California PCIP Shutting Down July 1, 2013

By Michael Grodsky, founder, Artist Insurance Services

If you are enrolled in California's PCIP (Preexisting condition Insurance Plan), your coverage is changing to the Federally-run PCIP as of July 1, 2013.

All PCIP and MRMIP plans will end as of January 1, 2014, because guaranteed coverage for all eligible persons becomes the law of the land. Open Enrollment begins October 1 for those new ObamaCare plans that will take effect January 2014. Click here to estimate how much it will cost you to purchase health insurance in 2014 and the amount of your financial assistance, if you are eligible for assistance.

Click here to subscribe to my Artist911 newsletter if you would like to kept informed about health insurance reform, educational events, and other interesting stuff. From July onward, I'll be hosting a webinar series and ground workshops in Los Angeles to educate folks about the upcoming changes and how to evaluate their options.

What to do if you are enrolled in PCIP
You can continue your PCIP coverage through December 2013 under the federally-run PCIP’s Transition Plan. This plan has a $1,000 annual medical deductible, and a $250 annual prescription drug deductible. After you have met the deductible, you will pay 30% of medical costs. For 2013, the maximum you will pay out-of-pocket for covered services in a calendar year is $3,125, or $5,000 for non-formulary prescriptions. Rates are below.

Rates for Federal PCIP Transition Plan
Age           Monthly Premium Cost
0-18 ..........$117
19-34 ........$161
35-44 ........$287
45-54 ........$366
55+ ...........$505

Instructions from California PCIP that apply to currently-enrolled PCIP members.

Dear Subscriber:

We are writing to let you know about a change in the California PCIP Program. California has been one of 27 states running its own Pre-Existing Condition Insurance Plan (PCIP) program as a contractor for the Federal government, with the remaining 23 states and Washington, D.C. having their state's PCIP run by the Federal government beginning July 1, 2013, California will no longer operate the state's PCIP program. As a result, to continue your health coverage after June 30, you will need to activate a new PCIP benefit plan through the federally-run PCIP before July l.

How This Affects You 
You will still have health coverage if you choose to enroll in the federally-run PCIP program. In June, you will receive an Enrollment Letter from the National Finance Center, which is the enrollment administrator for the federally-run PCIP. The Enrollment Letter will include information about the federally-run PCIP plan, how much it costs, and how to activate your coverage. You will not need to complete a new application to qualify for the federally-run PCIP. To activate your new coverage on July 1, and receive your PCIP ID card by that date, you must pay your first month's premium by the deadline stated in that letter. If you choose to do that, you will be a member of the federally-run PCIP program-joining more than 45,000 PCIP enrollees nationwide. You'll he enrolled in the Transition Plan and have a new benefits administrator.

If you are in the course of treatment or if you have received prior-authorization for services, you will be mailed guidance about transition of care. It is critical that you follow required preauthorization of benefits procedures for hospitalization, durable medical equipment or supplies, transplants, skilled nursing, long-term acute care or rehabilitation facility admission, spinal fusion surgery or cancer treatment plans anticipated to occur on or after July 1. This is necessary even if you were already authorized with your current California PCIP.

You may have questions about how this transition will affect you; and along with our Federal partners, we will do our best to answer them. Information and resources will be available to you, including a program web site, plan materials, and a national toll-free Call Center staffed with trained specialists available to answer your questions. For more information on the federally run PCIP, you can go to www.pcip.gov or call 1-866-717-5826 Monday-Friday 5:00am to 8:00pm (TTY: 1-866-561-1604).

If you have not paid your June premium for California PCIP by May 30, 2013, please do so immediately or you will be disenrolled before the PCIP transition, If you have already pre-paid your July premium for California PCIP, any credits on account will be refunded. If you have a recurring credit card payment or an automatic electronic fund transfer to the California PCIP, we will discontinue those recurring payments draws from your account. Premiums paid to the California PCIP, including pre-paid premiums for future months, cannot be applied toward your premium in the federally-run PCIP program.

Beginning July 1, 2013, the California PCIP will no longer be operating except for paying claims for services that were already received. If you ha>·e questions about your existing California PCIP, you can call 1-877-428-5060 (Monday through Friday 8:00am to 8:00pm, Saturday 8:00 am to 5:00pm) or go to www.pcip.ca.gov.

