, So Did My Close Relationship With My Only Sibling

Debby Waldman

(Editor's note: This story is part of Still Here, Still Positive: A series on the first generation of Americans aging with HIV/AIDS, with support from The John A. Hartford Foundation.)
As part of our special series "Still Here, Still Positive," we've been covering the realities of people aging with HIV/AIDS. The Centers for Disease Control and Prevention says "the risk of serious illness from COVID-19 for people with HIV is not known," though people with HIV/AIDS may be at increased risk of getting very sick with COVID-19 based on their age and other medical conditions.
During a March 14 White House news conference, coronavirus task force member Dr. Deborah Birx — who's worked extensively on the fight against HIV/AIDS — addressed the pandemic through the HIV/AIDS lens directly:
"Finally, I just wanted to conclude with a group of patients we are all very worried about – these are individuals that we call long-term survivors from HIV. They're here across the country that have survived more than four decades with HIV. Many of them still carry a level of immunocompromised. To all of them out there, please take care of yourself. Please ensure that you're doing everything possible to ensure you don't get exposed."
We want to do our part to keep readers safe by pointing to the current information and resources available related to the coronavirus and living with HIV/AIDS:
From Liz Highleyman for POZ
What People With HIV Need to Know About the New Coronavirus
New research is emerging about how the respiratory virus spreads and how people can protect themselves and others.
"Brooks' recommendations include ensuring at least a 30-day supply of medications, keeping up to date with flu and pneumonia vaccines, and establishing a plan for clinical care if isolated or quarantined. Finally, he advised, 'Maintain a social network, but remotely—social contact helps us stay mentally healthy and fights boredom.'"
From the National LGBT Cancer Network
Why are LGBTQ+ people at particular risk for coronavirus?
"As an LGBTQ+ person, the faster you take steps to reduce your potential transmission of the virus, the more community members (and others) you will help. These steps include: more vigilance about staying away from groups of people, avoiding touching common surfaces, frequent handwashing, avoiding or at least reducing the number of times you touch your face. All smokers should know they can access free cessation services by calling or visiting 1-800-QUIT NOW."
From John-Manuel Andriote for Psychology Today
Lessons for Living Through the COVID-19 Pandemic
HIV-AIDS taught us that silence = death, and information = power.
"Something we learned in the HIV-AIDS pandemic that is highly relevant to the outbreak of the novel coronavirus: Words matter. Facts matter. It matters how we talk about something like a virus, the illness it causes, and those affected by it. We learned that silence (and ignorance) equals death—and information equals power. Armed with fact-based information, we are best prepared to address the challenges that will lie ahead for many of us."
From Amanda Holpuch for The Guardian
She's a legend in the fight against HIV. Now Dr. Deborah Birx is taking on Covid-19
"Having gone head-to-head with global health leaders while overseeing a program responsible for saving millions of lives, Birx has become something of a legend in the global health community."
From Kendall Ciesemier for The New York Times
Afraid of Coronavirus? I Know What That Fear Is Like
I live with chronic illness. Here is my advice for keeping calm in a health crisis
"But years of living with transplant complications, including a compromised immune system, have taught me how to live despite this fear, how to navigate a world rife with potential danger at every turn."
Looking for Support?
State-by-state HIV/AIDS hotlines from the Ryan White HIV/AIDS Program
CDC HIV hotline:
1-800-CDC-INFO (232-4646)
1-888-232-6348 TTY
In English, en Español, 8 a.m. to 8 p.m. E.T., Monday through Friday
AIDSinfo hotline:
1-800-HIV-0440 (448-0440)
1-888-480-3739 TTY
1-301-315-2816 (outside the U.S.)
In English, en Español, 1 p.m. to 4 p.m. E.T., Monday through Friday
SAGE LGBT Elder Hotline:
877-360-LGBT (5428)
24 hours a day, seven days a week, in English en Español with translation in 180 languages
Next Avenue will continue to provide trusted coverage on the coronavirus as it evolves at nextavenue.org/covid-19. We're also fielding reader questions and want to know critical information you're not receiving from other media.
Additionally, our colleagues across public media offer excellent reporting that shares essential information we all need to know, without hyperbole and speculation. If you haven't already, please look to PBS NewsHour, NPR and your local public media outlets to stay current.


