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Health Topic of the Month: Skin Cancer Detection and Prevention


Basic Facts

Every hour, one American dies from melanoma. Melanoma, or skin cancer, is a very aggressive form of cancer. According to the Melanoma Research Foundation, 90% of skin cancer is caused simply by exposure to UV light and sunlight. (UV light also comes from the sun, but can be found in the light of a tanning bed.) It only takes one blistering sunburn to dramatically increase your chances of melanoma decades later in life.

Avoiding Skin Cancer

If you use a tanning bed, stop. The World Health Organization’s International Agency for Research on Cancer (IARC) puts tanning beds into the highest cancer risk category. In other words, tanning beds are carcinogenic to humans.

Avoid the sun. Seek out shade whenever possible. Bring a hat with you to avoid getting too much sun on your face. While driving, cover up your left arm with a long-sleeved shirt. And if you are going to be out in the sun, use sunscreen with an SPF of at least 30.

If you are prone to freckles and moles, get an annual skin review by a dermatologist. And insist on a full-body review. That means asking the doctor to look at all the parts of your body you can’t see. It might be a tough ask, but it’s worth avoiding a dangerous diagnosis later on.

Knowing Your ABCs of Melanomas

  • Asymmetry: Skin cancer comes in all shapes and sizes. Typically, the visible part of the cancer growth will have an unusual shape.
  • Borders: A non-cancerous mole will have a smooth, defined border. Skin cancer will not.
  • Color: Skin cancer can often be mottled in its coloring. It won’t have a single color (like a mole), but will range in tones from black to red to tan to purple.
  • Diameter: If it’s bigger than a pencil eraser (6mm), go see the doctor.
  • Evolution: Skin cancer will rapidly change over time. And if a mole that you’ve had for years starts to shift and change suddenly, it’s a serious indicator that you might have skin cancer.

Early detection of skin cancer is critical in a successful treatment plan. Don’t be shy or embarrassed about asking your doctor to look at your moles and freckles. And once you’ve asked, tell your doctor you will be asking about this issue on a regular basis.

Healthy Eating: Yogurt as a Source of Protein

There’s nothing worse than feeling hungry at 10pm. You know you shouldn’t eat, but your stomach is rumbling. And that bag of chips is calling from the cupboard. This is a perfect time to try having some yogurt.

Most of us don’t have any problems eating enough carbohydrates. And some of us have had enough carbohydrates to last through a tough, Nordic winter. But many of us just don’t eat quite enough protein.

So, when those midnight munchies hit, try hitting back with a bit of yogurt. Yogurt is packed with proteins. Greek yogurt is extra thick yogurt with an extra dose of protein.

If you really want to eat like a champ, try some unflavored yogurt. It might be a little tart, but when mixed with fresh fruit or a sweetener like stevia (see below), you’ll get all the protein without all the extra sugars.


OK… so what’s stevia and why is it showing up everywhere?

First came Sweet ‘N Low. (That’s the one in the little pink packet.) Then Equal (the blue packet). Splenda emerged in the 1990s as most like sugar (the yellow packet). And now… stevia.

But stevia is a little different. Stevia comes from a plant and frequently falls into the “all-natural” category of foods. For those people who are sensitive to chemicals, stevia might be a reliable no calorie option.

Keep in mind, stevia is not perfect. (It still has an aftertaste.) But when mixed with a touch of real sugar, maple syrup, or honey, stevia can give you the taste you want in an all-natural form. Several companies are producing stevia sweeteners, and most of them are using green packets to distinguish them from the other no calorie options. You can now find stevia in most major grocery stores and at Starbucks.

Stevia is very potent. And the majority of stevia powder is just filler. If you shop at Trader Joe’s you might be surprised to find a $20 container of pure stevia. It comes with a tiny tiny tiny scoop, because one mini-scoop of pure stevia is enough to satisfy the sweetest of sweet-tooths.

LIS, Medi-Cal, and Extra Help (Oh my!)

For lower income adults, there are several federal and state programs that can help reduce healthcare costs. We compiled some of the most common questions below and supplied you with the most precise answers possible. Of course, we always recommend calling your health insurance agent to go over the specifics of your financial circumstances.

What is LIS?

LIS stands for Low Income Subsidy. It’s also known as Extra Help. LIS is a federal program that helps reduce the costs of your prescriptions. For those who have to pay for a Part D (drug plan), LIS can help reduce the cost of the monthly payment.

How Do I Sign Up for LIS?

You sign up for LIS through the Social Security Administration website. (

I already get Medi-Cal/Medicaid. Shouldn’t I already get LIS?

Medi-Cal and Medicaid are state programs, and LIS is a federal program. In theory, there would be an easy-breezy flow of communication between all state and federal programs. But, that’s not always the case. Ask your health insurance agent for some help verifying that you already get LIS. And have a good talk with your agent about your current income levels. There are several tiers of support inside LIS and those tiers of support are based on your income. Plus, those income levels change over time. So if you were on the cusp of qualifying in the past, you might have access to more federal help now.

What’s the difference between Medicare, Medicaid, and Medi-Cal?

