Julie Edwards: Okay, and then
Julie Edwards: and just a bit here, i'll go ahead and start letting people in.
Julie Edwards: Okay, Good luck.
Julie Edwards: Hi, everybody, and welcome. Thank you for joining us. We're gonna get started here in just a few minutes, but I feel free to head over to the chat and say, Hi! And let us know where you're from while you're settling in here.
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Julie Edwards: We're gonna go ahead and get started. I am Julie Edwards. I'm a librarian and instructional designer with Niche Academy, and I would like to welcome you to this Webinar on Health insurance literacy and older adults.
Julie Edwards: I'm gonna do a little bit of our standard housekeeping first, and then we'll jump right in. Let me start by introducing Niche Academy. Niche Academy is an easy to use all in one learning platform to help libraries create and deliver effective training and measure learner success.
Julie Edwards: S0 0ur software is the perfect tool. If you're looking to increase your E resource, usage, improve and measure your learner's success and deliver training to impact your patrons and staff development.
If you're interested in finding out more about our e-learning solution, chatting with a member of our team hearing what your colleagues have to say, I'm going to drop a link t0 0ur website in the chat where you can learn more about us.
Julie Edwards: so a few housekeeping pieces for this next hour. We are recording this, and I will make the recording the slides and the chat transcript available to everybody who has registered for the presentation. I will send you a direct email with all of that information. In the next few days
Julie Edwards: you can turn on the closed captioning at the bottom of your screen in Zoom, if you would like to use that.
Julie Edwards: feel free to chat with each other in the chat. But if you have questions for Emily, please put those in the question and answer box things do get lost in the chat, and so I want to make sure that any questions that you have for our speaker today are in that Q. A. Box.
Julie Edwards: I will do my best to moderate the Q. A at the end of the Webinar. So this Webinar series is part of our commitment to solving bigger problems together. I'm so happy to see so many of you here, there, over 230 0f us here today. You can see our upcoming webinars and register for those. I will drop a link to that in the chat as well.
Julie Edwards: So, without further ad0 0ur presenter today is Emily Bardell. Emily is an assistant professor in the School of Library and information management at Imporia State University.
Julie Edwards: She teaches courses on the foundations of library, science, Reference and Health sciences, Librarianship.
Julie Edwards: Emily studies Health Information Behavior, focusing on health insurance literacy, and how people make health insurance decisions. I am absolutely thrilled to have her with us today, and I will turn the Webinar over to her.
Emily Vardell: Thank you so much, Julie. I'm really excited to be all here with all of you today as well. Talking about my favorite topic, health insurance literacy. And today i'll be focusing specifically on older adults.
Emily Vardell: So to get it started. I have a quote here from Senator Barbara Mikulski. It talks about what kind of health insurance and older adults can be summed up by so taking care of others. Public policy, Health.
Emily Vardell: Medicare. So as you can see, it's a multi layered idea. And so that's what's going to really guide me in my talk today. Here's a little outline of what i'll be talking about today. So first I'm going to give us some basic information. So we get a lay of the land. What does health insurance look like for seniors?
So i'll start with an overview of health insurance in the Us. Some Medicare basics, then i'll move more to the literacy piece. So, looking at Literacy and other concerns in this population, looking at solutions. To this
I will conclude with giving you some hopefully, some takeaways that you can use in practice as librarians and information providers. So, looking at Literacy informed sources. And what can we do about this? And I'll just say as a note that i'll be using seniors and older adults fairly interchangeably. And this is a huge population, so generally to find a 65, and above, you know, my parents and their parents fit in this category, and that can be really wide ranging of what the concerns are for this population. So we have all the way from
recent retirees to people who've been retired for 20 years, and may have a totally different list of health concerns and other concerns. So I will be
Emily Vardell: trying to cover all of that in this presentation. But I did just want to kind of open with some some thoughts about my terminology again, using both seniors and older adults, and who, I mean, and how this is a very diverse population, and in in and of itself.
Emily Vardell: So to get us started looking at a little bit of a timeline of health insurance in the Us. Of course, with a focus on older adults.
So really the first health insurance in the United States was the Veterans administration. The Va. Which started, as this little icon shows you in 1,865, and it provides obviously service for veterans to date. It's a services for over 9 million veterans.
Emily Vardell: and almost half of those are over the age of 65. So again, a huge portion of the va is serving seniors, and so that's something that i'll pick up a couple of times over the presentation, but something to think about. When we think about health insurance and seniors, it's not just Medicare. It also includes va services.
Emily Vardell: and then kind of continuing the the next kind of wave and health insurance in the Us. Didn't happen for almost 100 years later. That's employer sponsored insurance, and that's probably how most of us have our health insurance through our employers. And then the next thing was medicare, which was created in 1,965, and my next slide will go much more into depth about medicare. And then, finally, what probably most all of us remember in recent memory the affordable care Act in to extend health care, coverage to all in 2,010. So that's a very.
very brief timeline of health insurance in the Us. If we want to turn and look at Medicare specifically. it is one of the very few successful attempts at healthcare reform in the United States. The Us. Tends to be a resistant to to health care reform, but this one was a popular one. It focused on a politically sympathetic group. These are people who are uninsured through no fault to their own. They're retiring so they may not have access to employer sponsored insurance they paid into a system every month, so they sort of earned this idea of health insurance.
and then at first Medicare only Co. Covered catastrophic events. So it's really more like hospital insurance, worst case scenario coverage, but it has evolved over time, and i'll be talking a little bit about that as well, and that 1,965 legislation that created Medicare also created Medicaid.
Emily Vardell: I wanted to take a note also to tell you all that my slides are a little bit text heavy, but that's because I wanted you to have access to this information afterwards. So Julie and its Academy will be sharing these slides after my presentation as she mentioned. So if you you don't have to like Hurly, take down notes as i'm speaking. But I did want to have content on the slides that you could refer to afterwards after i'm done narrating. So just as a note.
So again, we'll continue talking a little bit more about Medicare, because it is such a integral piece for health insurance for seniors.