HIV/AIDS and Safety During COVID-19

Grace Birnstengel

Not only had I lived my entire life in Minnesota, but I had also worked my 25-year health care career there. As a patient, I always trusted I was safe. As a nurse, the weight on my shoulders to be fully competent in all areas and get everything done was always heavy.
With a little planning and research, snowbirds can establish a secondary health care team at their home away from homeI never thought about how Minnesota ranked compared to other states, but if the stress put on nurses there to do it all while doing it well was any indication, I should have known we had something to prove.
My family moved to Texas last year. Good health care was an unconscious expectation and not a consideration in our decision to relocate. I was stopped in my medical knowledge tracks quickly, though, by health care culture shock, if you will.
Trusting a new care team for winter travelers who need medical care year-round can be scary.
When another winter was approaching, I began thinking about all the snowbirds that would soon move to their southern winter abode before Minnesota's blustery wind chills set in. How would retirees who didn't know anything but the best get the quality of care they needed if I, a long-time registered nurse, could instantly pick up on the laxness of southern health care and recognize that I needed to advocate for myself?
Health Care Quality Varies by State
The United States health care system is often a point of public criticism. More than 70% of Americans feel failed by it.  High costs, low insurance coverage and lack of time with health care providers are just a few grievances on patients' extensive litany of complaints.
Forbes in 2023 published a health care rankings list for all 50 states based on 24 metrics in four broad categories: health care access, health care outcomes, health care cost and quality of hospital care. Minnesota ranked as the best state for health care, with no marks against it. Texas ranked as the 8th worst state.
Overall, southern states ranked more poorly than northern states. Seven of the 10 worst-ranked states are in the South (Georgia, Alabama, North Carolina, Mississippi, South Carolina, Arkansas and Texas).
Trusting a new care team for winter travelers who need medical care year-round can be scary. However, new and seasoned snowbirds transitioning seasonally between a summer and winter home can be successful. Though you cannot control how health care organizations run, you can be prepared and take charge of your health needs when away from your primary home.
Health Insurance and Services
Millions of older people (about 5.5% of Medicare beneficiaries) migrate between two homes yearly to enjoy retirement benefits. Some are motivated to relieve cold-weather physical symptoms, such as winter-induced respiratory illnesses or arthritis, while some still need year-long medical management of their health conditions.
Whether you are healthy or in need of regular care, knowing the details of your health insurance plan(s) will be helpful when it is time to see someone other than your usual doctor.
Some types of insurance plans and services to consider:
Medicare and Health Insurance. Find physicians and locations that are in your primary insurance and Medicare networks. Then, decide if supplemental insurance makes sense for you and your plans.Medicare.gov, an official government website, has information about its multiple plan options, covered provider locations and limitations. A Medicare specialist can help guide you through coverage and the complications of juggling locations.Snowbird Insurance. Yes! There is actual snowbird insurance through Medicare.Travel Medical Insurance. Travel insurance is for shorter trips. However, it may be useful for taking a trip or vacation while living in your winter home.Home Care Services. For continuity of care and insurance coverage, national home health care providers may be an option if you need to receive home care visits.Concierge Services. If cost is not a hindrance, concierge services can give you VIP status and take care of health care coordination for you.A Digital Game Changer
Most snowbirds are younger retirees with higher education and income, so technology may not be a barrier to accessing and transferring information online.
One study on older seasonal migrators found that winter travelers had higher rates of emergency room visits than non-seasonal migrators. Many visits were not for emergencies; a primary care physician could have treated the ailment. However, many of the winter migrants did not have a primary care physician at their summer domicile. The study showed that those who had established primary care in their warm-season homes had reduced unnecessary ER visits by 58%.
Adding a secondary care team near your winter home can be manageable with the internet, cell phones and mobile apps. Here are some tips on how you can keep your primary care at your fingertips to set up and utilize secondary care at your home away from home:
Telehealth and E-visits. You can meet with your primary care team via video call for non-urgent needs.Mail Prescriptions. Many mail-order pharmacies can switch between your winter and summer addresses with adequate advance notice. You can also use national chains near your homes for pick up or delivery.Universal Health Information Systems. Many major health systems use the same medical records software (EPIC is common). With consent from the patient, care teams can see your medical records from other providers.Patient Portals. Use your health care organization's patient portal to view, download and print visit medication lists, allergies, test results, immunization dates, visit notes and other documents. Make copies of these records for your secondary care team. You can also make requests and send messages to your doctor through the patient portal.Get your annual visits or checkups at your primary location at least a month before leaving to allow time to complete tests and follow-ups.
Tips and To-Dos
Taking time to make and check off your to-do list well before your departure will help keep you organized and have your necessary documents handy.
Here are some tips to get you started:
Take a picture of your insurance card with your phone and store it in your phone's digital photo album. Also keep a hard copy on you.Designate one of your home locations as your primary home.Get your annual visits or checkups at your primary location at least a month before leaving to allow time to complete tests and follow-ups.Schedule planned surgeries and procedures at least three months before travel to allow for recovery and follow-up.See your annual specialists in your primary home state but know where to find one in your winter state if an urgent visit is needed.Request a three-month prescription refill just before departure.Research in-network providers in your winter state. After choosing one, complete the new patient forms online or print hard copies.Familiarize yourself with nearby hospitals, emergency rooms and urgent care locations.Provide both care teams with a copy of your advanced care directives and living will.Make a list of your emergency contacts and give them to friends, family and neighbors.Be a Savvy Snowbird
Savvy snowbirds can smoothly transition from state to state. Early research, planning and organization can provide the information your secondary team needs to establish care or maintain an ongoing relationship. 
The less time it takes them to obtain your information and health history, the more quality time they can spend caring for you while you are there.


