Paleo Breakfast Casserole Egg Bake

This content originally appeared on Low Carb Yum. Republished with permission.

This super flavorful breakfast casserole is one of my favorite ways to enjoy eggs.

For a long time, my go-to was an omelette filled with cheese and vegetables. However, I discovered that dairy causes inflammation for me, so I’ve been trying to eat less cheese.

Simply eliminating the cheese from my omelette felt unsatisfying, though. I needed a new favorite breakfast. And that’s when the idea of a paleo breakfast casserole came to mind!

This is the kind of hearty breakfast that keeps you full and happy for hours. The sausage gives it amazing flavor, plus it’s packed with veggies. To be honest, I didn’t even miss the cheese in this dish.

It’s also a fantastic way to meal prep for the week. If you’ve been searching for healthy, budget-friendly meal prep ideas, this paleo egg casserole is the perfect solution. It will keep well in the fridge for a week, or you can freeze slices for later!

Easy Paleo Breakfast Casserole with Sausage

An easy paleo breakfast casserole with sausage and vegetables. Make ahead on the weekend for a full week of low-carb breakfasts or freeze some for later.

  • 1 tablespoon olive oil (or avocado oil)
  • 1 pound nitrate-free paleo sausage ( no casing (or other ground meat))
  • 2 cloves garlic (minced)
  • 1/2 teaspoon dry minced onion flakes (optional)
  • 3 cups yellow summer squash (cubed)
  • 12 ounces broccoli (chopped)
  • 12 eggs
  • 1/2 cup almond milk (or coconut milk)
  • 1/4 teaspoon sea salt
  • 1/8 teaspoon pepper
  1. Cook sausage, garlic, and onion flakes (if using) in oil over medium-high heat until sausage is browned.

  2. Add squash and broccoli and cook until vegetables are tender.
  3. Spread sausage and vegetable mix into a 9×13 casserole dish.
  4. In a medium bowl, whisk together eggs, almond or coconut milk, salt, and pepper.

  5. Pour egg mixture over sausage mix.
  6. Bake at 375°F for 30-35 minutes or until eggs are set and the top has started to brown.

Feel free to change up the recipe by using different vegetables, different meat, or adding in cheese (for non-Paleo).

Paleo Breakfast Casserole Egg Bake Recipe

Source: diabetesdaily.com

Keys to Long Term Success and Preventing Complications

Contrary to popular belief, you can live a long, healthy life with type 2 diabetes, without developing complications. In its 2010 report, Diabetes UK found that someone with type 2 diabetes is likely to have a reduced life expectancy by up to 10 years, and someone living with type 1 diabetes is likely to have a reduced life expectancy by up to 20 years.

However, with advanced technologies and therapies, people are living longer and healthier than ever. Results from the University of Pittsburgh after a 30-year longitudinal study found that people with type 1 diabetes born after 1965 had a life expectancy of 69 years — longer than any study had ever previously found.

In part four of our four-part series on living well with type 2 diabetes, we will dive into the keys to long term success managing your condition, and how to prevent complications over the long term.

What Causes Complications?

It’s important to know what causes complications in people with type 2 diabetes. Not everyone living with diabetes will develop complications, but the occurrence of chronic hyperglycemia, or high blood sugar, can lead to heart disease, kidney failure, nerve damage, and retinopathy (the most common complications of diabetes). It’s important to keep your blood sugars in range as much as possible to help prevent the onset of these complications.

Keys to Long Term Success

A number of factors have been shown to help slow the progression of (or completely prevent) complications in people with diabetes:

  • Keep HbA1c in range – Studies have shown that keeping your HbA1c lower than 7% can prevent the onset of complications, and closely monitoring your blood sugar (testing regularly) can help tighten your control. Talk with your doctor about the ideal number of times she would like you to test per day, and make sure you always test before and after meals.
  • Take your medications as prescribed – Some people think that insulin is “bad” or they just don’t like the thought of taking a pill every day. You’re prescribed your medicine for a reason, and you should follow all doctors’ orders to take them as prescribed. Rationing or skipping doses can quickly lead to complications or even premature death.
  • Follow a sensible diet – You don’t need to go completely paleo or keto to have better blood sugars, but speaking with your doctor or seeing a nutritionist can help you develop an eating plan that will work for you that you can sustain. Be sure to include plenty of fresh vegetables, protein, and water. Eating similar foods, eating a low carbohydrate lunch (of 20 grams or fewer) and limiting meals at restaurants has also been shown to help improve blood sugar management in people with diabetes.
  • ExerciseExercise is one of the most important things you can do to prevent complications. Not only does it lower blood sugars, but it gets the heart working and the blood pumping, increasing circulation and strengthening your whole cardiovascular system. Exercise boosts your immune system, and increases serotonin in the brain, making you feel good and helping to prevent the onset of depression. According to our Thrivable Insights study, people with type 2 diabetes who have an HbA1c <6.5% are more likely (20% vs 8%) to exercise 4-6 times per week than people living with type 2 diabetes who have an HbA1c of 8% or higher.
  • Surround yourself with support – Diabetes is a marathon, not a sprint, and the journey can be lonely at times. A study from the University Hospital in Denmark found that loneliness may actually cause premature death by damaging the blood vessels of the heart, which can be compounded with a diagnosis of diabetes. Long term success with your diabetes care is much more likely if you surround yourself with supportive family and friends, or if you can find a community who will understand. Sharing your thoughts, worries, and feelings will help lighten your load, and you may just learn a thing or two that you didn’t previously know about diabetes and how to better care for yourself!

Have you had diabetes for a long time, and are thriving without complications? What are some of the best strategies you’ve employed to achieve success? Share this post and comment below!

Source: diabetesdaily.com

Traveling Abroad with Diabetes: Have Your Dolce and Eat It Too!

This content originally appeared on diaTribe. Republished with permission.

By Maria Horner

Maria shares her experiences and strategies for managing blood sugar levels while studying abroad

Like many young adults, I love to travel and will take any excuse to do so. Going into college, I knew that I wanted to study abroad; the moment I learned about my university’s semester program at their Rome campus, I was ready to go. However, traveling with diabetes isn’t always easy. The longer the trip, the more complicated it can be, and especially a trip to Italy, a country known for all of its carbohydrates!

What’s someone with diabetes to do about managing their diabetes while living in Italy?

Preparation is key!

One of the most important things I did to ensure my trip went well was put a lot of time into preparation. This means figuring out the quantity of diabetes supplies you’ll need, ordering them in advance, and finding space to pack it all. On my blog, I created a handy spreadsheet that helps you calculate exactly how much of each item you’ll need. You should start refilling your prescriptions as frequently as possible months before you travel, to make sure you stockpile enough supplies to last the whole trip. When I was preparing to go to Italy, my insurance only allowed me to order three months of supplies at one time, so I had to wait a few weeks before refilling my prescription. If you’re short on time, ask your healthcare professional if they can help you order extra supplies.

Preparation also means making back-up plans in case anything goes wrong, like talking through solutions to possible challenges. I have a great team of people that support me at home, including my parents, friends, and healthcare professionals, so before I left, I made sure I had several ways to contact them while abroad. Once I arrived in Rome, my host family, my friends, and the staff at my school became the people who could help me if I needed assistance.

Here are some things to talk about with your support team before you travel:

  • If I run out of a diabetes supply, what will I do? Can I get this supply abroad? Is having it shipped to me an option, considering what can be sent through the mail, what is allowed through customs, and the reliability of the mail system?
  • If I need to see a doctor or go to the hospital, can I find English-speaking doctors? Where is the closest hospital?
  • How does insurance work? Do I need to get special insurance while I am abroad?
  • How can I get in contact with my doctor? Can someone from my support team contact my doctor if I can’t?

Here’s a little story about how back-up supplies and my support team saved the day while I was in Rome:

About halfway through my semester, I was returning from Venice on an overnight trip and I arrived back in Rome early in the morning. I must have been sleep deprived, because I left my phone on the train! To anyone else, that would be very frustrating but manageable; most of the things people use their phones for, like email and messages, can be done on a computer. For me, it felt like a disaster, because my Dexcom G5 continuous glucose monitor (CGM) was tied to my phone. I love being able to check my blood sugar with just a glance at my phone, but without my phone, I couldn’t use my CGM. Because I’m used to constantly knowing my blood sugar, not having readings for an extended period of time was hard. Long story short, it was two days before I could get my phone back, and only with help from my support team in Rome. Thankfully, I had plenty of test strips and a blood glucose meter (BGM), so my back-up supplies came to the rescue.

Enjoy new foods, but do so in moderation.

After all my preparation, living in Rome still brought different challenges my way. Even though I wanted to experience all that Rome had to offer, I still had to keep blood sugar management in the back of my mind, especially during mealtime. Italian cuisine is full of carb-heavy foods, from pastries for breakfast to sandwiches, pizza, and pasta for lunch and dinner. Unfortunately, all these unknown carbs can make it hard to keep one’s blood sugar in range.

