Fast and Easy 2018 Part D Breakdown

Is Medicare Part D confusing? Want a fast and easy 2018 Part D breakdown … Well look no further, we can help.

2018 Medicare Part D Breakdown

All Part D Medicare drug plans work the same as far as their coverage levels, they just offer different copayments and/or deductibles.

Deductible

If your plan has a deductible, you pay the total cost of your drugs until you reach your deductible set by your plan … then you move on to the initial coverage level.

Initial Coverage Level – $3,750

During the initial coverage level you pay your copay amounts set by your plan until your total drug cost reaches $3,750. The total drug costs is the amount “you and the insurance company” pay. Then you move to the coverage gap level, or “donut hole”

Coverage Gap Level / “Donut Hole” – $5,000

During the coverage gap level, you pay either a higher copay amount, or discounts until you pay a total in out of pocket expenses of 5,000. Out of pocket expenses is just the amount “you” pay. Then you move to the catastrophic coverage level.

Catastophic Coverage Level – Unlimited

The catastrophic coverage level is where you will pay generally the least copay amount until the end of the year at which time the plan will renew.

This fast and easy 2018 Part D breakdown is not company specific. If you need a specific quote for your Medicare 2018 drug plan click here.

Only some drugs are covered under part B of Medicare, but most drugs are not. You want to make sure that you get a separate drug plan when you become “eligible” for Medicare Part D, in order to avoid the future penalty.

New Medicare Card

New Medicare Cards are soon to be in the mail! The Centers for Medicare & Medicaid Services (CMS) will begin mailing new cards to people with Medicare benefits beginning in April 2018. This comes as an effort to meet the statutory deadline for replacing all existing Medicare cards by April 2019. The new Medicare card will no longer display your social security number (SSN) as your Medicare ID, rather each Medicare beneficiary will be issued a random alphanumeric-based number.

When will I get my new Medicare Card?

Medicare beneficiaries should use the new card once they get it, but either the SSN-based or the new Medicare card with the random alphanumeric-based number can be used through December 2019. Beginning January 1, 2020, only the new card will be usable.

I’m New to Medicare

New and existing Medicare enrollees will get the new Medicare card. New enrollees will get the new card starting in April 2018. Current enrollees will begin receiving a replacement card sometime between April 2018 and April 2019, state by state.

To Prepare for Your New Medicare Card:

This change does not impact your Medicare benefits in any way, nor does it impact your Medicare Supplement, Medicare Advantage, or Medicare Part D benefits.

Make sure your address is up to date so you get your new Medicare card. If your address needs to be corrected, Social Security is the organization who keeps all of the current contact records, even though the new Medicare card is from Medicare. If you haven’t done so already, you can create an online account at ssa.gov and update your address. If online access isn’t your thing, or you would rather talk to someone directly, you can call Social Security at 800-772-1213 and take care of it all over the phone.

Your new Medicare card may arrive any time between April 2018 and April 2019. You may get your card at different times from your friends and neighbors.

Please be on the ALERT to possible scams: Medicare will never contact you and ask for personal and private information in order to issue a new Medicare card or number.

If you are new to Medicare and need help call us 877-740-8683, we can point you in the right direction.

You want to enroll in Medicare 3 month prior to turning 65, and you can enroll by calling Social Security at 800-772-1213, or by going online at www.ssa.gov.

If you have Medicare and would like to compare rates on your Medicare Supplement Plan click here

Heart Disease Insurance

February is Heart Disease Month

President Lyndon B. Johnson proclaimed the first American Heart Month to be in February 1964. At that time more than half of the deaths were caused by heart disease in the U.S. Today, heart disease remains the leading cause of death, globally, with more than 17.3 million deaths each year and rising. Now more than ever you need heart disease insurance.

Compare heart disease insurance

Heart disease: It’s a killer

It goes by many names: coronary heart disease, congenital heart disease, arrhythmia, heart attack, congestive heart failure. Whatever form it takes, heart disease is the No. 1 cause of death among men and women in the United States today.1 Every 40 seconds on average, someone in the U.S. dies of heart disease.2 Nearly 86 million Americans (more than 1-in-3 adults) have one or more types of cardiovascular disease.3 But heart disease doesn’t have to be a certainty. When more people understand the causes, they can take steps to reduce their risk of developing problems in the first place.

