Opinion

Details

Written by: Roy Dufrain Jr.

Published: 20 January 2013

Stan Musial was before my time. But in a way he is the reason I fell in love with the game of baseball.

You see, Musial was my father's baseball hero. My Dad was living in Missouri during those all-important years in a baseball fan's life, the pre-teen years when lifelong fans are molded from the clay of boys and girls.

Musial played for the St. Louis Cardinals during those years. In fact, he played for the St. Louis Cardinals for his entire 22-year career.

They called him Stan The Man, and he was the greatest Cardinals player ever, and one of the greatest all-time, period. The numbers are golden: seven National League batting titles, lifetime .331 hitter, 475 home runs, 24 all star appearances.

In 1963, Musial was 42 years old and almost done, and my father had recently moved his young family from San Francisco out to the suburbs that were then metastasizing in the walnut groves of Contra Costa County.

Musial had announced his intention to retire at the end of that season, and fans in every National League city turned out to bid the future Hall of Famer adieu. And that was the moment that my father chose to introduce me to the game that would be a part of my life thereafter.

Who knows? Maybe my Dad really just wanted to see his hero Stan The Man trot out to the field one more time, to look out onto the field and somehow see his own boyhood in Musial's batting stance, his swing, a tip of his cap.

Baseball does that to men, I know that now. So, surely my baptism into the church of baseball wasn't the only reason we went to Candlestick Park that summer of 63 to see the Giants play the Cardinals.

I was 5 years old that summer. I don't remember the exact date. I don't remember Stan Musial. I remember what every 5 year old remembers from his first big league baseball game – that first bright glimpse of impossible green as you ascend from a dark stairway to your section of the stands, holding your Dad's hand – and suddenly the diamond takes shape in front of you, the white lines glinting in the sun so perfectly, almost painfully true.

And I remember Willie Mays. How could you not remember the first time you saw Willie Mays play baseball? I don't remember exactly what he did that day. I just remember looking out and seeing him in centerfield, like a shining Lamborghini, looking fast just standing still. I was instantly in awe of the man.

Looking through the box scores from that year, I like to think it was July 5. On that day, the Giants were down five runs to four, but tied it up in the bottom of the ninth inning, and won it in the bottom of the eleventh. Mays went two for four, Willie McCovey hit one out, and Musial got a hit too. Nice day at the ballyard.

But it doesn't really matter what game it was. It was my first game, that's what matters. As my father was watching the hero of his boyhood take a final bow, I was experiencing the first day of my formative years as a baseball fan. I was new clay ready to be molded by the grand old game.

Baseball wasn't on the television all season then. Nothing was on the television then as much as everything is on the television now.

Baseball then was a game that happened on transistor radios with telescopic chrome antennas, set out on workbenches in garages with the doors open to the summer streets of the neighborhood.

Baseball happened in the sports section of the San Francisco Chronicle. It was too big for me to open and hold up, but after my Dad was done with it, I would spread out the pages next to my trucks and my green army men on the big corded rug in the living room, and try to study the secret code of the box score.

Baseball happened on the backs of cards that smelled like bubble gum sticks and lived in shoeboxes under the beds of children. Entire seasons were played out in the whirring minds of sick boys sitting cross-legged on blue plaid bedspreads covered with carefully arranged baseball cards. Teams were formed, stats were compared, winners were declared.

And, when you turned on the radio, or spread out the sports section, or when you opened up that shoebox, memories came out. You could see the flashing green of the outfield in the sun, and smell the salty foam on the beers of the men in sport shirts. You could hear the fat guy yelling at the ump, “Hey Blue, try using both eyes.”

You could see Willie Mays rounding third base and headed for home as a roar climbed up the throat of the crowd. Or you could see Stan the Man stepping up to home plate, smiling out at the pitcher.

Stan Musial died Saturday, at the accomplished age of 92. Somehow, sadness doesn't seem to be that much in order here. Rather, it feels like a moment of recognition and gratitude.

Thanks Mr. Musial, for all the memories you gave to the game, for being the biggest reason I went to Candlestick Park for the first time.

Thanks for being the one tipping your cap for my father while I couldn't take my eyes off Willie Mays in the on-deck circle.

Roy Dufrain Jr. lives in Lakeport, Calif.

Details

Written by: David Sayen

Published: 20 January 2013

You may have wondered how Medicare works with other insurance coverage, such as a group health plan from a former employer or union.

It’s an important issue because it determines whether your medical bills are paid correctly and on time.

If you have Medicare and other insurance, always be sure to tell your doctor, hospital, and pharmacy.

When there's more than one insurance payer, certain rules determine which one pays first.

This is what’s called "coordination of benefits."

The "primary payer" pays what it owes on your bills first -- and then sends the balance to the "secondary payer" to pay.

In some cases, there may also be a third payer.

The primary payer pays up to the limits of its coverage. The secondary payer only pays if there are costs the primary insurer didn’t cover.

But keep in mind that the secondary payer (which may be Medicare) may not pay all of the uncovered costs.

If your employer insurance is the secondary payer, you may need to enroll in Medicare Part B before that insurance will pay. (The Part B premium for most Americans in 2013 is $104.90 per month.)

Here’s who pays first in various situations:

If you have retiree insurance (coverage from a former job), Medicare pays first.