Emily Vardell: It's really the only truly national health care program in the Us. It helps over 60 million seniors, and it also includes people with disabilities which is not always unknown. And one thing to think about and thinking about, how are! How? How are older adults getting their health insurance coverage? So
Medicare is kind of the default. But 30 0f people also have this employer sponsored insurance. So very lucky people maintain their health, care, coverage after retirement. This is expected to continue to drop. Probably many of us know we once we retire. We Don't have access t0 0ur health insurance coverage. But some people do. Some companies still offer that as a benefits package, so some seniors also have it through their employers.
and some seniors also have medicaid. So that's just something to think about. But the majority of individuals, 65, and older, obtain their health insurance coverage through Medicare. And that's really again the focus of this first part of my presentation, thinking about what are, what, what kind of ecosystem are they working within. And so Medicare is going to be the focus here at the beginning.
Emily Vardell: So Medicare. Yes, it provides health insurance coverage for adults, 65 and older, but it it's not a fix. All there are problems that are embedded within Medicare. So first, as I mentioned, the original Medicare was really just supposed to be like hospital, worst case scenario coverage, so that you wouldn't
Emily Vardell: not have access, you know you wouldn't be without access to coverage and and have to refuse care you wouldn't go bankrupt from the care that you might need, but it wasn't really designed for.
you know, regular care, access to medications, things like that, so as part of Medicare includes high deductibles. It includes things like coinsurance. It doesn't include coverage for a lot of things that older individuals need like long term services. So hospice
assisted living facilities, things like that dental services we all know most of the time. Dental insurance is separate from health insurance in the United States Vision insurance is separate from the United States and hearing aids. So all of these things, as we might assume, many people within the category of older adults need access to those kind of services.
and that at the beginning was not included under Medicare. So it's not fixing everything. S0 0ne of the things that kind of rose out of this are meta-gap policies. You might have heard of those before it's also called medicare supplemental insurance, and it did provide co supplemental coverage for 29 0f beneficiaries in 2,016, and it is sold by private health insurance companies. So what yet another piece to this puzzle. People might have va coverage. They might have medicaid coverage. They probably have Medicare, but they might also be
Emily Vardell: required to purchase additional coverage to help fill in these missing pieces, and that, of course, is going to lead t0 0ur conversations about insurance literacy and thinking about. Okay, i'm operating within this really complex field, and sometimes I have to buy extra stuff, because what I'm getting by default is not covering it.
Medicare also has 4 parts. This is the tech most text heavy slide. I promise they'll continue to be a little more engaging as we go along.
Emily Vardell: But again I wanted you to have this this content, and i'll try to summarize this because you may not be familiar with all the different parts of Medicare. You may have heard about them, and not known the difference.
Emily Vardell: So Medicare Part a is really like the original version of Medicare. It is we basically as soon as you turn 65, you basically have Medicare part. A. It's sort of the default. You are eligible for it. If you have paid into the Social security system.
so you and the spot your your spouse. You don't have to pay a monthly premium for it. So it is, you know. Free. It's the free version again. You pay already paid into it, but it it doesn't require monthly premiums, and a lot of people refer to this again as like hospital insurance. It's only covering
Emily Vardell: big time staff. So
Emily Vardell: you can imagine you're a 65 year old 7 year old, 75 year old. Yes, you might need to go to the hospital, but most likely you need a lot of other types of care. You need regular preventive medicine. You need mammograms, you need prostate exams. You need your high blood pressure medication. So all these other pieces of Medicare came after that, so Medicare part B. Does require a monthly premium, so like I said that a one is sort of the default. It's free. B. It was sort of the next
Emily Vardell: stop gap that was trying to design to kind of help fill in some of these issues, so it is more like a medical insurance, more like what we might be some more familiar with with employers and sponsored insurance.
But you do have to still pay deductibles and coinsurance. So it's still, you know, can place the financial strain on on people who are using it.
Emily Vardell: Part c. Is even a more of extension of that. This is called Medicare Advantage. You've probably seen commercials for that on TV. It is run by private insurance companies and over 20 million beneficiaries enrolled in Medicare Fair. So it's very popular about a third of people who get Medicare
Emily Vardell: pay for an extra plan from a company that's kind of covering a lot more of these extra expenses that come up. And then, finally, as part D. This one's easier to distinguish, because it's specifically about prescriptions. So like I was saying. You know many people, 65 and plus are on multiple medications. For a long time there was no way to address this.
but Part D is the most recent one. It came up in 2,006, and that's designed for covering prescriptions. But the thing about this is that
Emily Vardell: people have access to tons of different options, and i'll have some slides on this later on. But when there, when it comes time to picking from the options, especially from part C and part D,
Emily Vardell: they might have access t0 40 t0 60 different options to to decide between, and that can get really overwhelming. That's of course, where the literacy piece comes into, how in the world am I supposed to sort between all of these different options, those of us who have employer sponsored insurance. Usually, you know, we have what maybe
Emily Vardell: 3 2 3 4 0ptions to choose from every year when it's open enrollment time, and that's hard enough to decide between those 3 0r 4. So you can imagine when it comes time to signing up for some of these specific types of Medicare when You've got 40 t0 60 0ptions to choose between. It gets really overwhelming.
Emily Vardell: So now i'm going to turn towards looking more at literacy and focusing in on. Okay, now that we have a little bit of this background on what the landscape looks like for health insurance and older adults.
Emily Vardell: where how does literacy and other concerns fit within this piece. So i'm going to start with the affordability, and I I talked a little bit about that when talking about how you know. Medicare originally was just designed to like just cover an emergencies. And now we've got a few more things.
So in a in this research that was conducted in 2019 0f senior citizens. 45% of respondents had little to no confidence in their ability. To go forward health insurance and retirement.
Emily Vardell: So we might think. Okay, we've got this covered. We've got Medicare. I should be fine. No, most people who are looking ahead and thinking about retirement and thinking about health insurance. They don't feel like, you know, almost half feel like they do not have confidence in their ability to afford this.
