Monday, December 22, 2014

Medicare Enrollment. Mid year changes.

Greetings and happy holidays!  I hope you are all having a beautiful holiday season whether you celebrate Kwanzaa, Chanukah, Christmas or another winter holiday.

It's been a very busy year and I have not been online as much as I would like.  Busy is good however!

During the Medicare open enrollment I was working with a client to get her enrollment modified so that she would have more flexibility.  I was working with a wonderful insurance broker named Peter Palmiotto.  Peter presented multiple items and our client selected a plan just right for her.  We walked together to our respective cars and in our conversation I learned that there are actually times outside of the Medicare enrollment period when Medicare options may be changed.  I asked Peter to write a guest blog about this and here is what he has shared.  I hope you enjoy the read!

Laura Barish, AltaGolden

How To Change Your Medicare Insurance Year Round
Medicare insurance is a critical part of most seniors’ healthcare, yet can be extremely confusing and frustrating when trying to figure out all your Medicare options.  Changing a Medicare Advantage (MA) or Prescription Drug plan (PDP) can be nerve raking and often times can only be changed during the Annual Open Enrollment Period.  Yet most are not aware they can change their plans year round if the right conditions are met.
The Centers for Medicare & Medicaid Services (CMS) oversees the Medicare program and allows changes to be made, regardless of the time of year, during what they call a “Special Enrollment Period (SEP).”  A SEP is a specific period of time in which you can change, add or drop a Medicare insurance plan.  These SEPs are triggered by various events in your life that allow you to shop around without any medical underwriting or lapse in coverage.
There are over 30 different reasons why you may qualify for a SEP, yet most people typically use one of the top 6 reasons we’ll discuss here.
1)    Currently Living in a Skilled Nursing Facility:  Those living in a SNF may join or switch plans year round. Those discharged from a SNF have up to 2 full months after discharge to join or switch plans
2)    Entering Or Leaving a Long Term Care Hospital:  Those going into or coming out of a Long-Term Care Hospital have 2 full months after the admittance or discharge date to join or switch plans
3)    Moving From A Different County / State:  All Medicare Advantage plans will allow you to join, switch or drop your MA plan within 2 full months of your move. You can only switch your PDP plan within 2 full months if you moved to a different state as PDP plans are statewide.
4)    Those Receiving Medicare and Medi-CAL: Those that are dual eligible, have both Medicare and Medi-CAL benefits, may join, switch or drop plans year round.
5)    Low Income Subsidy Recipient: Those that have, or qualify to have a Low Income Subsidy (LIS) for Part D Prescription Drug Coverage can join or switch plans year round.
6)    Loss of Employer or Union Coverage:  Employer or Union health insurance coverage ends or is terminated, those affected have 2 full months after the end of prior to coverage in which to join a plan

For those with a Medicare Supplement Policy, also known as a Medigap plan, you may change your plan year round in order to help lower your monthly premium. Be aware that the insurance carrier will put your application through full underwriting review, and your application may be denied based on your health history.  

California’s “Hidden Secret” for those with Medicare Supplement Insurance
If you want to lower your monthly Supplement premium but are hesitant to go through medical underwriting, California is one of only two states nationwide that allows you to switch plans without the worry of being denied.  This is called the “Birthday Rule,”  in which you can switch your Medicare Supplement Insurance Plan to another like-kind plan within 30 days after your birthday without any medical underwriting or possibility of being denied.
As long as your switch occurs within 30 days after your birthday, you are guaranteed to be issued a new policy from any other company offering the same plan.  If you currently have a Supplement Plan G, you can only switch to another company and obtain another Plan G.  You can lower your coverage (switch from F to G), but you cannot increase your coverage (from G to F).  This is the best way to shop around each year to help lower your premium and save money.
For those looking to increase their benefits, lower their premiums or access different doctor networks, using a Special Election Period is a great way to switch throughout the year. Of course, you can always wait until the Annual Enrollment Period each year that occurs between October 15th and December 7th.
For more information or help with your Medicare insurance, please contact San Diego Medicare Options at 888-939-7383.
Peter Palmiotto is the founder and CEO of San Diego Medicare Options, an independent Medicare insurance brokerage firm.  Peter makes house calls or can help you over the phone. He is licensed in 5 different states and currently resides in San Diego.  He can be reached at 888-939-7383 or for more information visit:
A great gift to your parents for starting the new year is the gift of your time--whether it is a phone call, out of town visit, or taking them out to lunch or dinner.  I know my mother's favorite gift is being able to have dedicated time with her children and grandchildren.
There is also the great gift of caregiver services (you know I had to get in my AltaGolden plug!).  Give us a call if you'd like to discuss if we can help your loved ones in any way.  All of our services are customized for each client.  Our number is 858-779-9254.
Take care and have a blessed holiday!  Laura