Next Steps 
In June. look for the Enrollment Letter in the mail from the NatiOnal Finance Center. It's very important that you act quickly on the instructions given in this letter. After you pay your premium, you will receive your enrollment packet from the federally-run PCIP benefits administrator, including your new PCIP ID card and details about your new benefits plan. You don't need to take any action right now. Just watch out for the letter in the mail, which will tell you exactly what you need to do to avoid losing your health coverage. We at California PCIP have been privileged to play a part in extending health coverage to you and more than 23,000 other Californians since it~ inception. We wish yon good health in the future.

Sincerely, California PCIP

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Author Bio
Michael Grodsky, AIF, is founder of Artist Insurance Services, providing unbiased education and access to health insurance for Californians. He is a board member of Side Street Projects, a non-profit artist-run organization, and is an insurance and financial planning specialist for GYST, an artist-run company providing information and technology solutions for artists. Michael’s Health Insurance 101 workshops have been hosted by non-profit organizations throughout Los Angeles County. He leads the ‘Health Insurance 101’ monthly informational workshop at the Cancer Support Community-Benjamin Center.

Operation Luscious Life: Guidelines for Self-Care

Sara Zuboff is a certified Yoga instructor, massage therapist and thyroid cancer survivor. Along with Sharon Holly, she teaches a monthly, 2-hour, yoga-based workshop at the Cancer Support Community-Benjamin Center entitled 'Revive & Thrive' in which cancer survivors create mind/body shifts to overcome overwhelm, stress and struggle. For information on this and other free-of-charge CSC programs, please call 310-314-2555 or visit CSC's website at www.cancersupportcommunitybenjamincenter.org

I remember the day I realized I was just surviving. It was 3:30 a.m. and my oldest son had awoken from a nightmare while my youngest kept waking to feed. Rather than wake my husband and ask for help, I tried to tend to both children much to my sleep-deprived detriment as I got angrier with my inability to soothe them back to sleep. Fast forward three months and it is again 3 a.m., only it is me that can’t sleep. Laying there it dawns on me that I’ve only had one shower this week and it is now Thursday. This lack of self-care suddenly strikes me somewhere deep inside and I start to cry.

When you fly, they advise you that if you are travelling with small children and an emergency occurs to tend to yourself first, applying the air mask, before helping your child. To most people this will feel counter-intuitive, but absolutely necessary, not just for survival, but to thrive.

When you tend to yourself you have the energy and drive to help others. When you constantly make your own needs come in last, you may still help others, but inside you may begin to silently seethe as again and again your own needs are pushed back or not met at all.

Around this same time, I received a newsletter from Deepak Chopra asking what would my life be like if I treated myself like a precious child or a bar of gold. How would that shift how I treat myself and my life? These questions turned a light on the darkness of my own lack of true regard and self-care. It inspired me to start a journey I called, Operation: Luscious Life.

I’ve learned so much on this journey and the quality of my life has sky-rocketed with changes big and small. I feel like by living the answer to these questions, it has changed me fundamentally. I’d like to invite you to ponder these questions and allow the answers to manifest a full, more self-love filled life for you. To assist you on your self-care adventure, I’d like to share some guidelines that have helped me make the leap from surviving to thriving.

1. Experiment-This isn’t a go big or go home adventure. Little changes can make the deepest impact on how nourished you feel. I found myself feeling perpetually dehydrated and knew I needed to drink more water, but the problem was I decided I hated water. I mean in this Starbucks life, how “unsassy” was water? But I was determined. So, I started adding cucumbers or lemon slices and drinking out of pretty glasses. Voila, I was soon drinking 8-10 glasses of water a day.
Our days are filled with hundreds of small choices every day. Do not underestimate how, when the minutiae of your day is examined and shifted, the quality of those days shift too from parched to verdant and flourishing.

2. Be open to pleasure: When I was prepping for my radiation, I was determined to take great care of myself. One of those ways was ensuring I ate well. I created a spa menu of wholesome organic dishes and made all the meals I would need during my time in isolation. When I had my radiation, I felt incredibly sick. Eating was the last thing I wanted to do. Luckily, my sisters had sent me a care package filled with bath products made with all these wonderful essential oils. Taking a shower transported me from my bathroom to a Hawaiian vacation. It was lovely and needed. I ended up taking 6 showers a day and they totally saved me when I wasn’t feeling my best. Opportunities for delight abound. They are in the details. Be open to delight and you will find that life can and will astonish you.

3. Find beauty: Similar to a gratitude list, make a beauty list, whether a few a day or all in one sitting. List everything you find beautiful, again big and small. Albert Einstein said, “There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.” Life will challenge you on your journey. This list is to bolster you on the days when you doubt the miracle of your own life.