Medicare is the federal plan that gives you the Part A and Part B coverage for doctors and hospital stays. Many people qualify for Medicare when they turn 65, but some people who are disabled qualify sooner. Medicaid is the term used to describe the health coverage provided through your state. The state of California thought it would be clever if they called their Medicaid plan, Medi-Cal. Get it? Medi-Cal… like the word, “medical” but with the “Cal” for “California”? Isn’t that fun? (Yeah, we don’t think it’s all that amusing either.)

Who runs Medi-Cal?

Generally speaking, the state allocates money to each county in California, and then each county uses those dollars to provide the Medi-Cal services in the county. So, every county is a little different. When you ask your agent for some help about Medi-Cal don’t be surprised if they need to look up some specific information about your county.

Is Medi-Cal just for seniors?

No. (And this is where it really gets fun.) The Medi-Cal benefits for seniors are very different than the benefits for people under the age of 65 who use Medi-Cal as health insurance. So, you might hear someone say, “That doctor doesn’t take Medi-Cal.” But that could just be for someone under the age of 65. So we recommend (again) that you chat with your health insurance agent to go over your options.

There is no simple way to describe how Medicare and Medi-Cal function. Frankly, every circumstance is a little different. Your health insurance agent goes through weeks and weeks (and weeks!) of training and testing every year to be an expert. Trust him or her with your questions and give yourself the freedom to enjoy your retirement!



Prior Editions


Doctor Visits and Home Health Care

60 years ago, you woke up to a jug of milk and a newspaper on your front door step. And if you were feeling sick, the doctor came by for a visit. Over the years, we veered away from personalized home services. But thanks to technology, many of those same services are back. Today, you can order almost anything on-line and have it delivered to your doorstep – sometimes within the same day.

So, what about in-home care? Can I use my Medicare policy to have a doctor come to my home? In short, maybe. First, a clarification: a house-call by a doctor is different from home health care.


Some physicians that will go on house-calls will accept original Medicare and a supplement plan (like Plan F). In those cases, you will be charged the same way that you charged when you walk into the doctor’s office. Keep in mind, it’s up to each individual doctor or medical group to determine if they provide a visiting-doctor service.

There is a drawback when selecting a doctor simply because they will come to your home; you might have to manage the coordination of care. If you have more than one doctor, it’s unlikely that all your doctors will provide house-calls. And if you need your doctors to share information about your health, you’ll likely have to coordinate the transfer of records between the doctors every time you receive care.

If you have a Medicare Advantage plan, it’s less likely you will find a doctor to come visit your home. Medicare Advantage plans are typically HMO plans, and HMOs generally don’t include at-home doctor visits for routine care.

Home Health Care

Don’t rule out at-home care as an option if you are sick or in recovery. You’ll find that Medicare Supplement plans (like Plan F or Plan G) and Medicare Advantage plans will provide a home health care service. Typically, these services are provided for patients who are suffering from wound care, recovering from surgery, or facing serious illness. Generally, you will need to see a doctor face-to-face to get approval for home health care. Home health care aides can help patients change wound dressing, administer medications, supervise nutritional habits, and ensure a safe recovery.


For those who are comfortable with technology, many medical plans now include tele-doc services. Instead of going into a clinic or doctor’s office when you have a cold or feeling ill, you can speak to a doctor via video conference using your smartphone, tablet, or home computer. These doctors are generally board-certified physicians who can prescribe drugs such as antibiotics. If you have a co-pay, you might find that the co-pay for a tele-doc is less than an in-office visit.

New Medicare Cards

If you look closely, your old Medicare card uses your social security number as your Medicare ID number. And while your Medicare ID number also includes a letter at the end, that’s a poor disguise for an important piece of personal information.

Who’s Getting the New Card

Starting in April 2018, Medicare will begin sending out new cards to everyone. You won’t find your social security number on the new card. Because millions of Americans are already on Medicare, and millions enroll every year, it could take up to one year before you receive your new card in the mail.

Why the Change

Social security numbers are a key piece of personal information that can be used to steal identities and commit acts of fraud. In an effort to protect personal identity, the federal government is replacing everyone’s social security number with a personal identification number.

What to Do

You don’t have to do anything to get your new card in the mail. If you still haven’t received your new card by mid-2019, you can call Centers for Medicare and Medicaid Services (CMS) and ask about your card. Until then, you can continue to use your old card. Once you get your new card, you can destroy your old card. 1-800-MEDICARE (800-633-4227).


Pasta: How to Make It Healthy

Pasta might be filled with carbs, but pasta is also a good source of protein. You can get about 15% of your daily protein (about 8 grams) from one serving of pasta. So, when combined with a lean protein like chicken, pasta is a great way to feel full and stay healthy. A few pasta companies are now offering pasta with added protein. These pastas have about 10 grams of protein per serving.

To make your pasta even healthier, look for whole wheat pasta. Whole wheat pasta gives you more fiber. Typical white pasta will only give you two or three grams of fiber per serving. But whole wheat pasta will give you up to seven grams of fiber per serving.