Emily Vardell: and you know, if we can't afford health insurance. What does that mean? It means delaying or foregoing care. So just not going to the doctor. Something's wrong. I sorry I can't afford it health insurance. I just can't go to the doctor, and of course this is not just limited to seniors. This is
a concern for many people.
Emily Vardell: and Another thing to consider is going to link to a lot more of our conversations today in the Webinar is that lower health insurance, literacy and and poorer health. We're also associated factors with feeling like we couldn't afford health insurance. So in addition to having this financial, straight restraint streams, you also have the issues of not being able to understand the system as well, and bringing poor health to the table. And there's a lot of reasons why having a fair to poor health.
It is a complicating factor. S0 0ne you need more services. You've got to go to the doctor more often. You need more medications. You need more treatments. You need more surgeries, but then it's also the mental difficulties. When you're in poor health it's hard to focus on other things. So there's a lot of things that go into play with that.
Emily Vardell: But these results from this study I've got this quote here suggest: it may be possible to reduce concerns by raising confidence and understanding what they have already, and using health insurance. And so that's really like the motivating factor for me is helping
Emily Vardell: people understand what they already have access to. So you know, for so many people preventative care is covered under their health, insurance and other elements are covered. So, taking advantage of what you already have access to, and being able to use it effectively, and understand
Emily Vardell: what are my options, what makes the most sense for me and my loved ones. So that's really the the motivating factor for me in researching this and talking about this.
So
Emily Vardell: when it comes to measuring health, literacy and the preparedness of people to interact within the health care system. The biggest survey that pretty much everyone points to is done at this point 20 years ago by the national assessment of adult literacy. They surveyed 19,000 people, and it just hasn't been replicated since at that level. So we'll keep going back to those results, but obviously with the
Emily Vardell: caveat that they are dated. But in this assessment 6 age adults, ages 65, and older, have the lowest average health literacy of any category of any age group.
Emily Vardell: And for those people with Medicare, as you can see, about 50% had either below basic or only basic health literacy skills. So that's something to think about, is, and there could be several factors about Why, this is the case. It could just be that
Emily Vardell: they're interacting in systems that are new and different. So Medicare is new and different to them different options, more options. Some people will point to like mental
capacities. I think that's probably more of a concern on the older end of the spectrum. As I said, this is a really wide range ranging perspective spectrum. So if you're in the 65 side, I don't mean to L. L. Lump you into a huge category and then
Emily Vardell: it's interesting to think that people who've been interacting with health interns longer. Don't like somehow build up skills
Emily Vardell: that have helped them feel more confident. So you might think, okay, People who are 65 and older. They've had more time to be within the United States health insurance system. They're figuring out the ends and outs, but it's not the case. There's still have lower health literacy skills still having concerns with interacting with the Us. Healthcare system. So this continues to be an issue and continues to be a point of research and and study and outreach for people working in this space.
Emily Vardell: So this is specifically looking at health literacy. I'm going to turn to health insurance literacy, which is kind of under the umbrella of health literacy. What does health insurance literacy mean? So it's kind of got 2 aspects. So you can talk about the purchase of health insurance, and then you can talk about the use of health insurance, and they're very different. So with the purchase. Obviously you're picking from different options.
Emily Vardell: having to weigh between choices, comparing and contrasting costs and coverage. And then you're talking about using it. So, working within a system, understanding the paperwork.
Emily Vardell: arguing when something's not covered the way that it's supposed to making a choice between 2 things, because your insurance will cover this at this level and this at this level it's a lot of different skills, but it's a defined then as the knowledge, ability, and confidence to effectively choose and use it. So what is included under that?
Emily Vardell: Things like how to find a physician, how to fill a prescription, how to use and pay for medications, how to use a health savings account how to use preventive services. And as you can imagine, these are skills that many seniors need to have in order to use Medicare or their other insurance coverage plans effectively.
Emily Vardell: So how does that connect to health disparities? How does this impact? This? Is it a level playing field? Well, as you might guess it's not a living level playing field. Research has shown that there's a connection between
Emily Vardell: health disparities and health insurance literacy. So these categories here that are on the screen are categories that research is shown are populations that have lower levels of health insurance, literacy. So harder time choosing and using health insurance.
Emily Vardell: As you can see, the first category on here is 65 years and older, but this is not a a single issue concern there. There can be intersectionality. S0 0n top of that, it's also difficult for ethnic minorities. Esl. Individuals, lower socioeconomic level, lower health status, lower levels of education, younger Americans obviously separate, but and the uninsured. So all of these things make it harder for you to choose and use health insurance. And again, when we think about intersectionality and think Well, someone might be a part of you know 4 0r 5 0f these things. You can see how this just adds and adds and adds to having
Emily Vardell: difficulty, choosing, using health insurance, difficulty accessing the health care system, and then, either, you know, choosing to for or having to forego care, delaying care.
Emily Vardell: it leads to those health disparities, because you don't have the current coverage that you need, or you don't understand how to use the covers that you have. You may just not go to the doctor. You may not go. You may wait until it's gotten really bad before getting care and obviously exacerbating the health disparities that are already inherent in these populations as well.
Emily Vardell: So what does that mean for seniors? Well, if we have lower levels of health insurance literacy, they may not have the skills to navigate Medicare or select appropriate options. One of the issues with the health insurance system in the United States is that there's this
Emily Vardell: trend towards, you know, they might say, empowering the consumer, making sure the consumers picking the best option. So the idea is well you should be able to shop around and say, an X Ray cost this year, and this year let me pick the best option for my health insurance coverage, or my health needs
that requires a lot of time, and requires information that sometimes is almost impossible to find. So you mean I have the skills with those lower levels of health insurance literacy. And then with seniors. Of course, there's often higher medical needs. So you have more frequent interactions with the health care system and an increased reliance on those skills for which there may be cognitive or other limitations. And, like I said, this is a really huge group, so that's not true for everyone, but it tends to be true, especially the idea of higher medical needs. The older that you get, the more you need to go to the doctor, the more you might need medications.