4. Zen and the art of the reframe: I teach affirmations in my workshops; which takes a core negative belief and reframes it in a more positive life. For example, “I’m too fat” becomes “My body is abundant and I’m learning to make healthier choices.” Usually someone points out that this is just changing the wording of the truth and that’s actually the point. The truth didn’t change, but our relationship to the truth did, from a point of view that shuts us down to one that uplifts. It’s important to remember the quality of your life truly is up to you. Make no mistake; authentic self-care is just as much an inside job as it is an outside job. And while we may lack energy for some big external changes, there is always energy for internal shifts.

5. Learn to say no: I have an amazing yoga teacher and at least once during class when we’re in standing forward bend she tells us to nod our head “yes” to the things we want to manifest. And then she instructs us to shake our head from side to side. I find it interesting that she doesn’t give us the opportunity to say no to what we don’t want in life. Saying no has gotten a bad rap, but the choices in which we say “no” to giving up our power, to playing small, to putting ourselves last resound just as loudly and importantly as the things we say yes to. There is a lovely saying “to live this life as though it’s your last”. I believe that is the mantra of authentic self-care. Experiment, be open, find beauty, reframe, say no and most definitely pass it on.

If you’d like to explore more self-care concepts, it is the next theme of the workshop I’m teaching with Sharon Holly, Wednesday May 29th at 11:15 a.m. at the Cancer Support Community Benjamin Center. Come play!

PRESCRIBING A NEW KIND OF CANCER REHAB FOR CANCER SURVIVORS

At the Cancer Support Community-Benjamin Center, we have over 20 mind-body classes per week to help people with cancer and their families regain strength, focus, balance and energy, as well as workshops relating to nutrition and complementary care.  Since 1982, CSC (formerly The Wellness Community) has stressed the importance of taking care of the whole person and the whole family through a program of psychosocial support, including exercise, stress relief classes and education. 


By LAURA LANDRO
A version of this article appeared January 29, 2013, on page D1 in the U.S. edition of The Wall Street Journal, with the headline: Prescribing a New Kind of Rehab for Cancer Survivors.

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A new push for cancer "rehab" is helping patients avoid long-term physical disability and complications after treatment ends. WSJ's Laura Landro and Julie Silver, Harvard Medical School assistant professor, discuss on Lunch Break. Photo: Getty Images.

 

Patients who undergo cardiac-bypass or joint-replacement surgery routinely are given specific guidance to the exercises and therapies they will need to return to their everyday activities and to prevent complications or relapse.

For cancer patients, the story is very different.

After undergoing often harsh and debilitating treatments, there is often little help for their return to normal life.

Now, an increasing number of hospitals are offering programs to provide cancer patients with comprehensive rehabilitation services, amid mounting evidence that these can help speed recovery, shorten hospital stays and improve quality of life.

Rehabilitation services are "an absolutely essential part of cancer care," says Dan McKellar, chairman of the Commission on Cancer. Last year the nonprofit standards-setting group, overseen by the American College of Surgeons, began requiring cancer programs to offer rehabilitation services to be eligible for accreditation. Major cancer centers are taking steps to better coordinate rehabilitation after treatment. And Medicare and most insurance companies are covering such services.

Doctors who specialize in rehabilitation medicine can evaluate patients for fatigue, pain, anemia and decreased endurance that result from chemotherapy, radiation and surgery. They can then prescribe physical and occupational therapy, as well as treatment for sleep problems, depression and cognitive impairment. Dietitians help with nutrition, as cancer can change the way the body uses food and patients often lose their appetite from treatment. Some institutions offer massage and yoga.
More than a third of the nation's 12.6 million cancer survivors had physical or mental health problems that put their overall health in jeopardy and had a negative impact on their quality of life, according to a recent study of federal health data funded by the National Cancer Institute. While patients may get emotional help from friends, family and support groups, physical problems may get scant attention once they are no longer in the care of oncologists and surgeons.

"When cancer patients are diagnosed, everyone sits down to look at the case, decide what to do and convey that plan to the patient, but the same sort of process doesn't happen for survivors of the treatment," says Kathryn Weaver, lead author of the study and an assistant professor at Wake Forest Baptist Medical Center in Winston-Salem, N.C. Patients, she adds, may feel their physical problems are "the new normal" and may not ask their doctors for help. And even though most hospitals have rehabilitation services, there may not be a formal program to identify cancer-patient needs or coordinate a care plan among different therapists.