Thursday, October 9, 2014

Memory Center Sponsorship

Good morning all. As you may know AltaGolden has an adult day program called the Memory Center. We are starting a new program of sponsorships for those who are unable to afford the cost.  Would you like to donate money to assist those who are unable to afford the Menory Center?  Do you have a friend or loved one who could use this help?

Please let us know if you can assist. Currently two of our Memory Center clients can only afford to come to the program once or twice a month and even tho we discount their fees it's not enough for them to afford the attendance they desire.  Your sponsorship would be greatly valued. Your donation can be anonymous or, with the family's permission, we will give you a bio sheet. Please call if you can help. 858-779-9254

Thank you for considering!

Take care and have great day.

Laura Barish

Wednesday, October 8, 2014

Medicare Enrollment

Good morning everyone. If you have visited our website you will know that we have a Medicare enrollment seminar coming up this Saturday, October 11. Why is this an important seminar to attend? Why should you be concerned about Medicare enrollment?

October 1 of this year was the start of the Medicare enrollment period. Every year there are changes in insurance options and Medicare is no exception. I have spoken with several older adults about the seminar and I'm seeing a distressing trend of people saying, "This is too confusing for me. I'm just going to stay with what I've got because I don't understand the options."

I certainly understand the confusion as Medicare and our country's insurance system in general can make one's head spin.  It is important, however, that you look at your insurance plan and ensure that you have the type of coverage that will allow you access to the doctors and healthcare systems that best meet your needs.

For example, HMOs are a great way to make sure that all of your needs are met under the umbrella of a single carrier without having to worry about managing reporting and payments with both Medicare and a supplemental.  HMOs have their limitations however. Mobile doctors have become much more prevalent – at least here in San Diego – and I have several clients taking a vantage of this great system.  If you are an older adult who finds it difficult to get to the doctor because of a lack of transportation or you are disabled, you probably want to consider Medicare with a supplemental that will cover the cost of mobile doctors.  If you are fully mobile and in a healthcare system that you love, an HMO may be a great fit for you.

Are there doctors or specialists you want access to that are not in your HMO?  If so, an HMO may not be a good option. There is a lot to consider in making your selection.

Medicare part D is also another potential minefield. Each carrier has its own formulary of what is covered under the low cost option and what is not. Medications that are not covered can get quite pricey.  Whenever I am helping a client look at their Medicare part D options I take a list of their medications and check the formularies of the various Medicare part D plans to see who is going to provide the best coverage for the current list of meds.

I asked Rhonda Norton to come talk with us because I know Rhonda to be a wonderful advocate for older adults and their insurance needs. At this seminar she will discuss Medicare and the options (both HMONG and supplemental) available as well as how to determine what is best for you. There will be no sales at this seminar as we really want our community to have the opportunity to learn more about Medicare without worrying about a "sales job".

Seating is limited to 30 attendees so please call us to reserve your spot. Refreshments will be served and you'll have plenty of time to ask questions and socialize with your neighbors.