Power and purpose of the heart

The heart never rests. A normal heart beats about 100,000 times a day, cranking out 2,000 gallons of blood.4 As the blood circulates, it not only carries oxygen and nutrients to organs and tissues, it also carries waste products to the kidneys, liver and lungs to be flushed out of the body. By the time someone turns age 70, his or her heart has contracted more than 2.5 billion times.5 Given the organ’s importance inside the body, it’s easy to see why heart disease can be disabling or even devastating.

Compare heart disease insurance

It may be in your genes

Many risk factors that contribute to heart disease are manageable habits and behaviors.
These three are NOT:
♥ Family history. If someone in your family has struggled with heart disease, you are more likely to have problems as well.
♥ Gender. Men are more likely to suffer heart attacks, but heart disease remains the leading cause of death for American women.
♥ Race. Certain ethnic groups—including African-Americans, Mexican Americans, Native Americans and Native Hawaiians—are more likely to have heart disease.
Have you known someone who has had a heart attack, stroke, or suffers from heart disease?

Why do I need Heart Disease Insurance, I have health insurance.

Heart attacks and strokes happen unexpectedly, and generally at the worst time. When they do, it can leave you and your family vulnerable to out-of-pocket expenses that major medical insurance does not cover.  Let’s face it, health insurance these days isn’t what it used to be.  If you don’t see the right doctor at the right time, or if you are out-of-network your plan may not pay anything.  Heart disease insurance benefits are paid directly to you.  They give you piece of mind that you can see the doctor or specialist you want to see, even though he may not be in your plan network.  These plans can dramatically reduce the worry about how you will pay for those unexpected expenses, not to mention the normal living expenses that keep coming in whether you are able to work or not. With less worry, you can focus on getting well rather than how you will get the money to pay your electric or phone bill.

Let’s have a HEART-TO-HEART

So many people rely on you every day: your children, spouse or significant other, your employer and coworkers, your closest friends and even your parents as they age. And while you’re busy focusing on those who count on you, you may not realize how much you count on your heart. You work hard and give your best effort to take care of the important people in your life. During National Heart Month, take time to care for yourself. Make the choice today to lead a heart-healthy lifestyle and get added protection.

Contact your insurance agent or click below to learn more about how a supplemental health policy can provide protection and piece of mind for you and your family.

Compare heart disease insurance

The enclosed facts represent the U.S. population, are provided for information only and do not imply endorsement of Freedom Benefit Solutions or its products by any of the cited sources.
ENDNOTES:
1 Centers for Disease Control and Prevention, “Heart Disease Facts,” www.cdc.gov, August
10, 2015.
2 “Heart Disease and Stroke Statistics—2015 Update: A Report from the American Heart
Association,” Circulation, p. 29 -322.
3 Ibid.
4 American Heart Association, “The Heart: How It Works,” www.heart.org, 2015.
5 Ibid.

Retiring Baby Boomers Healthcare

Retiring Baby Boomers healthcare costs are a big concern and need to be planned for … starting now!

When you think of retirement, you think of white sand beaches, or sipping coffee on the porch, or riding your Harley till you find that quaint little town and stop and the night … basically you leave the bump and grind and being your stress-free life, right?  Retiring baby boomers are not thinking of having to deal with the complicated world of Medicare or your retirement health insurance. Yuck!

So for those of you who like to look through the “rose-colored glasses”, we have listed a few key things about healthcare costs that retiring baby boomers should be aware of so you can prepare now as retirement nears.

Medicare isn’t FREE.

Shocker?  Most retiring baby boomers assume that all of a sudden once they stop working and get on Medicare, magically all of their medical bills will be paid.  It’s probably because we all paid so much in for so many years, it would seem justified, however it isn’t the case.  How it really works is Medicare Part A covers things in hospital and that part is FREE for most enrollees.  Then Medicare Part B, which covers outpatient services and Medicare Part D, which is the prescription part, isn’t FREE.  To add to it, all of the parts of Medicare come with varying deductibles and other out of pocket costs that can add up, not to mention it doesn’t have an annual out-of-pocket limit like most of us are used to with our health plans.

