When it comes to picking a Medicare plan ….

By Julie Stroud
As a physician, the last thing I want is for a patient to make decisions about their health and well-being based on the cost of care and medication rather than their actual care needs.
Right now is a critical time for the over 1.4 million individuals in Washington who rely on Medicare for their health insurance. Evaluating your own healthcare needs can help you select a plan that will cover you when you need it the most and fit within your budget.
While it’s impossible to foresee all health issues that may require treatment, there are several things to consider during the Medicare Advantage and Prescription Drug Plan Annual Election Period (AEP), which ends Dec. 7:

  • Future health risks. In addition to making sure your plan covers your current health needs, speak to your doctor about health risks that may require additional treatment. For instance, if you have prediabetes, consider the potential for future diabetes management.
  • Prescription drug benefits. Prescription drug coverage is included in many Medicare Advantage plans, unlike Original Medicare. If you prefer Original Medicare, you can opt for a standalone Prescription Drug Plan through a private insurer. Prepare a list of your current medications to compare costs while choosing plans.
  • Doctors and hospitals. If you have a favorite doctor, ensure they accept your plan to avoid any additional expenses for out-of-network providers. Also understand if the plan requires referrals for specialized care.
  • Other benefits. Consider additional benefits that can positively impact your health and well-being. Medicare Advantage plans may include dental, vision, and hearing coverage; fitness programs; transportation to doctor visits; and even allowances that help eligible beneficiaries pay for healthy food and other essentials, like rent and utilities.
  • Costs. Different plans have different costs, so understand the full picture when comparing plans in your area. Look at monthly premiums, deductibles, and co-pays for hospital stays and doctor visits. Also, pay attention to annual maximum out-of-pocket costs. If you reach the limit, you will pay nothing for covered services the rest of the year.
  • Quality. The Centers for Medicare and Medicaid Services reviews and rates all Medicare Advantage plans before the enrollment period each year to help consumers make informed decisions. Plans are rated on a scale of one to five, with one indicating poor performance and five indicating excellence.
    Your health insurance carrier is a partner that helps you get the care you need. If you are eligible for Medicare, take time to research your options and ensure you select the plan that best meets your personal health and financial needs.
    The Medicare Plan Finder at Medicare.gov can help compare plans and benefits and get an estimated cost for each plan. More information from Medicare is also available at 1-800-MEDICARE (800-633-4227) 24 hours a day, seven days a week (TTY users should call 1-877-486-2048).

Dr. Julie Stroud is vice president of Health Services for Washington Humana, a Medicare Advantage organization.

A new skill-set at 78

By Cynthia Hammer

Some things are meant to be. COVID came along. I received a memoir from a friend in Australia and thought, Heck, during COVID isolation, why don’t I write my memoir? So I did.

I had never written a book, so I took free online writing courses. Learning how to write dialogue, the importance of simple, concise, and straightforward language was fun and challenging, and the value of description. My writing kept improving, and that was satisfying.

I shared my writing with friends, who said it was good and informative. They encouraged me, but I also learned that friends typically say that, so I hired a professional—a developmental editor. He cost as much as a college course, but working with him was like taking one.

I had written 55,000 words. His first action was to discard 15,000 of them, restructure my memoir to read like a hero’s journey, and have me write 15,000 new ones to fill in the journey’s gap. Then, it was on to submit book proposals.

Could I find a publisher for my book, even though I was a first-time author in a challenging market? I read that only 2 to 3 percent of authors find a publisher, which was intimidating information. But COVID made submitting proposals easier. Instead of mailing out proposal copies to numerous agents and publishing companies, they now accept proposals submitted as e-mail attachments. I spent days researching where to send my proposal. I set up a form to track who I e-mailed and the status of my submission. I sent out over 50 e-mails and got at most five replies, all negative.

Just when I was about to give up and consider self-publishing my book, I got a call. A publishing company was interested! Oh, wondrous joy! They liked my writing! They were willing to take a chance on a first-time, 78-year-old author. My book, “Living with Inattentive ADHD,” was released on Aug. 29, 2023 in the U.S., the U.K., Canada, and Australia. You can ask for it at your favorite bookstore.

Writing a book and getting it published was my first acquired skill set. But there is more. While writing my memoir, I learned that my late-in-life diagnosis of the inattentive type of ADHD continued to be a problem for others, so I thought, Why don’t I start a non-profit with a mission that children with inattentive ADHD are diagnosed by age 8 and adults with inattentive ADHD are readily and correctly diagnosed when they seek help? The non-profit is called the Inattentive ADHD Coalition, and its website is www.iadhd.org.  

Once I set up the website, I completed the paperwork to establish a non-profit and created the board of directors. Then, I focused on educating about inattentive ADHD by writing blogs, publishing online articles, creating a presence on social media, and creating and posting videos on YouTube, and on and on.

My work continues. My days are exciting, challenging, full, and fun.