I didn’t want to deny myself all of the delicious, yet carb-rich, Italian foods. But I also didn’t want to drive my blood sugars out of my target range. I found that my best option was to eat these foods in moderation (just one or two bites), and fill myself up with delicious lower carb options, like vegetables and meat.

To prepare for a meal that may contain many carbs, make sure to dose extra insulin before the meal. If you end up eating more carbs than expected (which can easily happen with Italian food), the sooner you’re able to dose additional insulin – even if it means stopping in the middle of the meal to take insulin – the more quickly your blood sugars will respond.

Do some research and know what to order at restaurants.

When eating out at a restaurant, a good tactic is to order a meat, seafood, or vegetable-based dish as your main entree. Before you’re faced with ordering low-carb food in a foreign country, it’s helpful to know what you can expect from a local menu. Here’s what I learned in Italy:

  • Italian meals consist of several courses, including antipasto (appetizer), primi (the first course, typically pasta), secondi (the second course, usually meat or seafood), contorni (a side dish, usually a vegetable), and dolci (dessert).
  • Most people order either a primi or secondi as their main dish.
  • You can find the best low-carb options in the antipasti, secondi, or contorni sections of the menu.
  • If you have diabetes, ignore the primi section – it won’t be helpful for keeping your blood sugars in range.

One more tip: when you’re not sure what something is on the menu, it never hurts to ask the server or look up a picture online. This was important for me in Italy, since some of the meat dishes are breaded. I’ve included a list of my favorite low-carb Italian orders at the end of this article.

Share food with friends and family!

If you don’t want to miss out on experiencing all the pizza and pasta, get your friends to help you out. If they order a high-carb dish, ask if you can trade a few bites of your food for theirs – that way, you get to taste some pizza or pasta, while still keeping your meal low-carb. The same thing can apply to desserts, like gelato: ask a friend for a few bites, or offer to split one.

No matter what you decide to eat, just make sure you watch your blood sugars carefully, especially when trying new foods and guessing on insulin doses. Don’t let your diabetes stop you from exploring all the wonders of a new cuisine and culture, but also, don’t let impulsive food choices throw your blood sugars off. That balance can be hard to find, but do the best you can and enjoy the experience. Mangia bene (eat well)!

For more details, tips, and advice on studying abroad with diabetes, visit my blog, Winging It.

Here are some of my favorite low-carb Italian food orders, classified by course.

Antipasti (appetizers):

  • Insalata caprese (mozzarella, tomato, basil salad) – if you’re lucky, they’ll use fresh mozzarella di bufala, the most delicious cheese I’ve ever tasted!
  • Verdure grigliate misti (mixed grilled vegetables)
  • Affettato misto or salumi misti (mixed cold cuts)
  • Prosciutto (ham)

Secondi (entrees):

  • Tagliata/bistecca/filetto di manzo (beef)
  • Salsiccia (sausage)
  • Petto di pollo (chicken breast)
  • Vitella (veal)
  • Bollito alla picchiapo (beef stew in tomato sauce)

Contorni (side dishes):

  • Carciofo alla romana (roman artichoke)
  • Peperone (bell peppers)
  • Spinaci (spinach)
  • Insalata (salad)
maria horner

Image source: diaTribe

Maria Horner is a college student from Northern Virginia. She was diagnosed with type 1 diabetes at age seven, but she hasn’t let that hold her back! She had the incredible opportunity to study abroad in Rome during the fall of 2018, and recently started a blog about her experiences, to help and encourage other people with diabetes that are interested in studying abroad. When she’s not in class, you can find her taking a dance course or trying out a new recipe in the kitchen. She also loves travelling and going on adventures, one of her most recent adventures being skydiving!

Source: diabetesdaily.com

Coronavirus and Diabetes: What You Need to Know

Unless you’ve been living under a rock the past few weeks, a new and deadly virus has quickly been spreading around the world: Coronavirus, or COVID-19, is a highly infectious, acute respiratory disease that is closely related to the SARS virus. This disease only affects mammals and birds, and seems to have originated from a seafood market in the Wuhan Province of China.

The numbers are changing daily, but the most recent numbers show that over 76,000 people have been infected with the virus, with 99% of them occurring within mainland China. There are now over 2,000 reported deaths, none of which have occurred within the United States. So how dangerous is the Coronavirus, and what do you need to know as a person living with diabetes? Read more to find out:

Do Not Panic

On January 30th, the World Health Organization declared the virus a global health emergency. There are currently protocols in place to restrict passengers entering the United States from mainland China (where the outbreak is the most devastating), and passengers suspected of being contaminated with the virus are being funneled through speciality airports with temperature screenings, to make sure they’re not bringing the virus into the United States. If someone is detected at an airport with the virus, they are being quarantined until they are no longer contagious, to stop the spread of the disease.