Emily Vardell: treatments, and other things that are requiring you to interact with the health care system.
Emily Vardell: So that's hopefully. These slides have really illustrated the the importance of this. So what are we talking about? So what so, seniors? Maybe lacking skills? I've got them here on reading and understanding dense pros text. So if anyone has
Emily Vardell: cracked, open their their explanation of benefits, forms, or the stuff that comes in the mail from the health insurance companies, it is often in dense pros text, so that can be a challenge.
Emily Vardell: It can be difficult to locate information and dense documents. So let's say you find out. You need a specific treatment. Well, theoretically, you should be able to navigate within this guide that's online to find. Okay, Well, for this specific treatment. What is the coverage like for me, but that requires
Emily Vardell: several skills along the way You've got to locate the document you've got to search within it. You've got to make sense of the information that's there. It can also be skills like locating quantitative information. Pricing percentages like coinsurance often will cover. Let's say it'll ask you to pay 20% of something. Well, you've got to do that quantitative math. You've got to locate 20 0f what
Emily Vardell: I can also mean, integrating multiple pieces of information. So I find out, okay.
Emily Vardell: this is covered. But now I have to go to a different chart to figure out what percentage is covered, and then I have to go to a different chart to figure out what tier is this medication on? So you're navigating between multiple pieces of information. It's not all just in one place, and again using quantitative information to to figure out multi-step problems.
So those are hopefully illustrating some of the scenarios that people might be finding themselves in that kind of Add all of this together to think about health, insurance, literacy, and older adults.
Emily Vardell: And again, these are exactly the skills as we look at them that are needed when selecting part d coverage, like. I mentioned that prescription coverage where often people are picking between like 40 and 60 plans, or navigating the health care system itself.
So more choices, more problems. Individuals often have to select between all these different competing private insurers. Originally, I think the idea between
Emily Vardell: making a system where we had all these choices. The idea was policymakers said, Well, if we have more choices, then they're going to have to. You know, work. They're going to have to compete against each other, to have the best plan to have the best pricing to, you know. Hopefully, maybe present the information in a way that's helpful for people to understand. But research has shown time and time again.
Emily Vardell: the more options that you have, the more difficult the choices.
Emily Vardell: So, instead of the options being helpful, the overwhelming number of options instead services, a barrier for seniors in selecting a coverage option that meets their needs. Research shows that people are actually just performing at near chance level. So it's not, you know. They get 40 choices, and they're just like. Let me just try this one.
They it's just, you know, shot in the dark. It it can be hard to make sense of all the choices between them so many. When in research studies where they'll have, they'll bring in seniors and have them sit down and say, okay, here are your choices
Emily Vardell: based on your health care needs based on your financial situation, which one would be the make the most sense to select. They often select poor coverage at greater cost, so it's like a double whammy. You're not getting as much, and you're paying more for it.
Emily Vardell: So with that in My! What are some solutions? So hopefully. We're turning a little bit now to figuring out. What can we do about this, or what can be done about this? S0 0ne thing that has started meditating metic Apps original solution here was to standardize these policies, and those are the policies that people pay like a little bit extra to pay for things.
Emily Vardell: They have standardized mitigat policies with required basic benefits and a predefined lettering system. For example, every State has t0 0ffer a plan, a. If they offer any medic that policy. So I ideally this is designed to make it easier to compare Medicare policies, and maybe hopefully, it's an attempt by the Government to reduce the information burden on the consumer. However, there are still 10 possible plans that States can offer, and as you can see in the picture there.
Emily Vardell: they can be a, B, C, d, F. G. K. L, m, and N. You don't have to memorize that, but you can see there's a lot of options, and it should be noted that my Medicare is a national program. But there are State regulators. So some companies, offerings and plan ability availability varies.
Emily Vardell: So, for example, I know we were hearing from where everyone was from lots of people from Massachusetts. Well, Medicare policies are standardized in different ways. If you're in Massachusetts, Minnesota, Wisconsin, so you can see as much as they try to make it standardized. There's still all these caveats to it.
Emily Vardell: Another additional solution, some ideas for how can we make this information more comprehensible for the average individual? So something to keep in mind? It's likely influenced by cognitive abilities that they possess like things like numeracy and making sense of numbers using numbers and the amount of information available. So it's kind of a push and pull between the actual abilities that someone possesses, and the information environment that they're in. And there's actually a really interesting
dialogue going on in the health literacy community about. Okay, Are we fixing people, or are we fixing systems? So some people say
Emily Vardell: people just have a a level of health literacy, and we can do some things to help improve it. But at some point maybe this is just some inherent cognitive abilities that people have, or there's limitations that people might have. And so then they say, Well, rather than in focusing on all these programs to help
Emily Vardell: inform people, we need to focus on the the systems that they are operating within. So how much information do they have available? What kind of information do they have available?
Emily Vardell: Who's supporting them? So it's an interesting idea to think about the 2 elements of this it's not only focusing on how can we help people or fix people or support people, but also like, Where are we asking them t0 0perate within.
Emily Vardell: So this list here provides some research based suggestions for what health insurance providers can consider. But I hope this is a helpful list for librarians, too, and thinking, okay, when we're presenting complicated information or supporting people. In looking for information on this.
Emily Vardell: let's develop resources or look for resources that use these kind of metrics. So things like symbolic representations. So you'll see people use like iconography, you know, a pill shape for the prescription coverage.
a little hospital building for hospital coverage. So thinking about symbolic representations helps people make sense between different options.
Emily Vardell: easily browse through the options side by side Comparisons is a big one. This is actually as part of the mandate of the affordable care that this has to be done when insurance companies are making you pick between plan options. So probably all of you have seen this. Come, open enrollment time you got a chart. You have this option, this option, this option, and there's a chart
that helps. That is, that been shown to help people make comparisons oftentimes in insurance settings. People use naming conventions that have to do with colors or medals like a bronze plan versus a goal plan.