If you are not able to attend but would like to speak with Rhonda, just give us a call and we'll put you in touch with her.  858-779-9254

Take care and have a wonderful rest of the week.

Laura Barish

Tuesday, October 7, 2014

Exciting New Alzheimer's Research

Greetings all.  Today I received a link for an article in Neuroscience News discussing potential reversal of Alzheimer's Disease through a combination of diet, brain stimulation, exercise, optimization of sleep, specific pharmaceuticals and vitamins, and multiple additional steps that affect brain chemistry.

The positive results of this study are not surprising to me as similar results have been experienced by Dr. Terry Wahls in her quest to cure Multiple Sclerosis, a condition she reversed in herself.  The article accessible through the following link is worth the read.

Have a wonderful and healing day!

Best always!

Laura Barish

Visit us online at or call me and AltaGolden's wonderful management staff at 858-779-9254.

A little 55+ humor for the day...

Good morning all.  We got an email from one of our caregivers and this one actually made me laugh out loud.  Enjoy!


ATD: At The Doctor's
BFF: Best Friend Fell
BTW: Bring The Wheelchair
BYOT: Bring Your Own Teeth
FWIW: Forgot Where I Was
GGPBL: Gotta Go Pacemaker Battery Low
GHA: Got Heartburn Again
IMHO: Is My Hearing-Aid On
LMDO: Laughing My Dentures Out
OMMR: On My Massage Recliner
OMSG: Oh My! Sorry, Gas
ROFLACGU: Rolling On Floor Laughing And Can't Get Up
TTYL: Talk To You Louder

I hope I haven't offended anyone's sensibilities.  Aging isn't for the feint of heart!

Have a wonderful day!

Do you need just a little (or a lot) of help?  Give AltaGolden a call.  We customize all of our support plans to the individual needs of each client.  Call us to chat at 858-779-9254 or visit us online at

Be well and have a joyous and blessed day.

Laura Barish

Friday, September 19, 2014

AltaGolden is starting a new SEMINAR SERIES!

AltaGolden is launching a new seminar series with topics designed to help our senior population.  The first in this series is about Medicare enrollment.  It's always a confusing issue so we've asked Rhonda Norton to come and help us.  I asked Rhonda because, every time I go to her with a question I come away feeling like I have just been given a great education without a sales job.

I hope you will join us for this great event.

Medicare Enrollment Demystified!

When: October 11th from 10:30am to 12pm

Where: AltaGolden Memory Center at 16885 West Bernardo Drive, Suite 212 (in the Parkwest Court Building)

Join us for refreshments and listen to Rhonda Norton of Hughes Norton Insurance Services,Inc talk about Medicare enrollment and your various options.  There will be plenty of time for questions and answers. 

If you are unable to attend this seminar but would like to make an appointment to speak with Rhonda please give us a call.

This is an informational presentation only!  There will be no signup for Medicare plans at this presentation.

For additional information please visit us online at or call us at 858-779-9254.

Thanks for visiting.  Don't hesitate to give us a call if you would like more information about AltaGolden services or you would like to schedule a visit to the Memory Center Adult Day Program.

Take care and have a wonderful weekend!

Blessings, Laura Barish

It's Just a Week Away!!! Senior Health and Resource Fair

AltaGolden Senior Health and Resource Fair

When: September 27th from 10am to 3pm

Where: AltaGolden Memory Center at 16885 West Bernardo Drive, Suite 212 (in the Parkwest Court Building)

Join us for refreshments and to speak with support vendors and hear presentations.  Each visitor will be given a raffle ticket to win prizes!  You may also buy additional tickets. 