If you’re 65 or older, have group coverage based on your or your spouse’s current employment, and the employer has 20 or more workers, your group plan pays first. (If the company has fewer than 20 employees, Medicare pays first.)

Your group plan also pays first when you’re under 65 and disabled, have group coverage based on your or a family member’s current employment, and the employer has 100 or more employees. (Medicare pays first if the company has fewer than 100 employees.)

If you have Medicare because of end-stage renal disease (permanent kidney failure), your group plan pays first for the first 30 months after you become eligible for Medicare. Medicare pays first after this 30-month period.

Medicare may pay second if you’re in an accident or have a workers’ compensation case in which other insurance covers your injury or you’re suing another entity for medical expenses.

In these situations you or your lawyer should tell Medicare as soon as possible. These types of insurance usually pay first for services related to each type:

• No-fault insurance (including automobile insurance);
• Liability (including automobile and self-insurance);
• Black lung benefits;
• Workers’ compensation.

Medicaid and TRICARE (the health care program for U.S. armed service members, retirees, and their families) never pay first for services that are covered by Medicare. They only pay after Medicare, employer plans, and/or Medicare Supplement Insurance (Medigap) have paid.

For more information, visit www.medicare.gov/publications and read the booklet “Medicare and Other Health Benefits: Your Guide to Who Pays First.”

You can also call 1-800-MEDICARE (1-800-633-4227) and ask for a copy to be mailed to you. TTY users should call 1-877-486-2048.

If you have questions about who pays first, or you need to update your other insurance information, call Medicare’s Coordination of Benefits Contractor at 1-800-999-1118. TTY users should call 1-800-318-8782.

You can also contact your employer or union benefits administrator. You may need to give your Medicare number to your other insurers so your bills are paid correctly and on time.

David Sayen is Medicare’s regional administrator for California, Arizona, Nevada, Hawaii, and the Pacific Trust Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

Details

Written by: David Sayen

Published: 29 December 2012

The Affordable Care Act strengthened Medicare in important ways. Signed in 2010, the federal health law already has provided free preventive health benefits to millions of people with Medicare, and saved billions of dollars for those who hit the gap in their Part D prescription drug coverage.

In 2013, discounts on prescription drugs for people who reach the Part D “donut hole” will increase, and Medicare will cover screenings and counseling for alcohol misuse, behavioral therapy for cardiovascular disease, counseling for obesity, and more.

If you reach the donut hole in 2013, you’ll pay only 47.5 percent for covered brand-name drugs and 79 percent for generic drugs. Thanks to the Affordable Care Act, these discounts will gradually increase until the hole is closed in 2020.

In 2013, Medicare will cover one alcohol misuse screening per year for adults with Medicare (including pregnant women) who use alcohol, but don’t meet the medical criteria for alcohol dependency.

If your primary-care doctor or other primary-care practitioner determines you’re misusing alcohol, you can get up to four face-to-face counseling sessions per year (if you’re competent and alert during counseling). A qualified primary-care doctor or other primary-care practitioner must provide the counseling in a primary-care setting such as a doctor’s office.

Medicare also will cover one visit per year with your primary-care doctor to help lower your risk for cardiovascular disease. During this visit, your doctor may discuss whether taking aspirin is appropriate for you, check your blood pressure, and give you tips to make sure you’re eating well.

If you have a body mass index of 30 or more, Medicare will cover intensive counseling to help you lose weight. This counseling may be covered if you get it in a primary-care setting, where it can be coordinated with your personalized prevention plan.

In 2013, Medicare also will cover screenings for chlamydia, gonorrhea, syphilis, and Hepatitis B. These screenings are covered for people with Medicare who are pregnant and/or at increased risk for sexually transmitted infection. Medicare covers these tests once every 12 months or at certain times during pregnancy.

In addition, Medicare covers up to two high-intensity behavioral counseling sessions each year for sexually-active adults at increased risk for sexually transmitted infections. Medicare covers this counseling only in a primary-care setting. Counseling in an inpatient setting, like a skilled nursing facility, isn’t covered as a preventive service.

You pay nothing for any of the above services if your primary-care doctor or other qualified primary-care practitioner accepts Medicare’s payment amount.

Medicare now covers one depression screening per year, too. The screening must be done in a primary-care setting that can provide follow-up treatment and referrals. You pay nothing for this test if the doctor or other qualified provider accepts Medicare payment, but you generally have to pay 20 percent of the Medicare-approved amount for the doctor’s visit.

Besides these services, Medicare covers a long list of preventive benefits – often at no cost to you – to help you stay healthy and detect disease in its most treatable stages.

Medicare-covered preventive services include tests and screenings for breast, prostate, cervical, and colon cancer; screenings for conditions that may trigger heart attack or stroke; checks for diabetes and glaucoma; and counseling to help you stop smoking.

You’re also entitled to a one-time “Welcome to Medicare” checkup during the first 12 months after you take Medicare Part B, and wellness visits with your doctor each year after that. These visits are free.

Shots to protect you against flu and pneumonia also are free.

The Affordable Care Act eliminated deductibles and co-pays for most Medicare preventive services in order to encourage people to use them more.

Please take advantage of them!

David Sayen is Medicare’s regional administrator for California, Arizona, Nevada, Hawaii, and the Pacific Trust Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).