Emily Vardell: People tend to be able to assess. Okay, the goal plan is probably the better one, but it might also cost a little bit more than bronze, so some of those naming conventions can be helpful. It's also helpful to do. Pricing breakdowns in different ways. So premiums which is what people pay
Emily Vardell: usually every month to take advantage of health insurance. Maybe for some it might be helpful to break it up in different ways, like. Here's what the weekly cost is. The monthly costs, the annual cost.
Emily Vardell: and other things might be things like educational tutorials and calculation aids. Many of us may have seen calculation aids things where you would like, put in. I anticipate. I'll go to the doctor 3 times this year, and I take a medication once a month, and you put in all these elements, and then it kind of spits out. Okay, this plan makes the most sense for what your needs are
Emily Vardell: So those are the kind of support systems that are the research it encourages us to put in place, and maybe to point patrons to when thinking about navigating within this really complex information environment.
Emily Vardell: And I focused on literacy. But there's a lot of things beyond literacy that also play a role like, I said, this is a multi layered issue.
Emily Vardell: thing, health, insurance, literacy, and older adults. So, as I mentioned at the beginning, individuals may be juggling multiple types of coverage. S0 0ne person might have Medicare and the Va. And they have some access to employer sponsored insurance as a retiree.
Emily Vardell: or someone might have both Medicare and medicaid based on income level.
Emily Vardell: They're also geographic concerns that can be unique to this population. So things like snow birds who travel between locations so they might live part of the year in Massachusetts and part of the year in Florida. So it can be challenging to pick a health insurance that makes sense for you because a lot of health insurance.
The coverages have things like networks where it's like, okay, I have to use a doctor within my network. Well, is my network in Massachusetts and in Florida. Is it going to work in both places?
Other things are like retirees who are lucky enough to undertake international travel? Does it work internationally? Do they elect to to buy coverage while they're traveling internationally.
And additionally, health insurance decision making is rarely something that happens in a vacuum Instead, Many individuals turn to spouses or family members, friends, colleagues, for a to provide assistance in determining what the best coverage option is for our older adults especially, there may be adult children who provide guidance on enrollment options, or they may turn to friends in a retirement. Facility to help them determine which coverage options might work for their specific needs. So you often turn to people who know your
Emily Vardell: particular health needs so particularly like family members, or who know the system that you're working in. So if you work, if you live in a retirement facility that has access to a certain health
Emily Vardell: coverage, your health access. You might ask people in that facility. Okay like which
Medicare met a gap. Policy works best here, Which one have you found to be the best within the facility facility that we're living in.
Emily Vardell: It's also possible that older adults may be facing greater isolation with the loss of work colleagues potentially smaller social networks, so these individuals may not have access to the people that they would normally turn to for advice on such matters.
which may compound the difficulties in selecting health insurance coverage. So those are some elements to think about when considering this population and health insurance literacy.
Emily Vardell: So now i'm gonna turn to what I was promising you, which is some. Hopefully, some take away resources that you can become familiar with, or you you can consider when providing support for people, especially older adults in selecting health insurance coverage or making the best use of it.
Emily Vardell: So i'll start with just some research on this topic. So in this study and these studies are a little dated, the first one especially so hopefully, there'll be continued research that will update this.
But the the research shows that seniors use an average of 2.8 sources. So let's say 3 for making informed decisions about Medicare, and that's helpful to know. So if we're providing resources for this. It shouldn't. We shouldn't just say, okay, here's the one thing you might want to use. People might like to consult multiple resources for making informed decisions.
Researchers also highlight the importance of educating people, equipping people with information and the susceptibility to aggressive marketing. So that's something that's really
Emily Vardell: a key piece of health insurance literacy is. There are a lot of companies involved in this insurance companies who want to encourage people to sign up for their health insurance plans.
Emily Vardell: And even if we don't take it to the level of you know, being too too aggressive to manipulate manipulative, there's still money on the line they're looking for to sell their product. And so it's an important to to note the sess of the the susceptibility to aggressive marketing, and maybe equip people with ways
to evaluate information and kind of tease this out. So we teach patrons how to assess for bias that can kind of be infused here as well. So are they trying to just sell it to me? Are they also providing information that's helping me make a decision?
Emily Vardell: So there's a need for targeted educational efforts aimed at intermediaries one of the things I'm doing now. So thinking about helping to provide information to people like patient advocates, consumer health, librarians, family members, health professionals and librarians who can help with some of these pieces.
Emily Vardell: So why is health insurance, literacy unique?
Emily Vardell: One of the things, I think, is really interesting about health insurance, is. It's a very difficult topic to get help from with the sorry, a difficult topic to get help about from someone without a vested interest.
So
Emily Vardell: if we, you know, taxes are complicated, like health insurance is complicated. Taxes is complicated. We can pay someone to d0 0ur taxes for us. and they don't really have a a financial interest in the outcome. They probably want to help us get the most deductions that we can, so that we get a great return and come back to them next year. But they're not getting any kind of
Emily Vardell: money back from whatever. Our outcome is so that is not the case with health insurance. There are some programs out there like there are insurance brokers, but they often get something from the choices that we make, even when we're doing employer sponsored insurance
we pick between options. If we go to Hr. They might point us to the cheapest one, because it's the cheapest one for the University. I'm not saying that they do. But there is some money on the line here, so it's hard to get help on health insurance without someone who has some vested interest.
I will point to a couple of resources. S0 0ne is the State Health insurance assistance program, and I've linked to it there.
Emily Vardell: So that is a Congress created State based program available in all 50 States as well as Guam, Puerto Rico, Virgin Islands and the District of Columbia. I saw we had someone from Puerto Rico here so available there as well where seniors can turn to for one on one counseling and assistance with Medicare.
Emily Vardell: And then, as you might guess, a a. Rp. Which is the American Association for retired people, although I think now they just go by the acronym. They have a Medicare resource center. I'm going to show right now a screenshot of it. It has a lot of really helpful information. There's a breakdown of
Emily Vardell: Medicare like saying, here's what a part a is. Part B. As part of it is lots of how lots of helpful information. But I mean, just take a look at this screenshot right here. I can see
Emily Vardell: at least 3 ads. I think I think it's 3 ads.