A typical retiring baby boomers healthcare costs will look something like this once enrolled in Medicare:

  • Part B premium, which for most people is $104.90 as of 2016, but those with higher incomes are subject to higher premiums.
  • Medicare Part A Deductible- $1,288 per benefit period (for 2016).  Now Medicare says a “benefit period” is the day your’re admitted to a hospital or skilled nursing facility up until you reach the point where you haven’t received inpatient care for 60 days in a row.  So basically, in a year you could pay that $1,288 deductible multiple times … there’s no limit to the number of “benefit periods” under Medicare Part A.  Plus, you are charged for each day you are confined, and there is no limit on that either.
  • Medicare Part B Deductible – $166 per year (for 2016).

So to boil it all down, when you are enrolled in Medicare alone, you will spend thousands of dollars each year out-of-pocket. In fact, in 2010, according to the Kaiser Family Foundation, Medicare beneficiaries spent an average of $4,745 on out-of-pocket healthcare expenses. That doesn’t sound FREE to me!

Retiring baby boomers need supplemental insurance.

Generally, Medicare will cover about 80% of the medical expenses, which is why most people use supplement insurance plans to cover the other 20%.   There are a lot of different Supplement Plans or Medigap plans available.  They are sold by individual carriers and vary by price and benefits.  Some do really good at picking up what Medicare doesn’t pay, and others have more out-of-pocket costs to you.  A Medigap plan with very little out-of-pocket cost will probably average you around $180 per month.

Now as we said, Medicare doesn’t cover everything, and may not meet all your retirement needs.  Just as Medicare doesn’t cover funeral expenses, it also doesn’t cover the cost of nursing home care or assisted living facilities, therefore you have long-term care insurance.  Key is, the best time to buy is when you are young and healthy, just like your life insurance.  The average 60-year-old couple pays about $3,400 per year in premium costs, but having a plan could save you and your loved ones thousands upon thousands in the long run. The American Association for Long-Term Care Insurance reports that more than 50% of applicants aged 50 to 59 qualify for long-term discounts based on their health, but that figure drops to 42% among 60- to 69-year-olds and 24% for 70- to 79-year-olds.  The facts show the older we get the less likely we are to qualify, so if you are interested in seeing about long-term care insurance, click here for a free quote.

“I’m not going to be 65 when I retire, what do I do for health insurance?”

So let’s say you are one of the “lucky” ones and will stop working before you get Medicare eligible, you will have to get health insurance on your own until you reach 65.  There are a few ways this can happen:

JOB:  If you had health insurance with your employer, you may can continue your coverage under that same plan, that is called COBRA, which allows you to keep the plan for up to 18 months.  If you elect COBRA, you will pay the full cost of your plan, whereas your employer most likely paid some of it.  Most COBRA premiums are high, but before you make the choice, you need to shop around, you generally have 60 days to elect it.

INDIVIDUAL:  If you didn’t have the option of COBRA, or you have exhausted your COBRA already but you still aren’t 65, you have the option of shopping individual plans.  Now days, everyone is talking about Obamacare, and on and off the exchange.  That is a whole other post you need to read … basically know it is available but keep in mind that the (2016) prices have gone up from when you shopped last, and plans have changed.  You may have to take a higher deductible or a plan with fewer copayments, but the main thing to look at is network.  Most carriers are only offering HMOs, so you must stay with a doctor in network – so make sure your doctor is in that network on the plan you choose, or you will have to change doctors.  Keep in mind, if you get a plan that is not ACA qualified, you will be subject to the penalty when you pay your taxes.

Good news!

Typically we see most retiring baby boomers are happier with the healthcare costs once they get on Medicare vs what they are paying on their individual plans.  However, once you retire, you’ll be on a fixed income, so the more you prepare now, either by putting back extra savings, or paying off more of your other liabilities, the better off you’ll be.

2016 Changes to Medicare

The 2016 Changes to Medicare were found throughout the parts of Medicare.  Since most people do not pay a Part A premium, that change is kind of irrelevant.  There were some changes to what you pay under Part A deductible and coinsurance but none as noteworthy as the Part B changes.  The Part B deductible and Part B premium both changed in 2016.  View the chart below to see the exact differences.