For an extra healthy pasta, consider using pasta made from black bean flour or chickpea flour. When carefully prepared (and not overcooked), these pastas can still provide the texture and satisfaction of traditional pasta. Bean-based pastas will have plenty of protein (25 grams) and lots of fiber (13 grams) without all the gluten and carbohydrates. The drawback with bean-based pastas is the cost. While traditional pasta can cost as little as $1 per box, chickpea and black bean pastas are more than $3 per box.


Health Topic of the Month: Autism

Generally, 1 in every 42 boys is on the autism spectrum, and 1 in every 189 girls is on the autism spectrum. So, if you are a grandparent, there’s a good chance that you, or someone you know, has a relative with autism.

Children typically develop autism between the ages of two and three. Autism is characterized by a range of behaviors that include reduced social skills and repetitive behaviors. The term “autism spectrum” is often used when diagnosing the condition. Not all children exhibit the same level of behaviors associated with autism – some may just seem withdrawn or shy while others may have extreme difficulty with everyday life.

A limited number of children with autism also have savant abilities in math, music, and spatial relations. Dustin Hoffman’s portrayal in the film Rainman is based on the savant, Kim Peek, who had an extraordinarily photographic memory.

Dr. Temple Grandin Ph.D., is a well-known author, speaker, and professor of Animal Science at Colorado State University. She is also autistic. Her website,, can provide you with a wealth of knowledge about empowering a child with autism. HBO produced a film about her life in 2010.




What is the Special Enrollment for People Affected by Wildfires?


In 2017, several counties in California suffered wildfires. Those fires displaced residents and disrupted their lives. In an effort to ensure everyone has an equal chance to review and change their Medicare plan options, Medicare created a Special Enrollment period. Typically, Medicare Open Enrollment ends on December 7. This year, because of the wildfires, you might still be able to select a Supplemental Medicare Plan, Prescription Drug plan (PDP), or Medicare Advantage plan (MAPD/MA) if you lived in one of the following counties in California: Butte, Lake, Los Angeles, Mendocino, Napa, Nevada, Orange, Riverside, San Diego, Santa Barbara, Solano, Sonoma, Ventura, Yuba.

Do I Qualify?
If you qualified to buy a plan during Open Enrollment (October 15, 2017 to December 7, 2017) and you lived in one of the counties listed above, then you likely qualify, and you can buy or change your plan. The Special Enrollment ends on March 31, 2018.

But I Wasn't Affected by the Fires?
The Special Enrollment is Medicare's way of ensuring that anyone (directly or indirectly) affected by the fires has a chance to buy or change their health plans. There is no need to detail how or why you were affected by wildfires. As long as you tell your agent that you were living in the county during the time of the fires, you will qualify for the Special Enrollment.

I Changed my Plan During Open Enrollment. Can I Switch?
Generally, no. If you made a plan selection during Open Enrollment, then you are not eligible to switch your plan because of the wildfire Special Enrollment.

Does Switching Plans Cost Money?
There is no fee associated with switching your plan. And your Agent cannot charge you a fee for services. Of course, different plans have different pricing structures and you might see a change in costs if you change plans or change insurance companies.


Schedule a Plan Review BEFORE Open Enrollment

If you feel confused by what benefits you can get through your Medicare insurance plan, you're not alone. Most people stumble through Medicare decision-making one time and may never review their options again. 

The decision you make at age 65, may not make sense five, ten, or twenty years later. Your finances will most like shift significantly when you retire in your 70s. You might move to a new home in a different city or state. You might lose or gain a spouse. 

In addition, Medicare insurance plans will change over time. Costs almost always go up -- either in co-pays or monthly premiums.

If you haven't had a good, long conversation with your insurance agent in the last two or three years, it's likely time to review what options you have.

For example, in 2018, one major insurance carrier is adding a medical alert benefit to its Supplemental plan. And many Advantage plans come with low and no-cost benefits like rides to the doctor, preventative dental care, and vision benefits. 

When you sit down with your insurance agent, he or she will review your current plan. Take the following steps to ensure a productive conversation.

  1. Know the name of all your doctors. 
  2. Bring a list of your current medications and dosage for each drug. 
  3. Write down an estimate of all current medical costs such as dental bills, doctor co-pays, drug co-pays, and drug store items. 


Healthy Eating Made Easy

We all know that salad greens and vegetables, like zucchini and carrots, are important. But preparing those vegetables with a sharp knife can mean getting a nasty cut. And chewing all of those raw veggies can be tough if you’ve got some dental problems. So let’s make this easy!

  1. Start with a handful of greens like spinach or kale. (The greener, the better.)
  2. Throw those greens in a big bowl.
  3. Use a spiral slicer to shred hard veggies -- like carrots and zucchini.
  4. Use kitchen scissors to chop that salad! (It can be a little tiring on your hands.)
  5. Add your favorite salad dressing.
  6. Enjoy!

This is a great way to create a chopped salad without using a giant knife. You’ll get a bite-size salad that’s softer and easier to chew. Add parmesan cheese, cranberries, scallions, or walnuts to enhance the flavors.





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