Emily Vardell: probably I mean so it's. You know it. It. It. It's not.
It's not devoid of a vested interest in what the outcome is. So, even if you like, search, Arp and Medicare. The first thing that comes up are some of the plans that Arp works with united health care to sell. So it's just something to keep in mind when looking at these resources.
You know. What is the agenda on the line here, and like i'm saying that doesn't mean that we rule things out, but it's just important to keep that in mind and include that caveat. If we're pointing patrons or others to using these resources.
Emily Vardell: So a couple of other resources that I would recommend one is Medicare and you. This is just automatically mailed out to every Medicare beneficiary household. It has been since 1,999. So if you. When you turn 65 you'll get it in the mail.
Emily Vardell: They create this, the centers for Medicare and Medicaid services create this handbook every year. It is really a primary information source for many enrollees. It is printed in a larger font size, so it is easier to interact with. It is a you know it has a effective use of white space. It uses a lot of those things that I mentioned like symbols, charts, and index.
So I would say, this is a good resource for getting information. This is obviously coming from the source itself, but it's a good, a good place to get some of that information about what Medicare is some of the ends and outs of it.
Emily Vardell: This next slide I have breaks down the different sections that you'll find i'm not going to read each one of them, but you can see it covers a lot of the stuff that I cover today like what is met a gap. What is part d. How to protect yourself from fraud. It does have some definitions at the end, which is nice, always like
Emily Vardell: helpful definitions of complicated health, insurance terminology, like premiums, copay coinsurance, that kind of stuff. and it is customized to the geographic location. So kind of the back part of the book is printed specifically for a different geographic location. So that's something to keep in mind.
Emily Vardell: Another thing that I find helpful is this book, Medicare for dummies. Now, obviously, you know this is this is not free. It is you have to pay to purchase this book. It is sponsored by a Rp. Which is kind of has that nice like note of approval, but just that little caveat like, okay, we might be selling something. But I think this is pretty
Emily Vardell: pretty user friendly, pretty free of bias as much as possible. It is way more in depth in Medicare, and you it's over 400 page lock pages long. It's a super thick book. Most likely you'd really want to use it to like hone in on a specific question of interest or a topic of interest.
If you this. If this is not in your library, I would recommend adding it to the library as a resource, having it available
Emily Vardell: again. It also has a lot of definitions of core terminology, and has these sections I find particularly helpful, which is getting help and making choices and top 10 medicare mistakes.
Emily Vardell: So I don't get any money from from this endorsement. But I just thought i'd point t0 2 books that are helpful in this space a couple of other resources. These are websites that i'm going to focus on next.
Emily Vardell: The Kaiser family foundation or kff.org is a great resource for anything. Health policy related health data related. If you're looking for data on health insurance, this should be your first place to go. You can select your state to link directly to State level statistics, or you can even pick one of these categories. So I've got an arrow here looking at health coverage and uninsured so like, for example, I I'm in Kansas. I could go click on that click on Kansas, and it would tell me
Emily Vardell: the breakdown of how many people in Kansas have Medicare. How many have medicaid. How many have employ your sponsored insurance, etc. So it's a really great way to get some of that overview information, and maybe become a little bit more familiar with the needs in your area.
Emily Vardell: Another website that I like to recommend is just plain, clear. This is a website that was developed by a health insurance company by a united health, as you can see there on the screen. But I've spent quite a bit of time like poking around trying to see some advertisements. I haven't seen any advertisements in it. I I find it a pretty good resource.
It is a.com. So we always, you know. Try to give that caveat, but I think it's a great resource. It has a it's a glossary, so it it provides definitions.
Emily Vardell: I it's got in the thousands of definitions. Any basically any health related insurance related term you could think of is in here, as you can see at the top. It's available in English, Spanish, and Portuguese. So, depending on your community.
Emily Vardell: this could be really helpful. I've got a screenshot here of an example just to kind of show you what it looks like. But here's their definition for deductible. It provides a a definition, and then kind of what it would look like in practice. And, as you can see, it links t0 0ther related definitions which is always helpful, and has direct links to translations.
Emily Vardell: So this one is a really helpful one to to to turn to if you've got questions about insurance or health related terminology. and then a couple of more to mention one is from coverage to care. So the from coverage to care was was designed by the centers for Medicare and Medicaid services, and they use a roadmap analogy. So you can see, step one through step 8 to help individuals learn how to use their health insurance and interact with the health care system.
You can request printed copies of this to be sent to your library. I've seen these people out and about. I. I was once at Walmart, and they had a table, and they were handing these out. I was really excited to see that. So if you've got people who kind of need to help with just seeing the lay of the land and how to interact with the healthcare system. This, you know, step by step, Guide, written with easy reading.
Emily Vardell: easy to read principles in mind, is a really helpful guide that you could you could turn t0 0r point people to. In addition to this printed guide, they also have videos. So, for example, this video is recommending. The individuals who are looking for a primary care provider should look for names of providers covered under their health insurance
by looking at the insurance company's website calling the company looking at the handbook. They also recommend asking friends or looking online, which is a nice way to kind of check some of that bias. So this is an area where I wouldn't
Emily Vardell: offer advice as a librarian, on which direct doctor to go to. But I could point to someone and say, okay, are you looking for a doctor who works in your what works with your health insurance? Here's some resources on figuring that out.
Emily Vardell: And these videos are in English and Spanish. So again, very helpful for different populations.
Emily Vardell: And then a 2 more websites that i'm gonna show you. One is from a Hr. Queue. They have a lot of really helpful resources for engaging in the health care system, particularly with doctors appointments. So they have things like 10 questions you should know ahead of time.