2016-changes-to-medicare

Please note … The standard Part B premium amount if you enroll after 2016 is $121.80 (or higher depending on your income).  However, most people who get Social Security benefits will continue to pay the same Part B premium amount as they paid in 2015. This is because there wasn’t a cost-of-living increase for 2016 Social Security benefits.

You’ll pay a different Part B premium amount if:

You enroll in Part B for the first time in 2016.
You don’t get Social Security benefits.
You’re directly billed for your Part B premiums.
You have Medicare and Medicaid, and Medicaid pays your premiums. (Your state will pay the standard premium amount of $121.80.)
Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount.

How will the 2016 Changes to Medicare effect me?

The 2016 changes to Medicare may effect each person differently.  If you only have Original Medicare, then your overall out-of-pocket costs will be greater.  If you have a Plan F, you may see your actual supplement premium increased.  If you have a Plan C, G, or any other plan that didn’t pay the Part B deductible …  your premium may not have increased as much, but you will notice when you go to the doctor you will pay a little more the first of the year over what you paid last year.   If you have Part C, or a Medicare Advantage Plan, then you may see changes when the plan renews for next year.  Regardless of the specifics, the 2016 changes to Medicare will have some effect on everyone who is on Medicare currently or who will be enrolling.

Need more information?

If you would like to shop for Medicare Supplemental Plans or need help with Medicare give us a call, we will be happy to help 877-740-8683 or locally 936-756-6199.

Medicare Supplement Plan F or Plan G

“That is the real question, which Medicare Supplement Plan do I go with?” Bob said. “Plan F or Plan G? They both look the same.” “Good question.” I told him. Then I began to explain as I do to all the folks I talk to who ask this same question. It’s funny how in the end, they always seem to agree and make the same decision because it just makes $ense.

Here is the deal. Plan F has been the most popular plan in the Medicare Supplement Market for years. Mainly because it is simple to understand; most people have almost no out of pocket costs other than what they pay each month for the plan. If Medicare pays, then the Medicare Supplement pays. Some people even say the “F” stands for “Full coverage”. However, “Full coverage” as we all know, comes at a price, and sometimes it isn’t the best “bang for your buck”.

Plan F and Plan G are identical, the ONLY difference is, on Plan G you have to pay for the Medicare Part B deductible. Therefore, Plan G is becoming more and more popular, mainly because of the cost. If you look at the graph below, the Part B deductible has not changed in the past 3 years.

PART B DEDUCTIBLE HISTORY

In 2010 Part B deductible was $155
In 2011 Part B deductible was $162
In 2012 Part B deductible was $140
In 2013 Part B deductible was $147
In 2014 Part B deductible was $147
In 2015 Part B deductible was $147

Even though the Part B deductible hasn’t changed much in the past 5 years (in fact it’s lower than it was in 2011), Plan F prices have steadily been increasing every year. Basically, for 4 years people with Plan F have been paying more for a benefit that hasn’t changed.

When you look at the actual numbers, the Medicare Part B deductible breaks down to around $12 per month ($147 / 12 months). So if a Plan F costs $12 more than a Plan G per month for you, then you are paying too much!!! Make $ense??

In some areas, we see a Plan F for a customer and a Plan G be as much as $40 difference! So tell me, if Progressive or Geico told you that you could save $480 per year in premium and only add $147 in your deductible, would you be willing to make that change? Of course you would, because it makes $ense.

So after quoting Bob Plan F @ $187.39 per month and Plan G @ $157.35 per month … I said to Bob … “I always give folks the choice by showing them the price difference and let them make the decision … which plan do YOU think you should go with?” Without hesitation Bob blurted “Well I would be dumb to not go with Plan G!” Bob is a smart man. Over 90% of our customers go with Plan G, however if you are willing to give an insurance company $200-$400 in trade for $147, then we won’t mind helping you do that.

2016 Medicare Open Enrollment

Most people don’t realize that the 2016 Medicare Open Enrollment Dates only apply to people who are wanting to make changes to their Medicare Advantage (Part C of Medicare) and prescription drug plan (Part D of Medicare). Each year, open enrollment runs from October 15 to December 7. Therefore in 2016 it will begin on October 15, 2015. That is the time for you to shop around for a new Medicare Advantage Plan (Part C of Medicare) or a new Prescription Drug plan (Part D of Medicare).