One model being adopted by hospitals, including Johns Hopkins in Baltimore, M.D. and Bon Secours St. Francis Health System in Greenville, S.C., is called STAR, for Survivorship Training and Rehab. It uses specially trained teams of caregivers, coordinated by navigators such as nurses, to help patients with physical and emotional issues, as well as any other concerns that arise.

In 2011, Dan Yarborough, a 67-year-old attorney, had two stem cell transplants within months of each other and high-dose chemotherapy to treat multiple myeloma, a form of blood cancer, at Bon Secours. The treatments left him weak and fatigued, with pain and numbness in his feet that threw off his balance and left him unable to walk steadily and unable to stop himself from falling if he tripped. Golf and travel, favorite pastimes, were out of the question, and he was worried about being able to argue his cases standing in court.

While hospitalized for his second transplant, a nurse navigator from the hospital's STAR program set him up with regular physical therapy appointments and nutrition counseling. Staffers helped him establish goals such as improving his ability to get in and out of his SUV, and worked with his doctors to change medications that were linked to his foot problems.

The program was "incredibly valuable," Mr. Yarborough says, giving him back the stamina to return to work. He is following up with a recommended exercise program at a medical fitness facility owned by the hospital where his exercise plan is overseen by a STAR-certified physiologist for a $30-per-month fee.

The Bon Secours STAR team also deals with specific issues such as helping head and neck cancer patients restore normal functions of swallowing, speech and movement after treatment. "In a lot of hospitals you will see these patients fall through the cracks after surgery, so their cancer is gone but they can't turn their neck to drive a car," says Lori McKitrick, a speech therapist who oversees the program. "We are doing a great job saving people's lives but we have to help them live their lives too."

Julie Silver, an assistant professor at Harvard Medical School and expert in rehabilitation medicine, developed STAR after her own treatment for breast cancer, which she says left her too sick to care for her family or return to work. Her oncologist suggested she rest and try to heal on her own, but "it left me thinking there has to be a better way," Dr. Silver says. "Every cancer survivor should have the opportunity to heal as well as possible and function at optimal level whether their cancer is cured, in remission or they live with cancer as a chronic disease," Dr. Silver says.

She started a company, Oncology Rehab Partners, which helps health systems and hospitals create their own STAR programs for many types of cancer. STAR certification is used by insurance companies in reimbursement decisions. The program costs a typical hospital about $25,000 to launch with an annual fee of $10,000 for continuing education and recertification, Dr. Silver says.

Michelle Houle, 45, has been participating in the STAR program at Bon Secours since she was diagnosed with breast cancer in 2010. After chemotherapy, a bilateral mastectomy and radiation, Ms. Houle, on long-term disability from her job as a food company shelf manager, says she felt "about 90 years old." Nurse navigators at the hospital set her up with a specialist to help prevent lymphedema, a painful swelling of the lymph nodes and a common side effect of breast surgery, and she began a physical therapy regimen.

Ms. Houle suffered a recurrence in 2011 and is now on another chemotherapy regimen, but keeps up her exercises at the hospital's medical fitness facility. She is slowly returning to activities like gardening and housework. The rehabilitation program provides "a base to keep you going," she says, "and there is always someone to talk to if I'm feeling side effects."

Signature Healthcare in Brockton, Mass, which includes Brockton Hospital and 150 employed doctors, treats local cancer patients and those who have had treatment at major centers in Boston, then return home for follow-up with difficult physical aftereffects. Last week, it launched its own STAR program after 23 staffers went through six months of training and received STAR certification. "These needs have been unmet for such a long period of time, and they are very excited to be able to offer this enhanced level of service" says Linda McAlear, the program's coordinator.

 

Is It Better To Look Good Than To Feel Good?

Victoria Moore is a writer and CSC member.

Style is optimistic. It is optimism made visible. Style presumes that you are a person of interest, that the world is a place of interest, that life is worth making the effort for.
Hara Estroff Marano from "How to Have Style"

Do you know what most people say when they meet me, even when they know I've had Stage II A Breast Cancer? "You look so good!!

Whenever they say that, it never fails to amaze me because it's so difficult for me to even look presentable. To get to the point where I can say, "Showtime Folks!" like Joe Gideon (Bob Fosse) did in "All That Jazz", I'm forced to confront a tired face, and a scarred body.  I have to find the energy to transform with makeup and clothes that reflect my own personal style.

On May 1, the facilitator for the Cancer Support Community-Benjamin Center's Writing Group gave us a topic which made me want to explore the subject of appearance. Below is the essay I wrote in response to the topic: Research indicates that holding onto unexpressed feelings or keeping a secret can take a great deal of energy in light of this I need to let you know that . . .