Emily Vardell: questions to ask. Like to have ready, so a lot of us know we get there, and then we forget. Oh, my goodness, I You know I I knew I wanted to ask you something, but I i'm here at the doctor, and now i'm kind of stressed out because the doctors in front of me. Well, it has some really good tips on. Okay, Write your questions ahead of time.
Write down the medications that you're taking or bring them with you. So it's a really great resource for helping people feel equipped and prepared to interact effectively in the health care system. And then, lastly, I always have to put in a plug for midline, plus. They have some great resources to, including a page on health insurance. That also has some descriptions and definitions that are health insurance related.
Emily Vardell: So finally, i'm going to conclude with, what can we do as librarians as information professionals in the space of health insurance, literacy, and older adults. So awareness is really one of the keys. So there's a lot of lack of awareness around Costs assistance programs.
Emily Vardell: Use of preventative medicine, particularly among those who might be experiencing health disparities. Already, like African Americans and those accessing public clinics, the research has shown that that certain populations have a lack of awareness around the resources that are available to them, and this could obviously exacerbate on equal access to coverage and care hopefully a promising opportunity for librarians and others to help bring awareness, help, raise awareness for
Emily Vardell: the resources that are out there cost assistance programs for covering different aspects of Medicare, or as covering access to public clinics that accept Medicare and I've included a screenshot here from Senior Navigator, which is an I believe, an IM less funded. Grant that is, Virginia based where they created this portal for older adults and caregivers. It is a geographic specific, so
Emily Vardell: probably mostly relevant. If you're in the Virginia area, but I offer as an idea of something that you might be able to implement in your area as well, and I have a citation there at the bottom. If you're interested in reading more about their project, that's that last citation there, so you can read more about the the work that they did in that space.
Emily Vardell: S0 0pportunities for collaboration. So, hopefully, we're not working on this alone. We can collaborate with community organizations like, if you have an area agency on aging we can develop and deliver programming for diverse audiences. And I also want to say that it it doesn't have to be a new program. We can infuse
Emily Vardell: health insurance Medicare content within successful outreach efforts. So maybe you already have programming for older adults at your library. How might you infuse topics around Medicare and health insurance within what you're already teaching. So if you're teaching a class on
Emily Vardell: navigating the Internet for seniors, what about navigating a page about Medicare, just to kind of help them see their resources that are out there. So hopefully. Those are some ideas for collaborating or making this possible at your institution. And lastly, I always like to talk about partnerships.
Emily Vardell: and i'll open that up in the chat, too, if you'd like to share ideas that you have. So some natural partners for this work might be friends of the library groups, volunteers, health care advocates, and if you have them in your area, affordable Care Act Navigators can be partners for work in this space.
And then, finally, I was going to share that. I was invited to do this Webinar from a chapter that I wrote for the in this book called Information Issues for Older Americans. So if you particularly work with this population, are really interested in in information issues and older Americans. I highly recommend this book, not just because I have a chapter in it, but my chapter goes into much greater detail into what I presented in this Webinar today, and there is a 30% off discount. I also don't get any
Emily Vardell: cut from this, so i'm just sharing it as a resource. I always like a coupon. So there's a code right there, R. L. F. And F. 30 for 30% off the book.
I believe a flyer with this information is going to be sent out with the recording for this session, so you'll be able to have access to that later, but just wanted to bring your attention. If this is something that's of interest to you, there is an an additional resource on that.
Emily Vardell: So lastly, I'd like to just conclude that and say, I hope I've provided you with some resources to help guide you in this space to help provide you with an overview of the information landscape that people are operating with, and and give you some ideas to spring forward and and work in this space.
So I am now open for questions. I see we have some in the question and answer section. If you have more, feel free to put them in there, and I think we have about 10 min for questions. So I look forward to hearing from you all.
Julie Edwards: Thank you so much, Emily. This is fantastic.
Julie Edwards: In that email. There will also be a direct link to the publisher of the book that Emily's chapter is in. So it won't come as an attachment. You'll have it. You can just click from the email straight to the publisher's website. So if you're interested in purchasing the book for yourself or your library, so let's get into as many questions as we can
Emily Vardell: Someone that is asking, Can you compare quickly Part C with Metacap insurance? Yeah. So let me pull it up.
Emily Vardell: I'm: sorry. Yeah, Hopefully, you look away. If you get a little seasick from the same slides, go quickly.
Emily Vardell: So met a gap and Medicare advantage are used interchangeably. It's really the same, the same idea. So it's an optional. Again, i'm going to read a little bit more from the slides, just to for some additional context, an optional program where it's enrolling in a private health plan.
Emily Vardell: So I know. For example, i'll use my my grandma as an example. She's got regular medicare, and then she pays another company and a monthly premium, and they are able t0 0ffer her much deeper discounts on
Emily Vardell: co-insurance, you know, instead of the default, you know, 20% from Part B. She might pay 5% of
Emily Vardell: you know, a medication so, and obviously a lot of medications that seniors might have might be really expensive. I know, you know there was one medication that was like a $1,000. So under
Emily Vardell: part B, she would normally have to pay $200, maybe. Am I doing that right? But because she has paid this little extra for this special plan she only pays, you know.
Emily Vardell: I don't know $20, or whatever, so it it provides that little added value, and it's designed to provide like the the the term goes a gap between what Medicare is able to be able to provide, and those those costs that can be really prohibitive.
Emily Vardell: So with employer, sponsored insurance, we're kind of all used to paying coinsurance When we go to the doctor we're used to that 20 we're used to hate like having to pay a deductible for many of us. That deductible is probably really high. I mean $1,500 is not
Emily Vardell: an unusual deductible for a high, deductible health care plan. But you can imagine, as a senior. If you have a $1,500 deductible that could just clear you out. Clear your bank account out. So these gap plans are designed to kind of help between that
Julie Edwards: fantastic Thank you. And yes, the recording will include the the chat. You'll get all of that in the the blog in a few days.
Do you know.
Julie Edwards: Emily? Is there a more recent version of Medicare for dummies other than the one published in 2,020?
