Health experts are talking about…

…ACA open enrollment.  Despite the current uncertainty about the Affordable Care Act (aka Obamacare), it’s still the law. Everyone is required to have health insurance, either through an employer or the individual marketplace. If you want to make changes to your existing health plan or sign up for a new one, you only have 45 days to do so this year. Open enrollment began November 1 and runs through December 15, 2017.

If you earn less than about $30,000 per year, you still qualify for a discount on your premium if you buy your insurance through the marketplace or your state’s insurance exchange. The controversy is over whether the government will repay insurers for providing these discounts.

Even if you don’t get financial assistance, you may still qualify for tax credits that help make up for some of the costs of your insurance premiums.

Many insurers have already raised premiums, especially on the most popular midrange plans, known as silver plans. Experts say now is the time to shop around and consider your options. Your monthly premium depends on where you live, how much flexibility your plan offers when choosing doctors or hospitals and how much you’re asked to pay out of your own pocket.

Regardless of which plan you choose, all must cover the same set of essential health benefits, including preventive care and pre-existing conditions. You can’t be rejected, charged more or refused coverage for any condition you had before coverage started. Once you’re enrolled, the plan can’t deny you coverage or raise your rates based only on your health. And one of the most popular options still remains—keeping your adult children on your plan until they turn 26.

If you’re confused about all that is involved in shopping for and enrolling in health insurance, you’re not alone. This glossary can help you make sense of it

…why you need that flu shot.  An annual influenza vaccine is the best way to protect your health during flu season, which generally lasts from October to March. If you’re generally healthy and under 65, the shot reduces your risk of illness by 70 to 90 percent. If you’re over 65, you can lower your chances of getting sick from the flu by about 50 to 60 percent.

The vaccine also lowers your chance of being hospitalized for the flu. An analysis by the Centers for Disease Control and Prevention (CDC) in 2016 showed that vaccinated adults 50 and over reduced their risk of hospitalization by 57 percent.

It’s especially important for people at higher risk of serious complications to get vaccinated. This includes older adults, very young children, pregnant women and those with long-term chronic health conditions. The CDC advises that everyone get the injectable flu shot, not the nasal spray vaccine, because of concerns about its effectiveness. And while some people may experience side effects from the vaccine, they are usually mild, experts say. Most commonly reported side effects include soreness at the injection site or a mild fever for a few days.

The CDC also says that older people tend to fare better with a high-dose flu shot, which contains four times more antigen—intended to create a stronger immune response—than is in the regular shot. As we age, our immune systems weaken, so higher doses provide better protection against the virus.  Those over 65 are also at higher risk for severe complications from the flu, so more doctors now recommend high-dose flu shots for these patients.

Under the Affordable Care Act, health plans must cover preventive care like flu shots at no cost. Medicare (both original and Medicare Advantage) also covers flu shots at no cost as long as your health care provider accepts your plan. Medicare plans may also cover the high-dose shot at no cost to you during flu season. Check your plan benefits to be sure.

A note of caution: the CDC says you should not get a flu shot if you are severely allergic to eggs or have had Guillain-Barré syndrome. If you’re uncertain, be sure to speak with your doctor first. 

…health discrepancies between LGB and heterosexual older adults.  Older lesbian, gay and bisexual (LGB) adults are in poorer health, overall, than their heterosexual counterparts, according to new research from the University of Washington.

Compared to heterosexuals, LGB adults have weaker immune systems. They’re also more likely to develop low back or neck pain and—worst of all—they run a greater risk of developing heart disease. But they’re ahead in one way: they’re more likely to take certain preventive measures, such as blood pressure screenings and HIV testing, to protect their health.

Investigators looked at two years of data for 33,000 heterosexual and LGB adults age 50 and over from the National Health Interview Survey, a large, ongoing study of US health. It was the first time that particular survey asked respondents about sexual orientation.

Strokes, heart attacks, asthma, arthritis and lower back or neck pain affect many more lesbian and bisexual women than heterosexual women. More than half (53 percent) of lesbian and bisexual women reported neck and back pain, compared with less than 40 percent of heterosexual women. More gay and bisexual men described heart-disease-related chest pain compared with heterosexual men (7 percent versus 4.8 percent).

Additionally, LGB adults were more likely to have weakened immune systems—about 17 percent of women and 15 percent of men, versus 10 percent of heterosexual women and 5 percent of heterosexual men.

However, more than three-quarters of gay and bisexual men and almost half of lesbian and bisexual women had been tested for HIV in the prior two years. In comparison, only one-quarter of heterosexuals got tested for the virus, although they account for about 25 percent of all new infections, according to the CDC.

While this study did not delve into the causes of the poorer health outcomes among LGB older adults, other studies have pointed to discrimination and victimization as factors.

About 2.7 million US adults 50 and older identify as lesbian, gay, bisexual or transgender. This number is expected to increase to more than 5 million by 2060, and more targeted, preventive efforts are needed to improve the health and quality of life of LGB older adults, experts say.

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