The following vendors will be here to meet with you…

AltaGolden In-Home Services and Adult Day Program
Dental Hygiene In-Home (Mobile Dental Hygienist) – Nicole Wendell
Holistic Wellness (Vendor is TBD) 
Hypnotherapy – Dr. Nikki Goldman
Living Design Interiors (Aging in Place) – Beppie Mostert
Shaklee Vitamins and Skin Care – Nutritionist Renee Van Heel
Bio-Cranial Therapy – Dr. Rudy Reyes
Accucare Medical Supplies – Paul Bernou
Home Physicians Medical Group (Mobile Doctor) - Michael Podd
Golden Equity Mortgage (Reverse Mortgage) – Michele Kole
Veterans Advocacy Associates (Vet Benefits) - Carlotta O'Hara & Peter Willis
Eternal Hills Memorial Park (Pre-need planning) - Onyx Llauger
Oakmont Senior Living (Independent, Assisted Living, Memory Care) 
Avalon Hospice – Kathy Cook
Home Downsizing Professionals – Jane Hautman
Palomar Pharmacy (Mobile Pharmacy) 
Fond Reflections Video (Remembrance Videos) - Fred Farmer

For additional information please visit us online at or call us at 858-779-9254.

Thursday, September 11, 2014


Join us at the Memory Center on September 27th from 10am to 3pm for a Senior Health and Resource Fair. We will have vendors from a variety of wonderful companies that will be giving talks and demonstrations throughout the day. This will be a fun event and a great way to spend your Saturday.

Visit our Events page at for more information about the event and a list of vendors.

Feel free to call us at any time with your questions and requests.  Be well and have a blessed day!

Laura Barish

Caution About Caregiver Scam

Good morning all. It's been very busy, which is always a good thing. For today's post I want to warn you of a scam that is going around.

There are some groups that are circulating some of the 55+ communities going house to house claiming to provide caregiver services.  While you are being engaged at the front door, their cohorts are checking to see if other doors and windows in the house are unlocked so that they may get in to rob you.

I don't know of any legitimate caregiver companies that go door-to-door trying to sell you services.  If someone like this does come to your door, tell them you can't talk and quickly lock your front door and go check the other avenues of entry to make sure they are secure.

I have also seen letters and fliers left at the door advertising caregiver companies.  In every case I have checked these out and none have been seasoned, good quality companies.  If you get a flier that looks interesting, go online and check to see if they are accredited with the BBB, see if they are operating out of an office or someone's home, and find out if there are complaints listed online.

It's very important to use a company that has good business practices.  Doing your research and using an established company will save you a lot of heartache in the long run.

Take care and have a happy, healthy day!  Many blessings to you always.

Laura Barish

Visit us online at or call us at 858-779-9254 with your questions.

If you have a blog topic you would like me to research and write about, please call and let us know. Nancy is the office manager and she takes all calls during the day. Off hours the calls come to me.

Tuesday, August 12, 2014

The Truth About Hospice - by Kathryn Cook of Avalon Hospice

Greetings all.  I have a very special posting for you today.  My friend Kathy Cook with with Avalon Hospice and I asked if she would do a guest blog.  The purpose and services of Hospice are frequently misunderstood and I asked Kathy to write about the ins and outs of using Hospice.  This is a great read!

by Kathryn Cook of Avalon Hospice

Hospice.  The mere mention of the word frightens patients and family members alike.

I would like to explain the benefits of using hospice services and also dispel a few myths.

          What is hospice?

Definition:  Hospice is a coordinated program of palliative (comfort, rather than aggressive) care and support services designed to meet unique needs of patients and families facing a life limiting expectancy. Services are provided through a medically-directed team of professionals....Physicians, nurses, social workers, chaplains, aides, therapists and volunteers.