How Snowbirds Can Find Quality Health Care

Andrea Wickstrom

She's the "Dancing Queen." At 99-years-old, Margaret Masters dances rings around many of those half her age. Masters is the master of her Zumba class, which she participates in twice a week. While she was attending classes at the Metairie, Louisiana Humana Neighborhood Center, Margaret now participates virtually. Neither surgery, nor a pandemic, nor Hurricane Ida can keep her away.  
Masters credits her good health to staying active and positive: "I don't let myself sit down and slow down…you need to move!"   
Her dedication is an inspiration to her fellow dancers and instructor, earning her the well-deserved 2021 SilverSneakers Member of the Year Award.  Those who know Masters describe her as "a wonderful example of growing older actively and graciously," and "one of a kind — with a sassy attitude and zest for life."  
When COVID-19 forced the SilverSneakers classes to go virtual in 2020, Masters didn't miss a beat. The tech-savvy nonagenarian had no problem doing Zumba on Zoom. In fact, she taught her younger friends how to access and use the app so they could keep up their dancing routine. While Masters would have preferred to attend class in person with her dance buddies, there were some advantages doing it from the privacy of her home. "You can do Zumba in your pajamas, and nobody cares," explained Masters.   
Masters had survived more than a year of the pandemic when Hurricane Ida made landfall on August 29, 2021. Her home sustained damage but she luckily stayed safe, riding out the storm at a neighbor's house. In just a few days, she was back in Zumba class thanks to her instructor, Deana Lejarza, using a generator to power her classes and help her students stay virtually connected and healthy. That connection was particularly important given that some class members had to evacuate to neighboring states. 
Not only does Zumba get your heart rate up and is just plain fun, research shows dancing is good for both your physical and mental health. It can significantly improve muscular strength and endurance, cardiovascular health, balance and cognitive ability in older adults, and studies have found that it reduces the risk of developing dementia. Dancing to music also releases serotonin, dopamine and endorphins — all natural mood-boosters. 
In addition to Zumba being good for the mind and body, the friendships formed in that class and during other activities at the Humana Neighborhood Center are as important to members' well-being. Masters believes that both dancing and friendship kept many in her class from falling into deep depressions during that very challenging time.
Now that the Humana Neighborhood Center is open again, Masters and her Zumba classmates can attend in-person or have the option of accessing the classes online through the Virtual Neighborhood Centers. In addition to the SilverSneakers Zumba classes, Humana Neighborhood Centers across the country offer special events, programs, activities and lessons such as crafts classes, cooking demos and meditation sessions, to name just a few.    
SilverSneakers classes at the Neighborhood Centers are available to Humana Medicare members whose plans include the SilverSneakers benefit. SilverSneakers classes are also offered at participating gyms and fitness facilities. Many other services offered at the Neighborhood Centers can be used by anyone, including those who are not Humana members, at no cost. Click here to find a Humana Neighborhood Center near you. 
During the upcoming Medicare Annual Election Period, which runs Oct. 15-Dec. 7, 2022, eligible beneficiaries — including individuals ages 65 and over and those living with disabilities — will have the opportunity to sign-up for Medicare Advantage plans that, unlike traditional Medicare, offer benefits that can include access to fitness programs like SilverSneakers or other types of gym memberships.     
Medicare Advantage plans can also help save beneficiaries money. In fact, Medicare Advantage members spent $2,000 less, on average, on healthcare costs than those using traditional Medicare. And they often experience better health outcomes — MA plan members had a 43% lower rate of avoidable hospitalizations and a 48% lower rate of hospitalizations for those with major complex chronic conditions, than those in traditional Medicare.  
For more information about Medicare Advantage plans, eligible individuals can visit www.Medicare.gov or call 1-800-MEDICARE (800-633-4227), 24 hours a day, 7 days a week. Additionally, you can learn about Humana plans, which are recommended by USAA* – a company known for its member satisfaction and commitment to the financial security of current and former members of the U.S. military – by going to www.Humana.com/Medicare or calling 1-888-372-2614 (TTY: 711) to speak with a licensed sales agent from 8 a.m. to 8 p.m. local time, seven days a week. Humana will offer in-person, online, telephone enrollment options and can provide support in 27 different languages. All enrollment options will connect Medicare beneficiaries with a local licensed sales agent.  
Disclaimer 
Humana is a Medicare Advantage [HMO, PPO, and PFFS] organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. 
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99-Year-Old ‘Dancing Queen’ Zumbas Her Way to Good Health

