On October 7, 2024, the Wellspring Center for Prevention hosted its annual Senior Conference, drawing caregivers and professionals together to discuss key issues facing older adults. The event featured four engaging speakers, each offering practical advice on health benefits, fraud prevention, and mental well-being for seniors.
Gina-Marie Mendez on Navigating Medicaid and Healthcare Access
Gina-Marie Mendez, a health educator from Horizon Blue Cross Blue Shield, kicked off the conference by focusing on Medicaid and healthcare resources for older adults. She highlighted the importance of understanding Medicaid, especially for those not yet eligible for Medicare, explaining how New Jersey Family Care (the state’s Medicaid program) fills the gap for adults aged 55-65.
“Health insurance is the biggest tool for managing our well-being,” Gina-Marie said. “It gives us access to care, but it goes beyond that. We also need to address the social drivers of health—things like housing and food security.”
Gina-Marie introduced the Cover All Kids program, which ensures that children under 19 can receive healthcare regardless of immigration status. While seemingly unrelated to seniors, Gina-Marie pointed out that many older adults are primary caregivers to grandchildren. She also offered a personal take on the Medicaid application process: “I like to give the acknowledgement, and my personal opinion is that the website is confusing. I do not think it’s user-friendly.”
Her advice? Seek help if navigating the system feels overwhelming. “We [at Horizon NJ Health] have a group of individuals who are New Jersey Family Care application experts. We can fill out the application for you, either remotely or in-person.”
Rachel Caccese on the Dual Special Needs Plan (DSNP)
Rachel Caccese, a specialist in quality assurance also with Horizon Blue Cross Blue Shield, followed up with an in-depth look at Horizon NJ Health’s Dual Special Needs Plan (DSNP), designed for people who qualify for both Medicaid and Medicare. The DSNP plan offers comprehensive care at zero cost, integrating Medicare and Medicaid benefits, which makes life easier for its members.
“Our members are more likely to have chronic conditions and need more specialized care,” Rachel explained. “That’s why every member gets a care manager to help coordinate their healthcare, whether it’s making sure they see the right specialists or addressing social determinants like housing or transportation.”
Rachel emphasized the importance of using the Horizon Total Care card to avoid billing issues, saying, “Just because a doctor accepts Medicare and Medicaid doesn’t mean they automatically take the DSNP plan.”
She also shared some of the perks DSNP members enjoy, like transportation to doctor’s appointments and a popular Over-the-Counter (OTC) benefits card. “This card is a member favorite. It works like a debit card, and they can use it for things like vitamins, dental supplies, and even healthy food.”
Valeria Escudero on Protecting Seniors from Medicare Fraud
Valeria Escudero, an outreach specialist from the Senior Medicare Patrol, shifted the focus to a serious issue: Medicare fraud. Valeria highlighted that Medicare fraud costs the system about $60 billion annually, affecting both current and future beneficiaries.
She explained three common types of fraud: double billing, phantom billing, and upcoding. Phantom billing, for example, involves billing for services or equipment that were never provided. “Last year, Medicare paid out a billion dollars for urinary catheters that beneficiaries never needed,” Valeria said, giving a startling example of how pervasive fraud can be.
Valeria’s advice to seniors was simple: review your Medicare Summary Notice carefully and stay vigilant. “Even if the statement says ‘this is not a bill,’ open it. It’s the only way you’ll know if something’s wrong with your account.”
She also urged attendees to be cautious about unsolicited phone calls: “If someone calls saying Medicare is issuing new plastic cards, hang up. Medicare isn’t issuing plastic cards.” She reassured the audience that the Senior Medicare Patrol is here to help, free of charge, to investigate fraud and protect seniors from scams.
Melissa Friedman on Mental Health and Retirement Stress
Melissa Friedman, a licensed clinical social worker, closed the conference with an engaging discussion on the mental health challenges faced by older adults, especially during retirement. While retirement is often portrayed as the “golden years,” Melissa emphasized that, for many, the reality is far more stressful.
“People think it’s going to be this glamorous time—golf, swimming, and relaxation,” she said. “But for a lot of folks, it’s not like that. There’s financial stress, health issues, and—most importantly—a loss of routine. When your identity is tied to your career and suddenly it’s gone, that can be a real challenge.”
She discussed how chronic stress can impact seniors physically, leading to high blood pressure, heart disease, and other conditions. But it’s not just physical: many seniors experience anxiety, restlessness, and low spirits. “The mind and body are best friends,” she noted. “When we’re stressed, it manifests physically—headaches, stomach issues, trouble sleeping.”
Melissa offered practical ways to manage stress, like deep breathing, physical activity, and even something as simple as spending time outside. She also encouraged seeking therapy, particularly for seniors who might never have considered it before. “A lot of seniors, especially men, are taught not to talk about their problems. I tell them, it’s okay to cry, it’s okay to ask for help.”
A Friendly Reminder
The 2024 Senior Conference underscored the importance of empowering seniors with the right resources, from understanding Medicaid benefits to protecting themselves from fraud, and maintaining mental health. Each speaker brought valuable insights, reminding everyone that while aging presents challenges, support is available at every turn.
As Valeria from the Senior Medicare Patrol put it, “Let us help keep Medicare strong.” By staying informed and proactive, seniors can navigate these challenges more smoothly—and know they’re never alone.