         How hospice differs from other types of healthcare?
  • Hospice offers palliative rather than curative treatment
  • Hospice treats the person, not the disease
  • Hospice emphasizes quality, rather than length of life
  • Hospice cares for the entire family not just the patient
  • Hospice offers help and support 24 hours a day/ 7 days a week
Now, let's look at a few of the myths surrounding hospice care.
  • Once I'm on hospice, I can't change my mind. Hospice is an elective benefit and you can change your mind at any time.
Hospice care is only for the last few days of life. 
  • The biggest benefits to using the hospice benefit comes from using an agency earlier rather than later.
Once hospice is involved, the patient will be medicated with morphine and they will die sooner. 
  • Hospice does not hasten death! It is our objective to provide the best care for patient and family for whatever life expectancy is remaining.
We cannot keep our own Physician.
  • Every patient has the right to keep the primary care physician they choose.
  • The primary care physician becomes part of the hospice team.
Hospice is expensive.
  • Hospice care is paid for by Medicare, Medi-Cal and most private insurances.
  • There is no out of pocket expense for the patient or family. 
  • No one is ever turned away from hospice.
If I get better and stop hospice care, I can't ever use the benefit again.
  • If a patient stabilizes and stops declining, they can revoke hospice services and be admitted again later.
I hope this information is helpful in clearing up much of the negative information floating out in our community. If you would like additional information regarding hospice services you may contact me directly.

Kathryn Cook, LVN/ Community Liaison
Avalon Hospice and Palliative Care
(760) 509-5705

A side note from Laura:  Both of my parents have been on Hospice.  My step-dad, Harry, ended up on Hospice when he had an accident and broke his neck.  After the doctors at the hospital determined there was nothing that could be done to save him, the Hospice team worked with us to transition Harry to a wonderful Hospice Hospital where he spent the last week being kept comfortable and pain free, which was a blessing to both him and his family as we spent time with him in his final days.

My mother went on hospice when she had an internal bleed that was not fixed by two surgical procedures.  Mom hovered between life and death for about a week and then her body started to heal itself.  Mom stayed on Hospice for almost three months and then signed herself off when she was ready to start physical therapy and get back to her life.

Through both situations we had caring hospice medical staff, social workers, and counselors helping us through the experience.  My step-sister had the support of Hospice in her last days with cancer and she died at home surrounded by her husband, children, and those of us that could get to Arizona to see her.

If you'd like more information about Hospice please call Kathy and if you'd like to have some support with your loved one through this difficult time, AltaGolden has wonderful caregivers experienced in loving hospice support. 

Be well and have a wonderful week.
Laura Barish

Sunday, July 13, 2014

A Day In The Life - Running a caregiving agency

Greetings friends and welcome to another installation of the AltaGolden Blog.  Today's topic is a day in the life of running a caregiving agency.  My day includes everything from making sure my management staff has all they need to do their jobs, taking care of online postings, coordinating with clients, acting as a back-up caregiver, and providing case management for clients and their family members.  Each day is very dynamic, fun, and sometimes a little stressful.

Our primary mission is making sure that all of our clients have exactly the type and level of care they want and need without over providing or under providing.

When potential clients come to us one of the first questions they often ask is about cost.  While cost is an important factor, I think the equally important questions include what are your personal needs and what do you need at this moment.  I also want to understand our clients so that we know what kind of caregiver is needed and what personality will be the best fit.  I encourage our clients to think of their caregiver as their own personal assistant.  Our management team works together to review each client and make sure that the services we provide are appropriate in each case.  I meet with clients in the office or in their home--often spending much of my day on the road.

We coordinate very closely with family members as well--especially those who live outside the area.  We become their feet on the ground and often assist with coordination with doctors or other service providers.  We encourage our clients to be independent and to continue to embrace life.

I coordinate with other service providers in the area and our clients know they can call us or come into the office to get trusted referrals.  Examples of some of our referrals may be found on our website on our Resources tab.

Another part of my job is managing online marketing.  These days most of our visibility comes through the internet.  Using a combination of search engine optimization tools, blogs like this, Facebook, Twitter, Linkedin, Yelp, and updates to our website are important so that people know we are out there.  It's what the search engines look for when you do a search.  Our continued growth helps ensure that we can provide you great caregivers and the best service possible.