What could be better when you get ready to celebrate your 80th birthday?

Cynthia Hammer is author of “Living With Inattentive ADHD” and executive director of the Inattentive ADHD Coalition, a non-profit organization based in Tacoma. Hammer, who has lived in Tacoma for 45 years, was diagnosed with ADHD in 1992 when she was 49 and later became an advocate of raising awareness of the disorder among adults and children.

The history and views live on

By Craig Romano

Snow-clad and draped in glacial ice, it seems unlikely that wildfire would pose a threat to Mount Rainier. However, ringing the base of the 14,410-foot volcano is a nearly unbroken canopy of towering firs, hemlocks, and cedars within the 235,000 acre national park. And surrounding the park are millions of acres of additional timberland managed within national and state forests and private tree farms. When the nascent United States Forest Service decided that it was a good idea to start building fire lookouts to watch over this treasure trove of timber, they looked toward Rainier’s lofty slopes as the perfect spots to site them.

In 1916, the Forest Service constructed a stone shelter for fire watching at 9,584 feet on Mount Rainier’s Anvil Rock, just below Camp Muir. The rock hovel was replaced 12 years later by a cupola cabin. And while this location did indeed provide excellent fire finding with its sweeping horizon-spanning views, all too often it was shrouded in clouds prohibiting any viewing at all.

That was the issue, too, with the park’s second fire lookout, situated on a 7,176-foot point on the Colonnade on Rainier’s northwest shoulder. Built in 1930, it was soon taken out of use, replaced by a new tower at lower Sunset Park. But Anvil Rock remained staffed until 1942, not so much as to report fires but to record weather data. Soon after the first tower was constructed on Mount Rainier, the park service and the forest service realized what many hikers know today–that some of the best and more reliable alpine views aren’t on the mountain itself, but on the surrounding lower ridges and knobs immune to near-perpetual cloud cover.

By the 1930s, the park service and forest service began surveying more appropriate locations for fire lookouts. And with the nation in a Great Depression with millions of unemployed young men enrolled in Civilian Conservation Corps (CCC); officials had an army of labor at their disposal to construct new fire towers.

Up they went, mostly two-story cabins with wraparound balconies; simple in elegance and utilitarian in design. Within the national park, seven new fire towers were built: Shriner Peak in 1932, Tolmie Peak in 1933, Sunset Park in 1933, Gobblers Knob in 1933, Mount Fremont in 1934, Crystal Mountain and another lookout on a nearby knoll above Crystal Lake in 1934. And along the park’s periphery in the Snoqualmie National Forest (now Mount Baker-Snoqualmie), Wenatchee National Forest (now Okanogan-Wenatchee) and Columbia National Forest (now Gifford Pinchot), the CCC constructed scores of fire lookouts on ridges, knolls and summits. To the north, lookouts sprouted up on Clear West Peak, Suntop, Kelley Butte, and Bearhead Mountain, among others.

To the south, a precariously built lookout rose above sheer ledges on 5,685-foot High Rock. And a lookout was built on a 6,310-foot rounded knoll in the Tatoosh Range; where long before beat poet Jack Kerouac immortalized the Deception Peak lookout in the North Cascades, author Mary Hardy penned a well-received book, “Tatoosh.” in 1947 about her experiences as a fire watcher during World War II.

Along Mount Rainier National Park’s western boundary, a lookout tower was built in 1934 on 5,450-foot Glacier View peak. Thirty years later, the Washington Department of Natural Resources constructed a tower on 4,930-foot Puyallup Ridge. It still stands and is listed on the National Historic Lookout Register. However, it is rarely visited due to access issues over private land.

But the lookouts that still remain are accessible (mostly by trail) to the general public. Within the national park, four fire towers remain, one in each corner of the park. And while they share the same construction–two-story, wood-framed, wraparound windows and balcony–they each provide a unique view and perspective of the sprawling forests surrounding Mount Rainier, and of the mountain itself.

Here’s a thumbnail of each, including how to visit them:

Tolmie Peak

Sitting watch over the northwest corner of the park, Tolmie’s 5,939-foot summit commands impressive views from the mountain to the Sound. The trailhead is reached via the Mowich Lake Road, where you follow the Wonderland Trail north for 1.5 miles to Ipsut Pass. Then bear left for 1.7 miles through open forest and sub-alpine meadows skirting sparkling Eunice Lake before making the final ascent to the peak.

Mount Fremont

Perched on a ridge over 7,000 feet, it has the distinction of being Rainier’s highest remaining lookout. Situated in the drier northeast side of the park, the meadows here are punctuated with pumice and rock. The view of Rainier’s impressive Willis Wall and Emmons Glacier is breathtaking. Thanks to a lofty trailhead elevation of 6,400 feet at Sunrise, you needn’t work hard hiking the 2.7 miles.