The Virus is Mostly Mild

Many people who are infected with the virus never seek treatment, and while COVID-19 is more contagious than SARS or MERS, the Chinese CDC estimates that the fatality rate is hovering around 2.3%. According to the World Health Organization, signs of the infection include fever, cough, shortness of breath, and difficulty breathing. If you suspect you may be infected, see your doctor right away.

Protect Yourself

To protect yourself from getting any type of seasonal virus, it’s best to avoid contact with other sick people, wash your hands frequently (especially and always after using the restroom and before preparing food!), wear a protective mask when traveling through airports or busy bus/train stations, get your flu vaccination, maintain a healthy sleep schedule, and eat plenty of fruits and vegetables. According to the CDC, Coronavirus is spread by respiratory droplets in the air, when an infected person sneezes or coughs. The virus can also be spread when an uninfected person touches a surface where the virus is (bathroom countertops or door handles), and then touches their face or mouth. Carrying antibacterial hand sanitizer with you can help to eliminate this threat!

Numbers Don’t Lie

Sometimes our diabetes gives us clues when we’re starting to get sick, and one of those clues is higher-than-normal blood sugars. If you’re starting to see your numbers creep up for no reason, it could be a sign that you’re coming down with something. Check out our sick day tips to stay on top of your diabetes when you get ill.

Seek Help

If you think you’ve become infected with the Coronavirus, call your doctor immediately. Even though most cases are mild, having a chronic illness and a virus at the same time can cause major trouble. If it’s severe enough, the Coronavirus can progress, eventually causing pneumonia and even death in some cases. Let your loved ones know you’re worried, and contact emergency medical help right away if you suspect something is wrong.

Have you or a loved one been affected by the international Coronavirus outbreak? Share your experience in the comments, below.

Source: diabetesdaily.com

Mediterranean Chicken of Love

This content originally appeared on TCOYD: Taking Control of Your Diabetes. Republished with permission.

By Chef Robert Lewis

You will find joy in serving this hearty dish. It’s rich in protein, packed with vegetables, and flavored with herbs.

Mediterranean Chicken of Love

Tender, juicy chicken infused with garlic and herbs is blended with tomatoes and beans for a rich and full-flavored nod to Greek cuisine.

  • 1 tablespoon extra virgin olive oil
  • 1 tablespoon garlic
  • 2 white button mushrooms (large, sliced)
  • ½ red bell pepper (sliced)
  • ½ green bell pepper (sliced)
  • 1 Roma tomato (diced)
  • ½ red onion (sliced)
  • 1/4 cup vegetable broth
  • 5-6 stalks asparagus
  • 1 teaspoon oregano
  • 1 teaspoon rosemary
  • 1 teaspoon basil
  • 1 tablespoon fresh garlic
  • 8 oz skinless chicken (sliced, precooked )
  • 10 black olives (pitted )
  • 1 can white Italian beans (15 oz., drained)
  • black pepper (to taste)
  • ½ fresh lime
  1. Heat oil in a large skillet over medium heat.
  2. Add the mushrooms, bell peppers, onions and asparagus and sauté for 3 minutes.
  3. Add the cooked chicken and garlic.
  4. Lower heat. Add vegetable broth, oregano, rosemary, basil, diced tomatoes, beans, olives, and simmer for about 5 minutes.
  5. Cook over low heat until chicken is nice and hot.
  6. Season with pepper to taste and a squeeze of lime.

Mediterranean Chicken of Love RECIPE

Source: diabetesdaily.com

Recipe Roundup: 4 Protein-Rich Recipes from Dietitians

Many people with diabetes follow a high-protein diet for good reasons. It’s low glycemic, which means it doesn’t cause abrupt sugar spikes. It also makes you feel fuller for a longer time, which can help you sustain your energy until your next meal. Studies have also proven it’s good for weight loss, building muscles, and bone health.

All these health benefits made us think of reaching out to dietitians and nutritionists for recipes that are not only protein-rich but also palatable. Here are their suggestions:

Pizza Chicken Foil Packet

pizza chicken foil pack

Photo credit: Abbey Sharp

Insulin dosing for pizza can be tricky, due to its combination of high carbohydrates and high fats, so if you’re craving for some but want to ditch the carbs, this savory meal can be a good substitute. Registered dietitian, Abbey Sharp, says it’s easy to pull this off and can be readily modified depending on what’s in your fridge or what you or your family like on your pizza. To ensure that it’s low in carbs, be sure to use sugar-free sauce.