Recruiting caregivers is an ongoing process.  We are always looking for a variety of great caregivers so that we can meet the individual needs of each client.  Some of our clients just want companionship and someone to take them shopping; and some need very skilled CNA or LVN support.  Because our clients have very varied needs, we have caregivers that can work at different times of the day and night.  Some of our caregivers are part time--working around another job or family requirements.  Some are full time.  We do our best to give our caregivers the schedules that works best for them while ensuring our clients are well matched and have their requirements fully met.

I also work as a caregiver.  I think it's unusual for the CEO of an agency to also be a caregiver but I feel it keeps me grounded and in touch with what we do and why we do it.  I started AltaGolden because I wanted to be of service.  This can take many forms and I am blessed that, in this case, it is integrated into what I do on a daily basis.

Are you interested in being a caregiver?  Are you an older adult who needs a little (or a lot of) help?  Are you a family member with an elder loved one in San Diego?  Give us a call.  We'd love to meet you.

Take care and have a great week.  Many blessings to you always.

Laura Barish

Monday, June 16, 2014

I'm baaaaaaaack... (After my visit to the Big Apple)

OMG!  It's been a few weeks and I've missed sharing with you.  It's been an incredibly busy time between work and going to NYC for vacation and my blogging has paid the price.  But, I'm back.  For this first blog back I thought I would share with you some details about my trip to NYC.

My nephew Peter was graduating from Cornell Med so Mom, Tom, and I went to the city to see Peter graduate.  I was born in NYC but grew up in Maryland.  After graduating from college I moved to NYC where I lived there for eight years and worked on Wall Street as an information technology consultant.  One of my clients was Dean Witter Reynolds in 2 World Trade Center.  My office was on the 42nd floor and I also worked with the traders on the 60th floor.

When Tom and I first spoke about the trip he wanted to visit the new World Trade but I told him that I wouldn't go.  It would be too painful.  When we got to the city Tom treated the three of us to a Circle Line boat ride around lower Manhattan.  From the water the redeveloped area looked really beautiful and I decided I wanted to see the site.

When I worked on Wall Street there was a subway station below the World Trade.  That doesn't exist any more so we got out at Vesey Street and walked from there.  From two blocks away we could see the new One World Trade Tower (the second tower has not yet been built).  It's a beautiful building--104 stories high.  Also dubbed the Liberty Tower, it is 1,776 feet high.  The original tower was 1,368 feet tall.

I remember sitting in my office in 2 WTC, feeling the tower sway in a high wind.  I worked with some very special people in that building.  I haven't had the heart to research if they were in the tower when the plane struck.  My boss, Ed Polito, retired not long after I left New York.  Other friends in the tower included Ellen, my best friend at the time, Michelle, one of the funniest women I've ever known, Jude, with whom I would go to off-Broadway shows, and Leigh, a kind woman who coordinated my work efforts toward the end of my time in NYC.  I choose to remember them as being the wonderful people they hopefully still are.

Walking down Vesey we were able to see the construction still going on.  Rounding 1 WTC we came upon one of two large fountains that memorialize those who lost their lives on September 11--including those in the Pentagon and on the hijacked flights.  My heart was breaking as I saw the beautiful memorial.  At first I didn't realize there were two pools.  I walked around the first fountain, touching the names and praying that I would not see any familiar.

We started heading over to Wall Street so I could show Tom other places that I worked and frequented when living in the city when we came upon the second fountain.  I didn't want to walk around this one.  I had seen no familiar names on the first fountain.  I was afraid my luck would not hold with the second.

The trip in general was wonderful and we got to add a new doctor to the family as well as see some of our New York cousins.  My cousin Joseph's daughter is a burgeoning artist and we got to see her display at an art show on the east side.

Even the trip home had fun surprises when the pilot let mom come into the cockpit during a layover in Las Vegas.  How much fun is that!

But it's good to be home and back to work.  On my next blog I'm going to do a "day in the life" and describe what it's like to run a caregiving agency.

Have a wonderful week and be well.  Many blessings to you always.

Laura Barish

Do you need a little help at home?  Give us a call to see if we can help - 858-779-9254 or visit us online at