In April, the Smithsonian Institution's National Postal Museum opened a new exhibition, "Baseball: America's Home Run," which features artifacts representing every era and facet of America's pastime.
Nearly 300 people attended the VIP opening, including the son of the Pittsburgh Pirates' Hall of Fame right fielder Roberto Clemente and two grandchildren of the Brooklyn Dodgers' Hall of Fame second baseman and civil-rights advocate Jackie Robinson.
From left, Joe DiMaggio New York Yankees rookie home uniform, 1936. On right, the Jackie Robinson stamp issued in 1982, the first U.S. issue ever to honor a specific baseball playerRubbing elbows with all of the celebrities and scions was a man few would recognize, Stephen Tsi Chuen Wong, a Goldman Sachs executive based in Hong Kong and the exhibition's honorary advisor.
"The opportunity to collaborate with someone as creative as Stephen is one of the rewards of being a museum curator."
Wong played a pivotal role in making the exhibition happen. He helped develop the exhibition's themes and script, wrote blog posts and recorded videos for the museum's website, recruited sponsors and sourced artifacts, more than 50 of which he lent from his own extensive collection.
Those items include bats and game-worn uniforms from Robinson, Clemente, Babe Ruth, Lou Gehrig and other baseball luminaries, as well as such unique items as home plate from the last game played at New York's historic Polo Grounds.
"The opportunity to collaborate with someone as creative as Stephen is one of the rewards of being a museum curator," says Daniel Piazza, who has chaired the Postal Museum's philately department since 2014. "We really fed off each other's passions — his for baseball, mine for stamps and postal history — in order to produce an exhibition that is a landmark achievement in both fields."
From a Single Card to a Sprawling Exhibit
The show, the Smithsonian's first major exhibition on baseball, officially took four years to develop, but its genesis really dates back more than four decades.
One day in the mid-'70s, when he was about 9 years old and living in Los Altos Hills, California, Wong got an urgent call from a friend, David Guslani, who had something "really important" to show him. Intrigued, Wong raced to his friend's house, where he got to see and hold a 1959 Roger Maris baseball card.
Maris was the man who in 1961 had broken Babe Ruth's single-season home run record. Wong was hooked. "It was one of those moments where the seas parted," Wong says. Before long, he'd begun a baseball card collection, handing over nickels, dimes, and even whole dollars for cards featuring players like Hank Aaron and Willie Mays.
Of course, many kids his age do the same thing, but the seas parted twice for Wong. While doing research at his prep school in Lawrenceville, New Jersey, he started flipping through a collection of yearbooks dating back to the late 19th century. 
"When I got to the yearbooks around 1910, I found a newspaper clipping wedged in between the pages that looked like it had been there for decades," he says. "It was all yellowed and brittle, and it was the poem 'Baseball's Sad Lexicon.'"
Dead-Ball Era Brings the Game to Life
Written in 1910, that eight-line poem describes a double play made by Chicago Cubs infielders Joe Tinker, Johnny Evers and Frank Chance, future Hall of Famers Wong had never heard of. "I knew it had to do with baseball because of the title, but I really had no idea who Tinker, Evers and Chance were," he says.
"Collecting became a way for me to forge a connection with the players and events that I had been reading about."
Intrigued, he hurried out and bought a copy of Lawrence Ritter's "The Glory of Their Times," an oral history of baseball's dead-ball era (roughly the first two decades of the 20th century). He read other baseball books as well and began collecting physical objects that connected with what he was reading about, including scorecards and advertisements featuring baseball players.