Salmon Burgers

salmon burger

Photo credit: Alexis Joseph

Packed with omega-3 fatty acids, this salmon recipe is a sure hit for everyone in the family. Hummusapien registered dietitian, Alexis Joseph, offers options to keep the carbs low. Instead of using breadcrumbs to keep the patties together, you can use almond flour. Instead of serving it in a bun with greens, you can chop it up and devour it in a loaded salad. The best part is that these burgers freeze well, making your dinner on busy days a breeze.

Easy Blackened Shrimp

blackened shrimp

Photo credit: Kaleigh McMordie

Is it possible to cook something healthy within 5 minutes? Yes, Kaleigh McMordie, the registered dietitian at Lively Table, proves this with this shrimp recipe. Just place the shrimp in a bowl, toss some lemon juice and blackening seasoning, and cook the shrimp in a non-stick skillet for 2-3 minutes each side. You will have extra blackening seasoning from this recipe, so be sure to store it in an air-tight container for future use.

Miso Chicken – One Pan Meal

miso chicken

Photo credit: Natalie Brady

Baked chicken and vegetables can be boring, but using a delicious dressing or sauce can make a huge difference in your meal. Registered Clinical Nutritionist, Natalie Brady offers her miso sauce as one of your options. Miso, a thick Japanese paste made from fermented soybeans, is rich in protein and nutrients.

What protein-rich recipe do you serve at home regularly? Share them in the comments – we would like to know and try them out!

Recipe Roundup_ 4 Protein-Rich Recipes from Dietitians

Source: diabetesdaily.com

A Focus on Emotional Well-being with Type 2 Diabetes

Maintaining sound mental health can be difficult if you live with diabetes, and many people know that diabetes and depression are comorbidities. The stressors of managing a chronic condition put you at higher risk for depression, and depression can put one at higher risk for type 2 diabetes. Scientists are still not completely sure why there’s such a strong link between the two conditions, but some studies have shown that diabetes doubles your risk of depression.

In part three of our four-part series on living well with type 2 diabetes, we’re focusing on emotional wellbeing and working to prevent depression while living with diabetes. If you’re newly diagnosed with diabetes and you’re worried about your risk for depression, check out our top ways to help prevent the onset of depression:

Find Your Tribe

Diabetes can be isolating and lonely, and finding a community that understands can make all the difference. Local support groups (in-person and online) can offer advice, encouragement, and assistance as you navigate the waters of your condition. If a support group isn’t for you, speaking honestly about what you’re going through with family or friends can be helpful as well.

Be Proactive

Instead of wallowing the loss of foods you should no longer eat, or missed opportunities you may experience, use this time to be proactive about your health. Take a cooking class to learn how to integrate more vegetables into your diet, or sign up for a yoga class or fitness challenge to jump-start your journey to health. Journaling about your feelings is helpful, and meditation can help calm an anxious mind. Filling your time with positive activities can help stave off depression and improve your blood sugars at the same time. A win-win!

Get Enough Sleep

Your mind and body need adequate sleep to rest, recover, and replenish cells nightly. Chronic sleep deprivation is harmful to both physical and mental health. Create a nightly routine, and aim to get to sleep at a predictable (and reasonable) time each night. You’ll be surprised by how rejuvenated you’ll feel after consistent, good sleep.

Treat Yourself

No one likes to live in deprivation all the time. When you meet a goal (for example, exercising 150 minutes per week, or losing 10 lbs), treat yourself. Maybe it’s movie tickets for this weekend’s show, or sleeping in on a Saturday while your spouse handles the dog and kids. Creating healthy rewards for progress not only improves your diabetes management, but triggers the “feel good” chemicals in the brain (dopamine and serotonin), so you don’t feel like your diabetes management is just constant work with no celebration.

Talk with Your Doctor

If your symptoms of depression are not improving, you need to speak with your doctor about treatment options. They may refer you to a therapist, or may prescribe medication to help manage your condition. There is no shame in seeking help to manage depressive symptoms!

How have you navigated the close relationship between diabetes and depression? What tactics have helped you to improve your mental wellbeing and live a healthier life? Share this post and comment below!

Source: diabetesdaily.com

Was Your Medicare Claim Rejected? Here’s How to Appeal

This content originally appeared on diaTribe. Republished with permission.