The effort I make to keep the secret that I'm not always "okay" by disguising it with my appearance has led me to a better place where I can deal with problems I wouldn't be able to handle if I didn't "front".  I'm not saying that it's always smart to pretend to be "okay" even when I'm not.  I'm saying that, lately, it's an alternative survival tactic that I need to use to confront issues that overwhelm me. Lately I've wondered how healthy this attitude is because it prevents me from asking for help when I need to and pretending to be strong when I'm not.

At times I'm glad I can reveal my process in my journal and my blogs, my articles and Writing Group and let go without worrying about others seeing who I really am when I'm totally vulnerable. One of the best ways I "hide in plain sight" is through my appearance, which I try to maintain whenever I'm out and about regardless of how I feel.  Realistically it's extremely difficult to keep up with fashion and popular trends when my mind is dually occupied with health issues, but I've found when I force myself to do it by either reading a fashion magazine or shopping at a store and buying something new, I'm diverted from the physical confines of my body and transported to the fun and glamorous world of appearance.

I don't feel separate any longer and instead of focusing and obsessing about all of my flaws caused by my illness and its side effects, I'm inspired by the transformation that new clothes bring, whether imagined or real. I feel like my old self again, even though deep down I've changed and I now see what used to be mere frivolity and happenstance in a new way. Now style's my armor and safety net, when I want it to be, which helps me deal.  And after reflecting during my down times when I'm my sometimes real raggedy self, it's a viable way to cope.

The Downside of Positivity; Giving Yourself Permission to be Real

Sara Zuboff is a certified Yoga instructor, massage therapist and thyroid cancer survivor.  Along with Sharon Holly, she teaches a monthly, 2-hour, yoga-based workshop at the Cancer Support Community-Benjamin Center entitled 'Revive & Thrive' in which cancer survivors create mind/body shifts to overcome overwhelm, stress and struggle.   For information on this and other free-of-charge CSC programs, please call 310-314-2555 or visit CSC's website at www.cancersupportcommunitybenjamincenter.org

At a workshop I taught last week, one of my participants had difficulty completing one of the exercises that included writing a letter of encouragement to herself.  She explained that she felt mired in feelings of sadness, anger and loss and she felt guilty over having these feelings.  Sometimes, I think when we’re going through something difficult there is a pressure to find the positive, to be positive, even when we’re not feeling up to it.

 When I received my own cancer diagnosis I had two family members who were diagnosed with different types of cancer around the same time.  Shortly after I finished treatment, they both died of their disease.  I was so wracked with guilt over my own survival, and whenever I spoke about these feelings, well-meaning friends or family encouraged me to be positive, to remember the joy of my six month old son and the beautiful family I had started with my loving husband.  And while I did feel those things, the truth is I also felt an incredible heaviness from this guilt.  Unexpressed, it cast a dark shadow over my days, making me short-tempered and on edge.  Which leads to an incredibly inconvenient truth about emotions; left unprocessed they will come out sideways, disrupting your life in unexpected ways until you turn around and face them.  However, I promise you that once acknowledged and processed you may find that your journey to positivity is much more ease-filled.

So, I write this in hopes that you’ll give yourself permission to feel all your feelings, even the scary ones.  I do have some tips that have helped me deal with mine and I hope they’ll help you deal with yours.

1.       Journal--Consider using your journal daily or whenever the mood strikes.  Write in a stream of consciousness style with the intention of leaving it all on the page.

2.       Move--Walk, run, dance, box…let your body move!  Not only will this release” feel-good” endorphins it will help release trapped, negative emotions.

3.      Speak Your Truth--Whether it’s your family, friends, therapist, or you have to go out and find a tribe of folks who have or are going through something similar, find a safe place to verbally express how you’re really feeling.  Words have power and by giving yourself space to really express ‘what’s up’ goes a long way towards empowering yourself when it comes to taking care of yourself and those powerful feelings.

4.     Feed Yourself Really Well--Whether it’s fresh whole foods (and I know that sometimes during treatment, eating is the last thing you want to do but do the best you can) or books, movies and social media;  seek out that which nourishes and uplifts rather than that which further shuts you down.

5.     Remember That This Will Pass--It may feel like forever, but these feelings, given proper care will pass and new ones will take their place. 

One of the gifts I got from going through cancer shortly after the birth of my first son is realizing it is possible to feel more than one feeling at a time.  I had periods of intense joy followed by astounding fear in a short span of time.  The trick is being present to both and allowing them to cycle through; because no feeling, when given space, is forever.  That’s the beauty of being human.