"Collecting became a way for me to forge a connection with the players and events that I had been reading about," he says.
Through college, law school and a job with Morgan Stanley in Hong Kong, Wong continued to expand his collection. "It evolved into higher things when I didn't have to sponge on my dad," he says.
Six years into his career, Wong felt burned out, in part because of the stress caused by the SARS epidemic, and left his job. As he tried to figure out what to do next, he rediscovered "The Glory of Their Times."
Inspired, he decided to write his own book, modeled after the earlier work but focusing on major private collections of baseball memorabilia. He got the support of several major collectors, wrote a proposal and pitched it to Smithsonian Books in 2003. It was quickly accepted, in part because Don Fehr, head of Smithsonian Institute Press, was a big baseball fan.
Writing the book, "Smithsonian Baseball: Inside the World's Finest Private Collections," took Wong two and a half years, including six months he spent traveling around America with photographer Susan Einstein to document 21 world-class collections. He returned to the corporate world in 2005 but has never left baseball behind.
Still Collecting After All These Years
Over the years, however, his approach to collecting has changed. Instead of acquiring for the sake of growing his collection, he began in the late 1990s to focus on game-used bats and uniforms, savoring the direct connection between an artifact and an iconic player. "That was the uniform he wore at home games or away games," he says. "I just felt the historical significance of that is almost unsurpassed."
Lou Gehrig’s New York Yankees road jersey with Baseball Centennial arm patch, 1937–1939Today, he focuses on artifacts with thematic connections. For example, he might display a uniform and bat used by Washington Senators outfielder Goose Goslin alongside a panoramic photo of the 1933 team and a scorecard from a 1932 game.
"I love the notion of combining artifacts in a very symmetrical way that really highlights the beauty of those objects but also shows the diversity of artifacts that commemorate baseball history," he says.
That approach is evident in the National Postal Museum exhibition. Given its setting, the exhibition includes hundreds of postage stamps, but they are all displayed with related artifacts. Take Jackie Robinson, for example. Visitors can see a stamp honoring Major League Baseball's first Black player, the original stamp artwork, the road uniform that appears on the stamp, an autographed baseball and a program and ticket from a 1947 game at Ebbets Field, the Dodgers' home before the team moved to Los Angeles.
More Exhibits Are in the Works
Wong is also increasingly committed to sharing his hobby with the public. He has published two more books with Smithsonian Books and has helped organize exhibitions at museums across the country.
"I consider it an extreme privilege to be able to own these artifacts and preserve them," he says. "Rather than them being locked up in Hong Kong, I want them to be shared with the public so other people in the public can enjoy them."
And the public is appreciative. "The exhibition has received excellent reviews from everyone that has visited in person, as well as those that have visited our virtual exhibition," said Elliot Gruber, director of the museum. "This exhibition is unique, telling amazing stories with one-of-a-kind, rarely seen artifacts."
After the Smithsonian exhibition opened, Wong's aunt, Marie Lam, posted a note of congratulations on his Facebook page. "So proud of you. Bringing a childhood hobby to this level in the heart of the Nation's Capital," she wrote.
Indeed, he has come a long way from the day he first saw that 1959 Roger Maris baseball card.