By Kara Miecznikowski and Eliza Skoler

Learn how to appeal a Medicare claim rejection under traditional fee-for-service Medicare, a Medicare health plan, or Medicare prescription drug coverage

A health insurance claim is a bill for your healthcare services, medications, or medical equipment that you think should be covered by your insurance plan. If you have Medicare health insurance, your healthcare practitioner will usually submit claims directly to Medicare for payment. If Medicare decides to reject the claim, you can challenge the decision. This is called an appeal.

In the United States, people have the right to appeal a denied claim for up to six months after hearing about this decision. Appeals can often be successful – a 2018 report showed that 75% of Medicare Advantage denials were overturned in the appeals process – which means that challenging a denied claim could save you money. This article will explain how to appeal a Medicare claim rejection.

To learn more about the appeals process in the United States – especially if you have a different health insurance plan – read our article, “When Insurance Gets Turned Down: Appeals Explained.”

How do Medicare appeals work?

You can appeal a decision made by the national Medicare fee-for-service program (Parts A and B), your private Medicare health plan (Part C), or your Medicare Prescription Drug Plan (Part D). Learn more about the different types of Medicare here.

Click to jump down to:

Appeals under Medicare Part A or B (“Original Medicare”)

Appeals under Medicare Part C (Medicare Advantage health plan)

Appeals under Medicare Part D (prescription drug plan)

Here are some common situations for appealing a claim rejection:

  • If you have already received the service, medication, or medical supplies. Example: your doctor gives you lab tests during a visit, but then Medicare rejects the claim.
  • If your doctor requested the service, medication, or medical supplies for you. Example: your doctor says you need an insulin pump and Medicare decides that is not medically necessary.
  • If you and your doctor request a change in price for your medication, based on what treatments work for you. Example: generic drugs do not work for your condition, so your doctor asks for a discount on the more expensive drug.

The appeals process is different under Medicare Part A, B, C, or D. There are five levels to the appeals process. If you disagree with the appeal decision at level one, you can continue to appeal the decision again at every other level.

With each appeals processes, write your Medicare number on every document you submit for your appeal, and keep a copy of all the materials you send in.

Filing an appeal under Medicare Part A (hospital insurance) or Part B (medical insurance), often called “Original Medicare:”

  • Your bill will be sent directly to Medicare.
  • The appeal must be filed within 120 days of receiving the Medicare Summary Notice (MSN) that shows that your claim was denied.
  • If you disagree with a Medicare coverage decision in the MSN, you can appeal the decision.

A Medicare Summary Notice (MSN) is a summary of the health care services you have received over the past three months, sent to you by mail.  It shows what Medicare paid for each service and what you owe for the service, and it will show if Medicare fully or partially denied a medical claim. The MSN also contains your appeal rights and step-by-step directions on when and how to file an appeal for a claim rejection.

Did you sign an Advanced Beneficiary Notice of Noncoverage (ABN) before you received the treatment? An ABN is a notice that your healthcare provider will give you if they think the health services they are recommending might not be covered by Original Medicare. Your ABN will list the items that Medicare is not expected to pay for, as well as the estimated costs of those health services. The ABN can help you decide if you would still like to receive the treatment, and if you will pay for it if Medicare declines to cover the cost.

When you sign an ABN you can ask your healthcare provider to submit the claim to Medicare (before billing you), asking Medicare to cover the cost. If Medicare rejects the claim, you can appeal the decision. If your healthcare provider did not give you an ABN before treatment, you might not be responsible for paying for the health service. Learn more ABNs and appeals here.

There are three different ways to file an initial appeal under Original (Part A or B) Medicare:

appeals

Image source: iStock Photo

  • Fill out a “Redetermination Request Form” with information from your MSN; send the form to the address provided on your MSN
  • Follow instructions on your MSN for filing an appeal without using the form:
  1. Circle the claim that you disagree with on your MSN
  2. On a separate piece of paper, explain why you disagree with the decision
  3. Write your name, address, phone number, and Medicare number on the MSN, and sign it
  4. If you have any other information that will support your case, include it; you can ask your doctor or other health care provider to help you
  5. Send all of the above materials to the address listed under “Appeals Information” on your MSN
  • Or, send a written request to the company that processes Medicare claims. Include:
  1. Your name and Medicare number
  2. The item that you disagree with on the MSN
  3. An explanation of why you disagree with the decision
  4. Your signature
  5. Send all of the above to the address provided under “Appeals Information” on the MSN

You should receive a decision within 60 days of your request, unless you submit extra information after you first file the appeal (which may delay the decision).