Emily Vardell: I think that's the the latest one I was able to locate. I don't know off the top of my head. I'd have to go, you know, to
Emily Vardell: to Amazon, or wherever the whatever book website you use to find that out. But I think that's the one I've been. I've been kind of relying on, and I don't think there has been
Emily Vardell: substantial changes. Obviously there's been a huge pandemic, so i'm sure that will be added to the the narrative, and the more recent version in the in the new version, but in terms of like how Medicare works it Hasn't changed as much. So
Emily Vardell: the content should still be pretty relevant. If you're looking for an overview of this the program in the system
Julie Edwards: Oh, great! And some people are saying they've got a 2,021
Emily Vardell: ken a library and become certified in health information, literacy, do you know?
Emily Vardell: Yes. So certified and health information literacy. So there are a couple of resources that I might write. Yeah, Chis: Thank you, Stephanie. I was just about to say that. So the National, the network of the National Library of Medicine has a certification program called Consumer Health Information specialization.
Emily Vardell: And I can try to find the link to that later. If someone has a link to that handy great. But basically what it is is it's a specialization that is comprised of different.
Emily Vardell: usually Mla or Nlm trainings continuing education courses. So the the courses from the national network of live in the network of the National Library and medicine are free.
So you can take these ce courses that are on consumer health topics, and if you get the right number of hours you can then apply for consumer health information specialization.
Emily Vardell: I will say it does cost money, but Nlm is sponsoring these costs for many librarians. So check that out before you pay the money. Try to find your regional library. So again, going to nnlm Gov. Is where you'll find that information, but especially in public libraries. They're trying to cover this the cost of the specialization in order to equip more public librarians to be able to work in this space
s0 0, great! And saying she's got hers, and N. Andlm sponsored it so it it's one of those things that can be done for free. You can get all of the ce credits from Nlm
from their courses that are offered for free, and then you can have them pay for this certification. You can also take classes through the Medical Library Association. Most of those you do have to pay for those C classes, and you can, you know, pay for the certification if it's not sponsored. But those are some options available.
Emily Vardell: I know what Emporia State University where I am at my one of my concentration areas, as Julie said in my intro is health. So I teach classes on health sciences, librarianship, and we have those approved for Chis certification. So if you take the class, you get the Chis certification you do have. If you're a practicing library, and you can enroll as like in continuing education credits, and there is a fee. But just to let you know that there are definitely a lot of options out there.
hey?
Emily Vardell: I'm seeing some some examples. So. Yeah, thanks for asking that question. That's the one that comes to my mind. It's it's the the title, as as you can see, says consumer health information specialization. So it's not specifically health literacy, but that's such an integral part of consumer health that you would, you know you could easily take all your classes on health literacy topics and get the to certification.
Julie Edwards: Thank you.
Julie Edwards: Do you happen to know which parts of Medicare, or whether Medicare covers travel and mental health services.
Emily Vardell: So I don't. I think it depends on the travel, and it probably depends on your plan
and the international travel probably not great coverage, which is why they offer those.
Emily Vardell: You know those travel insurance plans. I'd again don't get any money from any of those, but I think that's why those are offered for domestic travel. It'll depend on your network. So, like many of the part B and part C Medicare plans are.
Emily Vardell: you know, through Blue Cross, Blue shield or united health care, and a lot of those have more wide, widely available network. So there might be more doctors and hospitals in network, but some of them are kind of Hmo. Specific, and so they are.
Emily Vardell: You know you have to work within that Hmo. And so those are often like, really hyper, hypergeographically specific. So it really depends on the plan.
Emily Vardell: Thanks. Josh has got some advice there and about advantage plans and travel.
Julie Edwards: Yeah, there's great information coming up using chat. So I do a lot of good stuff. Yeah, I'll definitely include this Chat transcript in the blog when I send that out.
Emily Vardell: Do you have suggestions for good resources for getting to know Fsa's, Hsa's and the like. Yeah, good question.
Emily Vardell: I don't, really I so I my point to that just plain clear. I'm sure it has definitions for Fsa and Hsa. So i'm trying to think if I can think of a resource that like walks through how to use it.
Emily Vardell: I know the Irs website has a lot of resources on what's eligible for Fsa and Hsa. So if you have that question yourself, or you get a patron that says
Emily Vardell: like, Can I? Can I use my Hsa card to pay for my dogs? That bills? No, you can't.
Emily Vardell: But if that's a helping, and you know I I won't say whether that's right or wrong. But the Irs website will have like a specific section that says, you know, like I think I believe feminine products were recently approved to be eligible for Hsa and Fsa, so that information is now on the Iris website, so you can go in there and like, find specific information about what's covered. That's probably the piece that's most confusing for people when it comes to Fs and hsa's.
So that's what's coming to my mind. But if people have other suggestions, we toll free to put those in the chat.
Julie Edwards: Thank you.
Emily Vardell: Someone's asking Can you explain the difference between Medicare and Medicaid just really quickly. Yeah, Medicare is more age dependent. So you get it starting at 65 and you pay into it as you go through with social security, you know, as you work. So if you paid into social security, or if your spouse is paid into social security, you get Medicare starting at 65
Emily Vardell: Medicaid is money dependent, so you have to qualify, based on your income level, and there are only specific
Emily Vardell: populations that are eligible for Medicaid, so like mothers with children, people with disabilities. So there's kidney transplants. I think there's specific categories of people who who can be eligible for Medicaid.
Julie Edwards: Fantastic. Thank you so much.
Emily Vardell: I've been really I'm. I'm gonna go back and read the chat myself because it looks like lots of great tips. So I appreciate the involvement from all the participants. Thank you so much.
Julie Edwards: Yeah. I love an audience of librarians. There are some really fantastic resources floating around in the chat. You'll all get that in a few days.
Julie Edwards: Thank you all so much for joining us today, Emily again. Thank you so much. I will be sending out the slides and the recording and the Chat Transcript in just a few days, and I hope that we'll see you at the next Webinar in a couple of weeks. Thank you all so much. Have a great day.
Emily Vardell: Thank you.