Swinging for the Fences

Mark Ray

One of six older people experiences some form of abuse, says the World Health Organization (WHO). In Canada, the risk is much higher for Indigenous older adults, according to Statistics Canada. So how can ordinary people help to raise awareness of – and stop – elder abuse?
Gloria May Eshkibok combined her gifts of acting and activism in the projectHere's how our community arts company created a podcast series about elder abuse, with dramatizations of true stories created and performed by community members, facilitated by professional theatre makers.
"Mishoo miinwaa Noki ~ You, Me and Wrinkles" is part of that podcast. "Wrinkles" calls out abuse in a simple, courageous way – it names it, and says enough is enough. "Wrinkles" features authentic voices, in English and Anishinaabemowin (Ojibwe), at the heart of the podcast. Realistic scenes inspire listeners to bring elder abuse out of the shadows and normalize talking about it.
"We need to talk about these issues. Even though they are raw, hurtful and scary, we need to kiss that monster on the nose."
"We need to talk about these issues. Even though they are raw, hurtful and scary, we need to kiss that monster on the nose," says Ronat John, from M'Wikwedong Indigenous Friendship Centre in Owen Sound, Ontario, Canada.
The podcast is the brainchild of Joan Chandler, the artistic director of Sheatre, a community-engaged arts company based in Grey and Bruce counties in rural Ontario. Sheatre believes in the power of theatre and the arts to change lives and help build a compassionate and healthy society.
Since its inception in 1985, Sheatre has reached close to 185,000 people through the creation and production of 117 original plays and 1350 events in rural, Indigenous and small urban communities in Canada, the U.S. and England.
I've worked with Sheatre for just over 20 years, and in that time, I've been part of productions that tackled complex issues that most would rather not talk about, let alone make a play or song about. 
The approach is deceptively simple: invite people with experience of a thorny issue to come together and play, and through that guided play, build not only trust, but scenes that reveal the complex subjects: dating violence, homophobia, dementia and elder abuse. Creative workshops sometimes turn into full-length productions that go on tour if there's enough community traction and support from funders.
"Wrinkles" began as an original community play, facilitated and directed by Chandler in 2009. The cast were community members of Wiikwemkoong Unceded Territory on Manitoulin Island. They answered the call to speak out using theater.
The Premiere of 'Wrinkles' 
Celebrated Indigenous actor and activist Gloria May Eshkibok was instrumental in gathering and galvanizing the right volunteers. The "Wrinkles" premiere was memorable, and not only for the impactful subject matter; the audience and cast had to brave a ferocious blizzard to get to the show!
The cast of “Mishoo miinwaa Noki ~ You, Me and Wrinkles”Eshkibok, reflecting on the premiere, said, "The snow [that] came that day for that presentation was a sign from the Creator. It's important work that we're doing. It's important work that we're listening to. It's important work… to bring awareness." 
To reach more people and sidestep the difficult logistics and expense of touring a large cast of community actors, the cast recorded the play as an audio drama series, which aired on Indigenous radio stations in 2010 and 2011.
Fast forward ten years. The pandemic arrived, and reports of elder abuse skyrocketed, according to Elder Abuse Prevention Ontario. Sheatre had partnered with the organization to present a previous play about elder abuse, "Ye Canna Throw Yer Granny Off A Bus!" and were in the middle of a tour to seniors centres and conferences.
Now everyone had to shelter in place, and no live performances were allowed, despite the even greater need to confront and educate people about elder abuse. Chandler remembered her experience of adapting "Wrinkles" from play to audio drama and then hit on the idea of a podcast.
Pivoting to a Podcast 
In a break between COVID waves in the summer of 2020, the cast of "Granny" recorded a new adaptation, set in the pandemic, at a local studio. When on tour with the play, local service providers were invited to lead post-show Q & A sessions to unpack the scenes and suggest resources and strategies. The "Wrinkles" and "Granny" podcasts follow that two-part model: audio dramas complemented by discussions.
"It's not easy to talk about elder abuse, especially when we're so close to it."