For more information on the Original Medicare initial appeals process, see the Medicare webpage. If you disagree with the appeal decision at the first level, you have 180 days to file an appeal at the second level; information on the appeals process beyond level one can be found here.

Filing an appeal under Part C (Medicare Advantage health plans):

  • The initial appeal must be filed within 60 days of receiving the claim rejection.
  • You must send a written request (unless your plan allows you to file a standard request by phone, fax, or email instead).

In your request, include:

  1. Your name, address, and Medicare number
  2. The item you disagree with, the date that you received the service, and an explanation of why you disagree with the decision
  3. Any other information that may support your case

You should receive a decision about your appeal within 60 days, unless Medicare needs more time to obtain information from your healthcare provider. If waiting for a decision will hurt your health, your appeal decision will be made within seven days.

If your appeal is rejected (fully or partially), your request will automatically be sent to level two of the appeals process. More information on the initial appeals process under Medicare Part C can be found here. For information on the process after level one, click here.

Filing an exception request or appeal under Medicare Part D (prescription drug plans):

  • Reasons to request an exception to your Part D drug plan:
    • If your plan decides not to provide a medication you think should be covered.
    • If cheaper versions of your medication don’t work for you, you can ask for a discount on the more expensive medication.
    • If a drug you need is not on your plan’s drug list, you can ask for an exception.
  • An exception request must be submitted first; if your exception request is denied, you have 60 days to appeal the prescription drug claim rejection.
  • You must send a written request (unless your plan allows you to file it in another way).

An “Evidence of Coverage” document explains your rights with your Medicare prescription drug plan. You have the right to ask your plan to pay for a medication you think should be covered, and you have the right to request an appeal if you disagree with your plan’s decision to provide it.

appeals

Image source: iStock Photo

Before appealing a claim rejection, you will request an exception:

  1. Fill out a Medicare Prescription Drug Coverage Determination request form through your insurance plan sponsor
  2. Ask the healthcare provider who prescribed your medication to write a letter explaining why you need this medication
  3. Send the documents to your Medicare health plan

You should hear back about your request within 72 hours. If your exception is denied, you can appeal the claim rejection. To submit a written appeals request, include:

  1. Your name, address, and Medicare number
  2. The drug you want your plan to cover
  3. An explanation of why you are appealing the coverage decision.
  4. Any other information that may support your case, including medical records
  5. Send the documents to your Medicare health plan

You should receive a decision within seven days. If waiting for a decision will hurt your health, your appeal decision will be made within 72 hours.

More information on the initial prescription drug appeals process can be found here. If your request is not met (fully or partially), you have 60 days to appeal the decision at the next level; learn about further appeals here.

How can I get help filing an appeal?

You can have someone else file an appeal for you. This can be a family member, friend, lawyer, doctor, or anyone else that has agreed to be your representative. For more information and the representative form, see the Medicare website page on how to appoint a representative. For prescription drug appeals, your doctor or prescriber can request an initial appeal for you; you do not need to first fill out a form.

For more help with appeals, especially appeals beyond level one, contact your State Health Insurance Assistance Program (SHIP). SHIP is a network of free counseling services that help people navigate Medicare; find the SHIP program in your state here.

diaTribe Series

Image source: diaTribe

This article is part of a series on access that was made possible by support from AstraZeneca. The diaTribe Foundation retains strict editorial independence for all content. 

Source: diabetesdaily.com

Food Shaming: Changing How We Talk About Food

This content originally appeared here. Republished with permission.

By Brenda Manzanarez, MS, RD, and Cynthia Muñoz, Ph.D., MPH

You know you shouldn’t be eating that kind of stuff, right?

If you’d just eat better, you wouldn’t have to take so many medications.

I know someone who cut out all carbs and cured their diabetes; have you tried that?

Do any of these comments sound familiar? Maybe someone else has said them to you, maybe you’ve said them to someone, or maybe you’ve thought them about yourself. Either way, comments like this, even if they have good intentions, often come off as judgmental and shaming. This type of “advice” can cause confusion, anxiety, frustration, and an unhealthy relationship with food.

Our Relationship with Food

Food is important when it comes to keeping blood sugar in range, but managing diabetes is not just about glycemic control—we also need to juggle lifestyles, health goals, and mental health.

There are so many factors that influence our food choices, and you cannot see those factors by just glancing at a plate. Food is an important part of our lives, and it can have so many meanings to different people. It can mean health, love, sense of community, or pleasure, but for others, especially people with diabetes, it might cause feelings of anxiety and fear.