So first of, to be clear, as far as enrolling in Medicare, you can do that as soon as you are eligible … no matter what month it is. Most people become eligible when they turn 65, and begin enrolling in Part B up to 3 months before their 65th birthday month.

It is only during open enrollment that you can switch from original Medicare to Medicare Advantage (Part C of Medicare), or vice versa. Also, if you find that another Medicare Advantage plan (Part C of Medicare) will fit your needs, or has a broader network, you can switch from one Medicare Advantage plan (Part C of Medicare) to another. Same with a prescription drug plan (Medicare Part D), you can switch from one plan to another during open enrollment or drop your prescription drug plan (Medicare Part D) coverage altogether. However, you may incur penalties later on if you go without a prescription drug plan (Part D of Medicare) – we would not advise this. Especially since you can get prescription drug plans (Part D of Medicare) for generally under $20 a month.

Now for people who are on a Medicare Advantage plan (Part C of Medicare), who miss the open enrollment but who just want to go back to original Medicare, there is also a Medicare Advantage disenrollment period (MADP) that runs from January 1 to February 14 each year. At that time, you could opt to switch back to original Medicare and then sign up for a prescription only plan (Medicare Part D). Most people will do this if they are going from a Medicare Advantage Plan (Part C of Medicare) to a Medicare Supplement Plan.

For 2015 coverage, open enrollment is over for Medicare. Medicare Advantage (Part C of Medicare) and prescription drug plans (Medicare Part D) ended on December 7, 2014, and the Medicare Advantage disenrollment period ended on February 14, 2015. Remember, you can enroll year-round in Medicare if you are newly-eligible.

For more information or to shop plans, visit us at www.emedigap411.com  call 877-740-8683 or email.

Life events can change insurance

Some of our biggest life events that trigger special enrollments and change our healthcare coverage too.

Under the Affordable Care Act, many life events, such as losing a job, having a baby, moving, divorcing and getting married, allow people to sign up for health insurance throughout the year, outside of the annual open enrollment period.

Obamacare enrollment runs from Nov. 1 through Jan. 31 for 2016 coverage.

Young adults are more likely than any other age group to experience a life event that qualifies them for special enrollment

Once people understand that getting married, having a kid or moving can be an opportunity to enroll in affordable care, people are interested in hearing about their options. Especially if they picked a plan they are not so happy with.

One thing to remember though, there is only a limited period of time to get a new health policy when these life events happen.

As a general rule, you have to enroll within 60 days of a qualifying event. It’s not an open window.

Not all big life events can alter your insurance coverage — at least not immediately.

Pregnancy

Having a baby, triggers an opportunity to switch health plans, but most people are suprised to find out that pregnancy does not trigger an opportunity. Pregnancy doesn’t allow you to switch plans, it only allows you to add the child to the plan.

Here are some common reasons people qualify for a special enrollment period under Obamacare:

Losing insurance

The reasons for losing insurance are varied – The loss of a job-based plan, aging out of a parent’s coverage at the age of 26, losing coverage through divorce, or losing eligibility for Medicaid or the state’s insurance program for people with low incomes, trigger a special enrollment period.

Most people feel COBRA is their only option. They aren’t aware that after leaving or losing their job they can sign up for a plan and even apply for a tax credit to lower their insurance costs.

Once you elect COBRA, you can’t just drop it. If you continue your current job-based health plan through COBRA, you’ll have to keep it until it ends or the next annual open enrollment comes around when you can sign up for a new plan. Canceling COBRA before it expires does not count as a qualifying event triggering a special enrollment period.

In fact, losing insurance because of something you do yourself — say, stopping payment because you believe that your plan is too pricey — won’t qualify you for a special enrollment period.

Moving

Most health plans operate within a specific geographic area. If you permanently move to a new city or ZIP Code, you may qualify for a special enrollment period and have the chance to pick a new plan.

If you move to a ZIP Code where another plan is now offered or a plan that was offered is no longer available, that’s a qualifying life event.