The audio dramas draw the listener in with lively, challenged characters, humor and loving tributes. The discussions bring knowledgeable people together to share their experiences, reflect on the scenes they've just heard, and offer possible solutions and resources. 
Highlighted issues include physical, emotional, mental and spiritual abuse, isolation and neglect, family dysfunction, and in the case of "Wrinkles," the devastating impacts of Indian Residential Schools and colonialism. Speakers include Elders, survivors, community workers, law enforcement, harm reduction workers, legal aid representatives and children.
There's also music to uplift the listener including songs performed by the cast, by the Ode'min Kwe Singers from Wiikwemkoong, and by staff from M'Wikwedong Indigenous Friendship Centre. There's even some Hank Williams.
The "Wrinkles" episodes offer variety. In "Boozhoo/Welcome," Elder Shirley John of Saugeen First Nation starts off the series with the Grandmother Song, a prayer, and insights into the Seven Grandfather Teachings. Those teachings provide a foundation for "Mino Bimaadiziwin" – the good life – an Anishinaabe concept for healthy living through the balance of the four elements of health: physical, mental, emotional and spiritual.
There's an entire episode in Anishinaabemowin, "Kitchi Nshinaabeg dibaataanaawaa Kitchi Nshinaabeg miji doodwindwaa – Elders Talk About Elder Abuse in Ojibwe."
'Real Stories and Real Solutions' 
Others feature Elder Austin Elliott who recounts his family's story, kids from M'Wikwedong, who share their thoughts, and two cast members, Dorothy Wassegijig-Kennedy and Eshkibok, remember how "Wrinkles" came to life.
An Elder’s voice and reflection begins the “Wrinkles” podcast. Elder Shirley John from Saugeen First Nation."Well, I remember the feeling of it… I believe that there was a lot of spirit there," says Wassegijig-Kennedy. "And of course, we were there to talk about a rather stressful topic. It's not easy to talk about elder abuse, especially when we're so close to it."
"It's crucial to remember that elder abuse is a serious problem that's often not discussed or reported because of shame, fear, and lack of awareness of resources. These are real stories, and real solutions, told by real people. Wrinkles gives them a platform to be heard, and break the silence around difficult situations," says Chandler. 
The podcasts are available on Sheatre's website, along with links to  resources, and information on the cast and speakers. There's also a guide on how to use "Wrinkles" and "Granny" in your community.
"We've always accommodated so much over our own best interests, our own morale, our own enlightenment," says Wassegijig-Kennedy, who has worked for decades in her community as an Indigenous Healing and Wellness worker and presently as a language teacher. "So I just like to point that out, that we need to keep on bringing ourselves up. And we're not just tools to resource here … We're doing a great big thing here."
How to Get Help
If you or someone you know needs help, here are some resources:
In the U.S.: Call 911 if it's an emergency.
In the U.S.: Call 211 for help in connecting with supports and services close to home.
The “Mishoo miinwaa Noki ~ You, Me and Wrinkles” art is a detail of “Wisdom of Nokomis”In Ontario: If you or someone you know is affected by elder abuse, call the Senior Safety Line in Ontario anytime, anonymously and free of charge at 1866-299-1011.
Talk 4 Healing is a helpline for Indigenous women across Ontario. Talk, text or chat 1-888-200-9997. They are there to listen any time of day.
In Canada: The Indian Residential School Survivors and Family 24-hour Crisis Line is at 1-800-721-0066
Turning to a good friend or trusted family member may be an option. Community can be helpful, so look around and talk to each other.
"Wrinkles" contains scenes of violence against older adults, strong language and frank discussion. Listener discretion is advised.  Sheatre is located in the traditional territory of the Anishinaabek Nation, the people of the Three Fires known as Ojibwe, Odawa and Pottawatomi Nations. We thank the Chippewas of Nawash and the Chippewas of Saugeen, known collectively as the Saugeen Ojibwe Nation, as traditional keepers of this land, for the opportunity to meet here. We also acknowledge the Metis community whose history and people are well represented here. We recognize the long and continuing history of Indigenous peoples in this place and affirm that we are all treaty people with all the responsibilities and relations that commitment entails.