Changing the way you eat is a major lifestyle change, and major lifestyle changes always take time.

While you are on this journey, unsolicited advice from strangers and even loved ones can feel more like judgment and might cause you to question yourself or feel guilty about your own choices.

Changing the way you eat is a major lifestyle change, and major lifestyle changes always take time. There are a lot of things to juggle when managing diabetes, so be patient with yourself and with others.

Unintended Consequences

Food shaming often happens when someone’s own preferences and opinions don’t line up with others’. Judgmental comments like “you shouldn’t eat that” may be a projection of their own frustrations or a reflection of their misconceptions about diabetes.

As clinicians who work with children, teens, and young adults with diabetes and obesity, we know that talking about food can be very difficult. We also know that negative comments, pictures, and memes on social media can have a harmful impact on someone’s emotional well-being, especially people with diabetes.

No one should be shamed about their food choices.

No one should be shamed about their food choices. Shame leads to negative feelings about food, which can lead to anxiety, depression, and even disordered eating. And these conditions can cause more damage to physical health than poor diet.

Rethink the Role of Food and Your Health

Instead of thinking of food as “good” or “bad,” or judging people (or yourself) by the way you eat, picture food and eating as being neutral and adopt a non-judgmental way of thinking. The food you put on your plate, is just food that will provide energy and nutrients to fuel your body.

Unlearning what we have been exposed to takes time but being aware of those negative thoughts is a start.

Instead of thinking of food as “good” or “bad,” picture food and eating as being neutral.

Remind yourself that there is no one right way to eat with diabetes— it has to be tailored to your own unique needs— like your budget, taste preferences/favorite foods, cultural norms, cooking skill, time, etc. And you don’t have to feel guilty about enjoying a treat every now and then.

Break the cycle and be nice to yourself and to others. Instead of criticizing people, ask them how they feel about the changes they’ve made and have them decide how they feel about it. If appropriate, provide encouragement.

If you are concerned about a loved one, privately ask how they are doing, and don’t offer advice unless they ask for it. Ask if there is anything you can do to support them, and/or seek information about healthy food choices and incorporate this in your own life as a form of support for your loved one.

If you feel this is a big issue in your own life, don’t be afraid to seek out help—talk to your primary doctor or with a therapist. If you don’t have a therapist ask for a referral from your doctor. To find a mental health provider with knowledge about diabetes, check this directory.

Bottom Line

Food is meant to be nourishment for our bodies and to be enjoyed; find a balance that works for your health, be confident in your choices, and be accepting of other people’s choices.

If you find yourself wanting to criticize someone else’s food choices or appearance, don’t! This is generally not helpful and can have a negative emotional impact.

A neutral and non-judgmental way of thinking is best when talking about food and diabetes; there are no “good” and “bad” foods. The key is to balance what you eat to get the nutrients you need.

If you receive a negative comment from a stranger on social media or in person, remember that person doesn’t know you and how you take care of yourself. Don’t beat yourself up and continue to focus on ways to be the healthiest version of yourself.

Source: diabetesdaily.com

Sun-Dried Tomato Marinara

This content originally appeared on ForGoodMeasure. Republished with permission.

Raw food followers believe heat kills food’s nutrients & natural enzymes. For those of us who like high temperatures, cooking changes a lot of things, most significantly … flavor. This sauce is no exception. A classic marinara with the combination of tomatoes, onion, garlic, and herbs, however, the addition of sun-dried tomatoes and lack of heat, elevate the intensity to something altogether unexpected.

Sun-Dried Tomato Marinara

This recipe works great as sauce for your homemade pizza, poured over zucchini linguini or as an accompaniment to your morning fried eggs.

  • 4 cups tomatoes (chopped)
  • 1 cup sun-dried tomatoes (drained if in oil)
  • 1 cup basil
  • ½ cup parsley (chopped)
  • ¼ cup red onion (chopped)
  • 2 tablespoons olive oil
  • 2 teaspoons garlic (minced)
  • 1 teaspoon apple cider vinegar
  • 1 teaspoon chili flakes
  • 1 teaspoon maple syrup
  • 1 teaspoon oregano
  • ½ teaspoon salt
  • ¼ teaspoon pepper
  1. Using the processor, combine tomatoes, sun-dried tomatoes, basil, parsley, onion, olive oil, garlic, vinegar, chili flakes, syrup, oregano, salt and pepper, until thick and creamy.

Naturally low-carb and gluten-free.

Net carbs: 6g

Sun-Dried Tomato Marinara Recipe

Source: diabetesdaily.com

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