Marriage – Divorce – Adoption

You can add someone to your health plan if you get married, or if you have or adopt a child. Losing insurance coverage because of divorce also qualifies you to buy a new policy during a special enrollment period.

There are a few other special events that may trigger a special enrollment opportunity. To learn if you qualify for special enrollment email us directly or call 877-740-8683 and we will be happy to assist.

Ebola FAQ

Ebola FAQ

What is Ebola?

There are five types of Ebola virus. Four of them cause the disease in humans. The strain that is going around is a rare but deadly virus that causes bleeding inside and outside the body. It spreads through the body damaging the immune system and organs and eventually causes the cells that clot the blood to die. Once you are no longer able to clot blood, your body bleeds uncontrollably.

The disease, kills up to 90% of people who are infected.

The Ebola virus first appeared during two 1976 outbreaks in Africa. It gets its name from the Ebola River, which is near one of the villages in the Democratic Republic of Congo where the disease first appeared.

How Do You Get Ebola?

You are more likely to get a colds, the flu or measles than you are Ebola. You can only get it by direct contact with the skin or bodily fluids of an infected person or animal. Generally the people who care for the ones infected with ebola or the ones who bury them are the ones that often get it.

You can also get Ebola from contaminated needles or surfaces. Ebola can live up to 6 weeks in certain environments.

They say you CAN NOT GET Ebola from the air, water, or food. Also, you cannot spread Ebola unless you have symptoms. You may carry the virus, but if you have no symptoms, you are not contagious.

What Are the Symptoms?

Ebola starts out like the flu or common cold. After 2 to 21 days of infection the symptoms progress to include:

High fever
Headache
Joint and muscle aches
Sore throat
Weakness
Stomach pain
Lack of appetite
As the disease gets worse, it causes bleeding inside the body, as well as from the eyes, ears, and nose. Some people will vomit or cough up blood, have bloody diarrhea, and get a rash.

How Is Ebola Diagnosed?

Unfortunately it is hard to tell if someone has Ebola from the symptoms alone, as you can see. Doctors test to rule out other diseases like cholera or malaria. This could explain the rapid spread. They can also test blood and tissue to diagnose the virus.

If you contract Ebola, understand, you will be quarantined immediately from the public to prevent the spread of this deadly disease.

How Is Ebola Treated?

There is no known cure for Ebola. Researchers are working on experimental treatments including a serum that destroys infected cells.

What We Don’t Know About Ebola

When Dr Elke Muhlberger, PhD, a microbiologist at the Boston University School of Medicine, who specializes in the study of filoviruses, the virus family to which Ebola belongs and Dr Amesh Adalja, MD, an infectious disease specialist at the University of Pittsburgh Medical Center and Dr Thomas Geisbert, PhD, a microbiologist and immunologist who specializes in Ebola at the University of Texas Medical Branch in Galveston were asked about Ebola, here were their responses.

1. Why are humans so vulnerable to Ebola?

Muhlberger: Ebola virus causes a very severe disease in humans, and that’s also the case in monkeys and great apes. In great apes it’s a really big, big issue, because they’re very close to extinction.

But other animals, say mice and guinea pigs and bats, don’t have any problems controlling Ebola virus infection. They don’t get sick, and they are quite happy if they’re infected with Ebola in the wild.

If we are, in a very bad sense, the exception in terms of Ebola, the question is why are we so vulnerable? What are the differences in the immune response in mice and bats that keep them safe compared to humans?

2. Which patients may be likelier to spread the virus?

Adalja: We know how people catch Ebola. It’s only passed through close contact with the bodily fluids of infected individuals.

But what we don’t really know is whether some people may spread the disease at different rates than others.

With smallpox, for example, people who bleed from their mouths and noses, a rare form of the disease called hemorrhagic smallpox, are more contagious than people who have the disease, but don’t bleed.

Sicker patients may be more apt to spread the virus. Or maybe they are less risky because they’re more likely to be bedridden and thus not able to interact much with others.

We know that 50% of [people with] Ebola cases bleed internally, or hemorrhage, and 50% don’t. Does that make them more likely to spread virus or not? There are people who may be vomiting more than others, or having more diarrhea. All those factors may be things that determine how likely a person is to spread the disease.

