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Out-of-Pocket Mental Health Care Can Be Reimbursed by Medicare Supplemental Plans

By Commentary, Preventive Medicine, Primary Care No Comments

If you are on Medicare and pay directly for outpatient mental health services to a psychiatrist or psychologist or social worker who does not accept Medicare, you may be surprised to know that you should be eligible for substantial reimbursement of those expenses because a Massachusetts law requires Medicare supplemental plans to cover such services from nonparticipating providers.

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Quick Updates: Covid-19 and Flu

By Commentary, Covid-19 Epidemic, Health Care Policy, Preventive Medicine, Primary Care 2 Comments

The Covid-19 pandemic continues. Immunization remains critical to individual health and suppressing the epidemic. A third dose of Pfizer vaccine suggested for those over 65 or younger people at higher risk. Moderna vaccine maintains its effectiveness. Breakthrough infections occur but hospitalizations and death largely occur in unvaccinated. OHC plans flu clinics beginning Wednesday October 13 and hopes to offer Pfizer boosters.

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Covid-19 Is Now a Marathon — Vaccine, Virus and Self-Protection Updates

By Commentary, Covid-19 Epidemic, Preventive Medicine, Primary Care 6 Comments

I have a lot of ground to cover since my last post in February. At that optimistic point it appeared we might get everyone immunized by summer and beat the pandemic if we could move quickly enough. That has not happened nor is it likely to happen. Let me summarize accurately for you in three major sections what I consider…

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Covid-19 Shots Starting for >75, Distribution Improving, Confusion Still Reigns

By Commentary, Covid-19 Epidemic, General Science, Men's Health, Preventive Medicine, Primary Care, Women's Health 10 Comments

Covid-19 vaccines began last week for everyone over 75 in Massachusetts. The state distribution program includes websites to sign up, outreach calls from major health care organizations and pharmacies, and a new 211 call center. Most all elders should be started on vaccination this month and finish by late March. The over-65 population and younger people with several comorbidities will follow. When younger, healthy populations get vaccine late Q2 will depend on vaccine supply. While there remains lots of uncertainly, the roll-out seems to be working and even improving. Stay calm.

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BE CAREFUL! Too Many Infections. Vaccine Coming, Still Unclear When

By Commentary, Covid-19 Epidemic, Men's Health, Preventive Medicine, Primary Care, Women's Health 10 Comments

Covid-19 infections are peaking, with far too many infections in our practice. People are NOT being careful with non-immediate family or at work. We are set to vaccinate each of you, but do not yet have vaccine allocation from DPH. We believe (but don’t know) that the start of vaccination will be second week in February.

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Calculating the Risk of Asymptomatic But Infectious Person in a Group

By Commentary, Covid-19 Epidemic, General Science, Health Care Policy, Preventive Medicine, Primary Care 4 Comments

We use available state Covid-19 infection rates and other published data together with the binomial distribution to calculate the risk of unsuspected infections in small group gatherings. With our current high level of infections (20 times higher than summer) the risk is 5-10% for groups of 10 or 20. You DON’T want to gather indoors with other than household members this winter.

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Why Do We Fail With Covid-19? Antibody Infusions Not Realistically Available

By Commentary, Covid-19 Epidemic, General Science, Men's Health, Preventive Medicine, Primary Care, Women's Health 4 Comments

Two monoclonal antibody treatments are conditionally approved by the FDA, seem to substantially help moderately severe cases of Covid-19, and are supposed to be available for use as outpatient infusions to prevent hospitalizations and deaths. In practice they are not actually available, as I found out this weekend trying to arrange an infusion for a patient. This is another fail of our health system.

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