'Wrinkles' Podcast 'Kisses the Monster' of Elder Abuse in Indigenous Communities

David Sereda

Jerry McCoyJerry McCoy was in bad shape. His diabetes and high blood pressure were out of control. It had gotten so bad that, for two months, he was unable to leave his home in Houston. What was especially hard for McCoy was that his poor health prevented him from going to church, which had been a central part of his life. 
When he finally was feeling well enough to resume some activities, including going back to church, he attended a senior banquet that changed his life and likely saved him. It was there he met Gail Venyah, a member of the CenterWell Senior Primary Care center staff, who encouraged him to use his Humana health plan benefits to schedule an appointment at the primary care center.  
CenterWell is not your typical doctor's office. It is solely focused on treating older adults, and not just their physical health. A care team consisting of physicians, pharmacists, behavioral health specialists, social workers, nurses and care coaches not only addresses patients' medical needs, but also their socioeconomic challenges, such as food and housing insecurity, access to transportation and utility services and mental health care.  
It was not what McCoy was used to experiencing since developing diabetes some 20 years ago. "I've never had care like this before," said McCoy. "They made me feel like I was the only patient they had and were more concerned about me than I was." 
There was good reason for their concern. McCoy is one of 35.4 million Americans living with type 2 diabetes. When not properly controlled, diabetes can lead to a host of complications, including heart disease, chronic kidney disease, nerve damage and vision loss, as well as other physical and mental health conditions. It can also result in death, with Black Americans twice as likely to die from the disease as white Americans. 
When Amy Kelleh, a pharmacist at CenterWell Senior Primary Care in Houston, had her first appointment with McCoy, his blood sugars were extremely elevated and his blood pressure was dangerously high. She discussed what his lab results meant, the medications that were prescribed to treat both his diabetes and hypertension and answered all his questions. McCoy recalls, "She stayed in the room as long as necessary and made things so comfortable and clear. And then she called me once a week to check on how I was doing and if the medications were working. I never before had a pharmacist who told me to call them anytime I needed to — that just doesn't happen." 
Before becoming a CenterWell patient, McCoy would go to medical appointments and be told what he needed to do but would never be asked for his input or included in the decision-making process. In contrast, CenterWell takes a patient-centered care approach where healthcare providers and patients are partners in making treatment decisions. Research has shown that patient-centered care improves self-care and quality of life for patients with diabetes.    
That has definitely been true for McCoy. Two-and-a-half months after his first appointment at CenterWell, McCoy lost 30 pounds, exercises regularly and felt great.
For the CenterWell staff, helping patients like Jerry make such remarkable strides in improving their health is what their jobs are all about. "Seeing a patient reach their goals is confirmation that what we're doing really matters," said Kelleh. 
McCoy is grateful for that day in church when he learned about the CenterWell Senior Primary Care center. "It's changed my life and it's all because of the care that CenterWell offers. I feel better now than I have in years." 
The Advantages of Medicare Advantage Plans 
CenterWell Senior Primary Care centers are available to older adults on a wide variety of Medicare Advantage health plans, including those from companies other than Humana. To find a CenterWell facility near you, click here. 
Medicare Advantage plans are often focused on coordinating care for those with multiple chronic conditions, helping lead to cost-effective interventions to address the unique health needs of aging and disabled Americans. In fact, MA plans had a 43% lower rate of avoidable hospitalizations and a 48% lower rate of hospitalizations for those with major complex chronic conditions, compared to fee-for-service Medicare patients.In addition to improving health, these outcomes demonstrate real savings for older adults and the health system. 
During the 2023 Annual Election Period, which runs Oct. 15-Dec. 7, 2022, eligible beneficiaries can sign up for Medicare Advantage plans that, unlike fee-for-service Medicare, may offer affordable drug plans and supplemental benefits including vision and dental, as well as gym memberships, and some plans may even offer special supplemental benefits that cover some living expenses for those with chronic conditions (who meet qualifying criteria) such as transportation for medical appointments, rent and groceries.   
For more information about Medicare Advantage plans, eligible individuals can visit www.Medicare.gov or call 1-800-MEDICARE (800-633-4227), 24 hours a day, 7 days a week. Additionally, you can learn about Humana plans, which are recommended by USAA* — a company known for its member satisfaction and commitment to the financial security of current and former members of the U.S. military — by going to www.Humana.com/Medicare or calling 1-888-372-2614 (TTY: 711) to speak with a licensed sales agent from 8 a.m. to 8 p.m. local time, seven days a week. Humana will offer in-person, online, telephone enrollment options and can provide support in 27 different languages. All enrollment options will connect Medicare beneficiaries with a local licensed sales agent.  
Your results may vary. It may not be typical to improve health conditions by taking the actions McCoy did. 
Humana is a Medicare Advantage HMO, HMO SNP, PPO, PPO SNP, AND PFFS organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. 
*USAA and the USAA logo are registered trademarks of the United Services Automobile Association. All rights reserved. USAA means United Services Automobile Association and its affiliates. Use of the term "member" or "membership" refers to membership in USAA Membership Services and does not convey any legal or ownership rights in USAA. Restrictions apply and are subject to change. 
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