Shriner Peak

The loneliest of Rainier’s lookouts, Shriner guards the quiet southeast corner of the park. The 4-mile hike to this 5,834-foot peak begins off of State Route 123. With over 3,400-feet of elevation gain, the trail is often deserted. Consequently, chances are good for viewing wildlife. Much of the peak’s lower slopes were engulfed by a wildfire before the lookout was constructed, creating open meadows and prime habitat. Bear, elk, deer, and grouse are abundant.

Gobbler’s Knob

At 5,485-feet, Gobbler’s Knob is the lowest of Rainier’s lookouts and the closest one to the volcano. It used to be the shortest to reach, too, just a 2.5-mile hike from Round Pass off of the West Side Road. But Tahoma Creek has continuously flooded the road, forcing its closure. To reach the trailhead now, you must first bike or walk an additional four miles.

Nearby remaining lookouts on national forest lands also invite exploring and make for excellent hiking destinations:

  • Suntop is perched on a 5,271-foot open knoll just north of the park. Reached by Forest Road 7315 (off of FR 73 near The Dalles Campground on State Route 410), it is a popular family picnicking and sightseeing spot. Hikers and mountain bikes can access it by following a 7.5-mile trail from Buck Creek.
  • High Rock, perhaps the most dramatic of the remaining lookouts, sits on a precipitous peak above sheer cliffs over 600 feet high along the appropriately named Sawtooth Ridge. The trailhead is reached by following Forest Road 8440 from Skate Creek Road.
  • Kelly Butte was recently restored by volunteers. The 1.7-mile trail, too, has been rebuilt in places, making what was once a short and steep hike a little less steep. Chances are good of seeing mountain goats. Reach the trail via Forest Road 7030 off of Greenwater River Road.

These lookouts, like many of the surviving fire lookouts from coast to coast, are primarily no longer used for fighting forest fires. Succumbing to aircraft surveillance, these backcountry sentinels remain historic landmarks. But beyond their weathered clapboards, they ignite passion and awe in their admirers by offering some of the hottest views in the Northwest.

Source: Visit Rainier, a non-profit organization that promotes Mount Rainier tourism.

How Medicare covers preventive healthcare


By Jim Miller

Dear Savvy Senior,

How does Medicare cover preventive health screenings? I’m due to get a physical and a colonoscopy this year, but I want to find out what I’ll have to pay for before I go in.

Just Turned 65

Dear Just Turned,

You’ll be happy to know that Medicare covers a wide array of preventive and screening services to help you stay healthy, but not all services are completely covered.

Most of Medicare’s preventive services are available to all beneficiaries (through Part B) completely free with no co-pays or deductibles, as long as you meet basic eligibility standards. Mammograms; colonoscopies; shots against flu, pneumonia, COVID-19 and hepatitis B; screenings for diabetes, depression, osteoporosis, HIV, various cancers and cardiovascular disease; and counseling to combat obesity, alcohol abuse, and smoking are just some of Medicare’s covered services. But to get these services for free, you need to go to a doctor who accepts Medicare “on assignment,” which means he or she has agreed to accept the Medicare approved rate as full payment. Also, the tests are free only if they’re used at specified intervals. For example, cardiovascular screening blood tests once every five years; or colonoscopy once every 10 years or every two years if you’re at high risk.

Medicare also offers a free “Welcome to Medicare” exam with your doctor in your first year, along with annual “Wellness” visits thereafter. But don’t confuse these with full physical exams. These are prevention-focused visits that provide only an overview of your health and medical risk factors and serve as a baseline for future care. 


There are a few Medicare preventive services that require some out-of-pocket cost-sharing. You’ll have to pay 20 percent of the cost of the service after you’ve met your $226 Part B yearly deductible. The services that fall under this category include glaucoma tests, diabetes self-management trainings, barium enemas to detect colon cancer, and digital rectal exams to detect prostate cancer. For a complete list of services along with their eligibility requirements, visit Medicare.gov/coverage/preventive-screening-services.

If you’re enrolled in a Medicare Advantage (Part C) plan, your plan is also required to cover the same preventive services as original Medicare as long as you see in-network providers.

You also need to know that while most of the previously listed Medicare services are free, you can be charged for certain diagnostic services or additional tests or procedures related to the preventive service. For example, if your doctor finds and removes a polyp during your preventive care colonoscopy screening, you will pay 15 percent of the doctor’s service fee. Or, if during your annual wellness visit, your doctor needs to investigate or treat a new or existing problem, you’ll probably be charged. You may also have to pay a facility fee depending on where you receive the service. Certain hospitals, for example, will often charge separate facilities fees when you’re receiving a preventive service. And you can also be charged for a doctor’s visit if you meet with a physician before or after the service.

To eliminate billing surprises, talk to your doctor before any preventive service procedure to find out if you may be subject to a charge, and what it would be.  

Jim Miller is a contributor to NBC TV’s “Today.” Send senior questions for him to Savvy Senior, P.O. Box 5443, Norman, OK 73070, or at savvysenior.org.