I think that’s an important thing to figure out, because if you knew that, then you’d prioritize the contacts of those super-spreader types, because that’s where you’d have the biggest impact.

We understand how it’s transmitted. During an outbreak, it’s important to figure out who are the main sources of infection. Is everybody equal, or not?

3. Where does the virus lurk when it’s not making people sick?

Muhlberger: There must be an animal where the virus lives before it moves to humans. We call that a “reservoir.”

So, what is the natural reservoir for Ebola?

There are some indications that fruit bats are this reservoir, but nobody has ever isolated Ebola virus from fruit bats.

We’ve found antibodies and RNA in fruit bats, but not infectious virus, so we have to guess. We’re not sure.

Geisbert: I think this is a really important question.

In this current outbreak in West Africa, was the virus always there? The genetic sequences suggest it has been there for a while as opposed to coming from Central Africa, but how long was it there? How long did it maintain itself in nature and not pop up until now, or did it pop up before and just wasn’t recognized?

Did it emerge because of some environmental condition? Is it more people? Is it people encroaching on areas that before didn’t have close contact with it? I think that’s important to understand.

4. Can many more lives be saved with the right intensive care treatment?

Muhlberger: We always hear that 50% to 90% of patients die of this disease, but now with the patients coming to the U.S. and getting intensive care treatment, all of them have survived so far, and some of them seemed to be severely ill.

So if they get the treatment they need, which is rehydration — that’s very important, electrolyte treatment — it seems it is possible to save these patients and to save their lives.

So that’s my question: Is it really necessary that anyone dies from Ebola virus if we know that intensive care treatment helps to save these people who are infected? Because for me it was a big surprise and a good surprise that so far, all the patients treated here have survived.

Adalja: We have wildly varying fatality rates that vary among Ebola strains and vary among outbreaks. It’s really important to know why. Is it due to the fact that supportive care is or is not given to a patient, or are there genetic markers that give somebody a survival advantage with Ebola like there are with other infectious diseases?

5. Do quarantines work?

Adalja: I think a quarantine is a last resort. It’s something that’s really hard to enforce and has a lot of downsides to it. One of the downsides is that when you quarantine a population, you not only prevent people from leaving, you prevent things from going in. So you prevent public health experts from going in. You prevent doctors from going in, you prevent food and water from going in. You have waste piling up. You have dead bodies piling up. You have dogs eating the bodies like we saw in the West Point neighborhood [in Monrovia, Liberia]. And then you have massive distrust of the population because they’re now stuck in this area they can’t get out of. Often excessive force is used. So, during the West Point quarantine, people were shot. This is not something most public health people favor.

For Ebola, quarantining asymptomatic individuals doesn’t make sense, because Ebola is only contagious if a person has symptoms.

Geisbert: Historically, quarantines have worked really well, but this outbreak has broken a lot of rules.

Previously, there were smaller outbreaks, in more well-defined areas in Central Africa. And you had some groups that had a substantial amount of expertise in knowing how to handle them and properly quarantine and trace contacts, etc.

It was a sad situation for the affected area because some of these outbreaks have had case fatality rates up to 90%. They would quarantine the people and identify close contacts of people who were potentially exposed and isolate them and quarantine them, and it just burned out.

And here, what you have now in West Africa, everything happened concurrently across this huge geographic area, and it became like whack-a-mole. And the resources of the people who knew how to put these things out were spread so thin, they couldn’t deal with everything at once. You just have very poor countries, poor public health infrastructure, and an area that had never experienced Ebola before, so you have the education of the public and just kind of helter-skelter situation there and not really being able to properly quarantine.

6. How to treat or prevent Ebola infections?

Geisbert: It’s true that we don’t yet have an effective vaccine or treatment for humans, yet.

But we have vaccines that can completely protect monkeys against it. We have drugs — ZMapp and TKM-Ebola — that when given even after exposure can completely protect monkeys against it. So I think that there’s been a lot of progress in the last 5 to 10 years in developing effective countermeasures.

The glitches and delays have been in getting funds to these small biotech companies who have been involved in the development of some of these really promising countermeasures.

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